Author + information
- Received July 20, 1983
- Revision received November 15, 1983
- Accepted January 6, 1984
- Published online June 1, 1984.
- Steven C. Port, MD, FACCMa,
- Shantilal Patel, MD and
- Donald H. Schmidt, MD
- ↵aAddress for reprints: Steven C. Port, MD, Mount Sinai Medical Center. P.O. Box 342, Milwaukee, Wisconsin 53201.
The purpose of this study was to test the hypothesis that myocardial blood flow distal to a critical stenosis would increase during intraaortic balloon counterpulsation. Accordingly, 13 patients with severe coronary artery disease were studied at the time of elective preoperative insertion of an Intraaortic balloon catheter. Hemodynamic measurements and measurements of myocardial blood flow were made before and during counterpulsation. Myocardial blood flow was measured with a xenon-133 washout technique. Compared with control measurements, the heart rate decreased from 87.8 ± 18.8 to 82.8 ± 13.4 beats/min (p = 0.02) and systolic arterial pressure decreased from 112.1 ± 17.9 to 97.8 ± 14.8 mm Hg (p = 0.004) during counterpulsation. Diastolic arterial pressure increased from 72.2 ± 10.1 to 120.2 ± 21.4 mm Hg (p = 0.00002) during counterpulsation. Myocardial blood flow for the entire group decreased from 48.8 ± 14.1 to 42.6 ± 11.0 ml/100 g per min (p = 0.008). Regional flows in the left anterior descending and circumflex distributions also decreased. Left anterior descending artery blood flow decreased insignificantly from 51.5 ± 14.4 to 47.4 ± 11.7 ml/100 g per min (p = not significant), while circumflex flow decreased from 50.7 ± 12.2 to 41.1 ± 8.9 ml/100 g per min (p = 0.008). When normalized for the rate-pressure product, myocardial blood flow was 53 ± 16 x 10-4at rest and 55 ± 12 x 10-4(p = not significant) during counterpulsation.
The results suggest that the effects of Intraaortic balloon counterpulsation in stable patients with severe coronary artery disease are largely due to a reduction in demand, rather than to a primary increase in coronary blood flow.
- Received July 20, 1983.
- Revision received November 15, 1983.
- Accepted January 6, 1984.
- American College of Cardiology Foundation