Circulation, Vol 77, 1108-1115, Copyright © 1988 by American Heart Association
DG Harrison, MS Florentine, LA Brooks, SM Cooper and ML Marcus
These studies were performed to test the hypothesis that left ventricular
hypertrophy arising as a complication of chronic hypertension is associated
with impaired coronary autoregulation. Twelve dogs with hypertension and
left ventricular hypertrophy (one- kidney, one-clip model) and 11 normal
dogs were instrumented and subsequently studied while conscious. Circumflex
pressure, measured with an intracoronary catheter, was adjusted to 100, 75,
and 40 mm Hg with a hydraulic occluder that was placed proximally. At each
circumflex pressure, myocardial perfusion was measured with radioactive
microspheres. Reduction of circumflex pressure over this range did not
significantly alter heart rate, left atrial pressure, or arterial pressure.
In normal dogs, reduction of circumflex pressure did not alter total
myocardial perfusion or the transmural distribution of perfusion. In
contrast, in dogs with hypertension and left ventricular hypertrophy,
circumflex subendocardial perfusion decreased 46% when pressure was
decreased from 100 to 40 mm Hg (p less than .05 compared with normal).
Autoregulation was quantified for each third of myocardium with the use of
autoregulatory gain values (1 = perfect autoregulation; 0 = the absence of
autoregulation). For pressure changes of 100 to 75 mmHg, values for
autoregulatory gain were near unity for all layers of myocardium in both
groups of animals. When pressure was decreased from 75 to 40 mm Hg, values
for autoregulatory gain among the normal and hypertensive groups were,
respectively: for subepicardium 1 +/- 0.2 (mean +/- SE) vs 0.9 +/- 0.2 (p =
NS), for the midwall 0.8 +/- 0.2 vs 0.5 +/- 0.2 (p = NS), and for the
subendocardium 0.8 +/- 0.1 vs 0.1 +/- 0.2 (p less than .05).(ABSTRACT
TRUNCATED AT 250 WORDS)
ARTICLES
The effect of hypertension and left ventricular hypertrophy on the lower range of coronary autoregulation
Cardiovascular Center, University of Iowa, Iowa City.
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