Blood flow velocity in the right coronary artery: Assessment before and after angioplasty

Heller, Louis I.; Silver, Kevin H.; Villegas, Bernard J.; Balcom, Sharon; Weiner, Bonnie H.

doi:10.1016/0735-1097(94)90863-x

Cited by 49 publications

(20 citation statements)

References 22 publications

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“…As the IMR is the product of myocardial flow (1/T mn ) and distal arterial pressure (P d ), it can be influenced by blood flow pattern, flow rate, vessel geometry, and the myocardial mass that is supplied by the specific target vessel. 27,28 This influence is supported by the work of Murai …”

Section: Assessment For Microvascular Disease With Imrmentioning

confidence: 99%

Integrated Physiologic Assessment of Ischemic Heart Disease in Real-World Practice Using Index of Microcirculatory Resistance and Fractional Flow Reserve

Lee

Layland

Jung

et al. 2015

Circ: Cardiovascular Interventions

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Background-The index of microcirculatory resistance (IMR) is a quantitative and specific index for coronary microcirculation. However, the distribution and determinants of IMR have not been fully investigated in patients with ischemic heart disease (IHD). Methods and Results-Consecutive patients who underwent elective measurement of both fractional flow reserve (FFR) and IMR were enrolled from 8 centers in 5 countries. Patients with acute myocardial infarction were excluded.

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Section: Assessment For Microvascular Disease With Imrmentioning

confidence: 99%

Integrated Physiologic Assessment of Ischemic Heart Disease in Real-World Practice Using Index of Microcirculatory Resistance and Fractional Flow Reserve

Lee

Layland

Jung

et al. 2015

Circ: Cardiovascular Interventions

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“…The predominance of systolic flow and small DSVR have been described in the right coronary artery. 11,24,25 The differentiation between TIMI 2 flow with a significant coronary stenosis and TIMI 3 flow may be more difficult in the right coronary artery. Finally, the number of study patients is relatively limited.…”

Section: Study Limitationsmentioning

confidence: 99%

Relation of Phasic Coronary Flow Velocity Characteristics With TIMI Perfusion Grade and Myocardial Recovery After Primary Percutaneous Transluminal Coronary Angioplasty and Rescue Stenting

et al. 2000

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Background-A residual stenosis and/or microvascular damage have been proposed as mechanisms of TIMI 2 flow for acute myocardial infarction. Coronary flow dynamics were assessed in patients with TIMI 2 flow to predict whether additional intervention would improve TIMI grade. Methods and Results-In 35 patients who had a successfully recanalized anterior acute myocardial infarction using angioplasty or rescue stenting, coronary flow patterns were compared with corresponding TIMI grade and regional left ventricular wall motion (LVWM) 1 month after the intervention. After angioplasty, the time-averaged peak velocity (APV) was lower in patients with TIMI 2 flow (nϭ22)

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“…The right coronary artery (RCA) has a flow-velocity pattern that is less diastolic dominant than that of the left coronary arteries (7) and has different proximal and distal flow-velocity patterns (16). While a number of theories have been put forward to explain the features of the flow-velocity waveform in the left coronary arteries (4,13,24), the intra-coronary arterial waves (as opposed to flow waveforms) have not been compared between the right and left coronary arteries.…”

mentioning

confidence: 99%

Differences in cardiac microcirculatory wave patterns between the proximal left mainstem and proximal right coronary artery

Hadjiloizou

Davies²,

Malik³

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

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Hadjiloizou N, Davies JE, Malik IS, Aguado-Sierra J, Willson K, Foale RA, Parker KH, Hughes AD, Francis DP, Mayet J. Differences in cardiac microcirculatory wave patterns between the proximal left mainstem and proximal right coronary artery. Am J Physiol Heart Circ Physiol 295: H1198 -H1205, 2008. First published July 18, 2008 doi:10.1152/ajpheart.00510.2008.-Despite having almost identical origins and similar perfusion pressures, the flow-velocity waveforms in the left and right coronary arteries are strikingly different. We hypothesized that pressure differences originating from the distal (microcirculatory) bed would account for the differences in the flow-velocity waveform. We used wave intensity analysis to separate and quantify proximaland distal-originating pressures to study the differences in velocity waveforms. In 20 subjects with unobstructed coronary arteries, sensor-tipped intra-arterial wires were used to measure simultaneous pressure and Doppler velocity in the proximal left main stem (LMS) and proximal right coronary artery (RCA). Proximal-and distal-originating waves were separated using wave intensity analysis, and differences in waves were examined in relation to structural and anatomic differences between the two arteries. Diastolic flow velocity was lower in the RCA than in the LMS (35.1 Ϯ 21.4 vs. 56.4 Ϯ 32.5 cm/s, P Ͻ 0.002), and, consequently, the diastolic-to-systolic ratio of peak flow velocity in the RCA was significantly less than in the LMS (1.00 Ϯ 0.32 vs. 1.79 Ϯ 0.48, P Ͻ 0.001). This was due to a lower distal-originating suction wave (8.2 Ϯ 6.6 ϫ 10 3 vs. 16.0 Ϯ 12.2 ϫ 10 3 W ⅐ m Ϫ2 ⅐ s Ϫ1 , P Ͻ 0.01). The suction wave in the LMS correlated positively with left ventricular pressure (r ϭ 0.6, P Ͻ 0.01) and in the RCA with estimated right ventricular systolic pressure (r ϭ 0.7, P ϭ 0.05) but not with the respective diameter in these arteries. In contrast to the LMS, where coronary flow velocity was predominantly diastolic, in the proximal RCA coronary flow velocity was similar in systole and diastole. This difference was due to a smaller distal-originating suction wave in the RCA, which can be explained by differences in elastance and pressure generated between right and left ventricles. coronary artery hemodynamics; coronary blood flow; wave intensity analysis; coronary velocity THE CORONARY ARTERIES have a unique flow velocity profile in that most blood flow occurs in diastole (11) rather than in systole, as in other systemic arteries (14). The contractile function of the heart enables it to pump blood to other organs of the body, but, in doing so, it paradoxically impedes its own blood supply. Previous studies have investigated the basis for the unique flow velocity profile, some by analyzing the flow-velocity profile in normal (16) or diseased left coronary arteries (15) and others by using invasive animal models (5, 24).The right coronary artery (RCA) has a flow-velocity pattern that is less diastolic dominant than that of the left coronary arteries (7) and has different proxi...

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Blood flow velocity in the right coronary artery: Assessment before and after angioplasty

Cited by 49 publications

References 22 publications

Integrated Physiologic Assessment of Ischemic Heart Disease in Real-World Practice Using Index of Microcirculatory Resistance and Fractional Flow Reserve

Integrated Physiologic Assessment of Ischemic Heart Disease in Real-World Practice Using Index of Microcirculatory Resistance and Fractional Flow Reserve

Relation of Phasic Coronary Flow Velocity Characteristics With TIMI Perfusion Grade and Myocardial Recovery After Primary Percutaneous Transluminal Coronary Angioplasty and Rescue Stenting

Differences in cardiac microcirculatory wave patterns between the proximal left mainstem and proximal right coronary artery

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