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First Department of Internal Medicine, Asahikawa Medical College, Asahikawa 078-8510, Japan
On the hypothesis that coronary
sinus occlusion (CSO) may reduce myocardial ischemia, we
examined the effects of CSO on coronary collateral blood flow and on
the distribution of regional myocardial blood flow (RMBF) in dogs.
Thirty-eight anesthetized dogs underwent occlusion of the left anterior
descending coronary artery with or without CSO and intact vasomotor
tone. We measured RMBF and intramyocardial pressure (IMP) in the
subendocardium (Endo) and subepicardium (Epi) separately. With intact
vasomotor tone, CSO during ischemia significantly increased
RMBF in the ischemic region (IR), particularly in Endo from
0.17 ± 0.03 to 0.33 ± 0.05 ml · min
1 · g
1
(P < 0.05), and increased the Endo/Epi from 0.59 ± 0.10 to 1.15 ± 0.15 (P < 0.01). These effects
of CSO were partially abolished by adenosine. However, the Endo/Epi was
still increased from 0.90 ± 0.13 to 2.09 ± 0.30 (P < 0.01). The changes in RMBF in IR were significantly correlated with the peak CS pressure during CSO. The
Endo/Epi of IMP in IR was significantly decreased during CSO. In
conclusion, CSO potentially enhances coronary collateral flow, and
preserves the ischemic myocardium, especially in Endo.
intramyocardial pressure; regional myocardial blood flow; coronary collateral blood flow; anesthetized dog
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