Evaluation of regional myocardial perfusion and ischemia from coronary venous blood

D. L. Roberts, H. K. Nakazawa, S. M. Nordlicht

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6 Scopus citations

Abstract

The usefulness of simultaneous great cardiac vein (GCV) and coronary sinus (CS) blood sampling for detecting regional differences in flow per unit weight (F/W) and metabolism has been examined in the canine left ventricle. In normally perfused ventricles, F/Ws in myocardium represented in GCV and CS drainage agreed within ±10% over a wide range (23-355 (ml/min)/100 g); GCV and CS PCO2, pH, and percent lactate extraction differed by 0.45 ± 1.5 (SD) mmHg, 0.002 ± 0.014 units, and 0.3 ± 5.4%, respectively. GCV F/W exceeded CS F/W by >10% during selective increases in left anterior descending (LAD) inflow or reductions in left circumflex (LC) inflow; it was >10% below CS F/W during reduced LAD inflow or augmented LC inflow. GCV-CS differences in PCO2, pH, and percent lactate extraction increased noticeably during reduced LAD inflow, averaging 5.7 ± 3.9 mmHg, -0.037 ± 0.036 units, and -25 ± 14%. Similar but directionally opposite changes occurred during reduced LC inflow (-5.8 ± 3.5 mmHg, 0.035 ± 0.032 units, and 26 ± 17%). Blood sampled near the origin of the GCV reflects perfusion in myocardium supplied virtually entirely by the LAD. GCV-CS differences that exceed normal values reflect increased heterogeneity of left ventricular perfusion and/or metabolism independently of the absolute values of the parameters measured.

Original languageEnglish
Pages (from-to)H385-H390
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume5
Issue number2
StatePublished - Jan 1 1979

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