ABSTRACT
To determine whether or not slow coronary flow (SF) depends on hemodynamic variables, we studied 17 patients (15 men, mean age = 47.8 years) with SF at coronariography. Exercise thallium-201 myocardial scintigraphy revealed perfusion abnormalities in 13 (76.4 per cent) patients. We then selected 89 individuais submitted to cinecoronariography for comparison: 15 were normal and 74 had heart disease. The coronary flow velocity was evaluated by the number of heart beats (HB) needed for coronary artery dye filling. The patients in the SF group had normal hemodynamic variables which were significantly different from those of patients with heart disease (P = 0.001). Patients with heart disease needed no more than 4 HB to fill their arteries, in contrast to 6.88 ñ 1.68 (5 to 11) in the SF group (P<0.OOO1). Thus, in our patients with myocardial scintigraphy suggesting ischemia, SF was found to be an event which did not depend on hemodynamic factors.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Angina Pectoris , Coronary Circulation/physiology , Coronary Disease , Thallium Radioisotopes , Analysis of Variance , Hemodynamics/physiology , Blood Flow Velocity/physiologyABSTRACT
Foram estudados oito cäes mestiços, com pesos variáveis entre 12 e 15 Kg, submetidos à anestesia geral, toracotomia lateral e pericardiotomia longitudinal. Após ligadura da veia ázigos, as veias cavas anterior e posterior foram isoladas por cadarços de algodäo em torniquetes. Com técnica de bloqueio do retorno venoso, a artéria pulmonar foi aberta e as comissuras de sua valva suturadas, produzindo estenose pulmonar. A artéria pulmonar fou suturada e o retorno venoso liberado, assumindo os animais novo equilibrio hemodinâmico. Um cateter especial de angiocardiografia para aplicaçäo endocavitária de Laser (modelo Armelin e col.) foi introduzido na via de saida do ventrículo direto (por via transparietal em quatro casos e por cateterismo transvenoso-femoral nos demais). O laser foi aplicado na valva pulmonar obstruída até o desaparecimiento do gradiente pressórico estabelecido com à estenose pulmonar. Estudos hemodinâmicos e anatomopatológicos confirmaram a eficiência do método na desobstruçäo da estenose pulmonar