What does this research mean for the field?

During exercise with critical coronary stenosis, the use of subepicardial vasodilator reserve causes a transmural 'steal' phenomenon that reduces subendocardial perfusion and impairs regional contractile performance. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine the functional and hemodynamic consequences of utilizing subepicardial vasodilator reserve during exercise in the presence of critical coronary stenosis.

November 1, 1982AJP Heart and Circulatory Physiology

Myocardial blood flow and function with critical coronary stenosis in exercising dogs

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Why the study?

Does critical coronary stenosis alter myocardial blood flow distribution and regional function during exercise in dogs?

Population

6 exercising dogs chronically instrumented to measure myocardial blood flow, regional function, and coronary…

Comparison

Critical coronary stenosis produced with a… vs Resting control conditions

Design

Preclinical

Authors

KGK P GallagherUnited States Department of Veterans Affairs GOGenta OsakadaKyoto Medical Center MMM MatsuzakiNihon University

Discussion

Member takes

Implication

May indicate transmural steal during exercise in critical stenosis; leaves open relevance to human ischemia.

Key Points

To determine the functional and hemodynamic consequences of utilizing subepicardial vasodilator reserve during exercise in the presence of critical coronary stenosis.
Evaluated 6 chronically instrumented dogs subjected to treadmill exercise with critical coronary stenosis induced by a hydraulic occluder.
Measured myocardial blood flow using radioactive microspheres, regional myocardial function via sonomicrometer wall thickening, and coronary blood flow velocity using pulsed Doppler.
Subendocardial blood flow decreased by 50% (P < 0.05) while subepicardial flow increased by 104% (P < 0.01) relative to resting control, demonstrating a transmural steal phenomenon.
Systolic wall thickening decreased significantly from 31.5 ± 6.8% at baseline to 9.4 ± 2.0% during exercise (P < 0.01).

Structured PICO

Does critical coronary stenosis alter myocardial blood flow distribution and regional function during exercise in dogs?

Population

6 exercising dogs chronically instrumented to measure myocardial blood flow (MBF), regional function, and coronary blood flow velocity (CBFV)

Intervention

Critical coronary stenosis produced with a hydraulic occluder during treadmill exercise

Comparator

Resting control conditions

Outcome

Myocardial blood flow (MBF), regional function (systolic wall thickening), and coronary blood flow velocity (CBFV)surrogate

Critical coronary stenosis during exercise in dogs causes a transmural 'steal' phenomenon, reducing subendocardial perfusion and severely impairing regional contractile performance despite subepicardial vasodilator reserve.

Cite This Study

Gallagher et al. (1982) studied this question.

synapsesocial.com/papers/6a1d643932d43530c25da7d0 https://doi.org/10.1152/ajpheart.1982.243.5.h698

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Myocardial blood flow and function with critical coronary stenosis in exercising dogs

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Myocardial blood flow and function with critical coronary stenosis in exercising dogs

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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