Key result
Arterial and coronary sinus catheterization with multi-site venous sampling aids ischemia detection and therapy evaluation.
Arterial and coronary sinus catheterization can detect myocardial ischemia through metabolic markers, though multiple-site sampling is needed to account for nonuniform venous inflow.
May inform metabolic evaluation in select ischemic cases; leaves open validation versus contemporary noninvasive methods.
Metabolism of the human heart during myocardial infarction may be studied by means of arterial and coronary sinus catheterization at little risk, but definite inconvenience. Ischemia has been readily detected through myocardial production or release of lactate, potassium, hydrogen, and certain enzymes. These findings may be of help in identifying the presence of acute myocardial injury or infarction and in evaluation of applied therapy. Other studies, particularly of metabolized substrates, including oxygen, have been less rewarding. The patchy nature of coronary atherosclerosis and its partial compensation by collateral vessels renders coronary venous inflow nonuniform. This makes interpretation of the meaning of the concentration of substances contained within the coronary venous effluent extremely difficult. Multiple-site venous sampling is particularly helpful in overcoming this inherent defect in the method.
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Richard Gorlin (1969) conducted a review in Ischemic Heart Disease. Arterial and coronary sinus catheterization was evaluated. Arterial and coronary sinus catheterization with multiple-site venous sampling aids in detecting myocardial ischemia and evaluating applied therapy in ischemic heart disease.
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