The Effects of Increase in Heart Rate on Coronary Flow Reserve and Flow Profiles : A Study with Intracoronary Doppler Wire.
10.4070/kcj.1995.25.6.1091
- Author:
Han Soo KIM
;
Seung Jea TAHK
;
Joon Han SHIN
;
Yun Kyung CHO
;
Won KIM
;
Bon Kwon KU
;
Byung Il CHOI
- Publication Type:Original Article
- Keywords:
Heart rate;
Coronary blood flow;
Coronary flow reserve
- MeSH:
Adenosine;
Arteries;
Chest Pain;
Coronary Vessels;
Female;
Heart Rate*;
Heart*;
Hemodynamics;
Humans;
Hyperemia;
Male
- From:Korean Circulation Journal
1995;25(6):1091-1098
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Measurements of coronary flow reserve(CFR) and phasic coronary flow profile are useful in assessment of the physiologic significance of coronary lesions. However, alterations in hemodynamic status are known to influence coronary flow reserve. The purpose of this study was to assess the effect of increase in heart rate on maximal pharmacologin coronry flow reserve and phasic flow pattern. METHODS: We investigated 12 patients(9 females and 3 males, mean age : 49+/-12 years) with normal coronary artery and atypical chest pain syndrome for the measurement of CFR and coronary flow profile. CFR and systolic and diastolic coronary flow velocity integral(CFVI) were measured at the proximal portion of left anterior descending artery with 0.018 inch(12MHz) Doppler guide wire before and during intracoronary injection of 12 mcg of adenosine. The heart rate at the baseline ranging from 62 beats/min to 79 beats/min(mean : 70+/-5 beats/min) was increased to 100 beats/min and again to 120 beats/min by right atrial pacing. RESULTS: CFR progressively decreased from 3.0+/-0.5 at baseline to 2.4+/-0.4 during pacing at 100 beats/min and to 2.0+/-0.3 during pacing at 120 beats.min(p<0.001). CFVI/min at baseline was progressively increased(130+/-15% of control value at 100 beats.min, 135+/-30% at 120 beats.min(p<0.01) whereas in adenosine hyperemia remained unchanged(286+/-81% at hyperemia baseline, 296+/-91% at 100 beats/min, 289+/-105% at 120 beats/min, p>0.05). Systolic CFVI/min was increased at baseline(185+/-35% at 120 beats/min, p<0.01) and in adenosine hyperemia(377+/-153% at hyperemia baseline, 457+/-178% at 120 beats/min, p=0.01). Diastolic CFVI/min was increased at baseline(134+/-178% at 120 beats/min, p<0.01), but in adenosine hyperemia, no significant change was observed(278+/-77% at hyperemia baseline and 251+/-77% at 120 beats/min, p>0.05). CONCLUSION: Increase in heart rate induces a substantial reduction in maximal CFR. Thus,heart rate appears to be one of important variable for the measurement of CFR and phasin coronary flow profile.
