This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nichols, A. B. Articles by Esser, P. D. Search for Related Content PubMed PubMed Citation Articles by Nichols, A. B. Articles by Esser, P. D.

Circulation, Vol 74, 746-757, Copyright © 1986 by American Heart Association

ARTICLES

Effect of coronary stenotic lesions on regional myocardial blood flow at rest

AB Nichols, C Brown, J Han, EL Nickoloff and PD Esser

To determine the effect of atherosclerotic coronary lesions on myocardial blood flow in patients at rest, regional myocardial blood flow was measured distal to stenotic lesions in 29 patients with isolated proximal lesions of the left anterior descending artery. Severity of coronary stenosis was measured by computer-assisted cinevideodensitometric analysis of digitized coronary arteriograms. Regional myocardial blood flow was measured from the clearance rate of intracoronary 133Xe injected into the left main coronary artery and recorded with a multicrystal scintillation camera. In 21 patients with stenotic lesions ranging from 19% to 84% area reduction, distal regional myocardial blood flow was normal. In all eight patients with reduced regional myocardial blood flow distal to left anterior descending lesions, the minimum area of each stenotic lesion was less 0.80 mm2 (mean 0.34 +/- 0.2 mm2), minimum calculated diameter was less than 1 mm (mean 0.59 +/- 0.3 mm), and percent stenosis, based on the reduction in cross-sectional area, was greater than 85% (mean 94 +/- 4%). For all patients, distal flow, expressed as a fraction of normal flow, correlated with the lesion cross-sectional area (r = .84), minimum luminal diameter (r = .84), and percent area stenosis (r = - .70). Thus, resting myocardial blood flow distal to stenotic lesions of the proximal coronary arteries remains normal until the degree of narrowing is severe. The dimensions observed for critical coronary stenotic lesions correlate well with theoretical predictions based on fluid mechanics and with experimental preparations in laboratory animals.

This article has been cited by other articles:

				R. Lautamaki, K.E. J. Airaksinen, M. Seppanen, J. Toikka, R. Harkonen, M. Luotolahti, R. Borra, J. Sundell, J. Knuuti, and P. Nuutila Insulin Improves Myocardial Blood Flow in Patients With Type 2 Diabetes and Coronary Artery Disease Diabetes, February 1, 2006; 55(2): 511 - 516. [Abstract] [Full Text] [PDF]