Watanabe H, Kusachi S, Saito D, Hina K, Tani H, Ueeda M, Mima T, Uchida S, Haraoka S, Tsuji T
First Department of Internal Medicine, Okayama University Medical School, Japan.
Pflugers Arch. 1990 Dec;417(4):410-7. doi: 10.1007/BF00370661.
Reactive hyperaemia, the cardiovascular response to transient occlusion of a vessel, was examined and compared in the right coronary artery (RCA) and the left anterior descending coronary artery (LAD) in the same heart of an open-chest dog. First, to study the relationship between reactive hyperaemia and occlusion time in the RCA and LAD, respective flows were measured and reactive hyperaemia was induced with different occlusion times. Occlusion time required for half the maximum peak percentage reactive hyperaemic flow (%PRH), t 1/2, for the RCA was approximately twice that of the LAD: 11.4 +/- 2.3 s versus 5.9 +/- 1.4 s. Maximum %PRH of the RCA was significantly greater than that of the LAD while the percentage repayment of the RCA was lower than that of the LAD. Augmentation of right ventricular oxygen consumption shortened t 1/2 and increased percentage repayment significantly. Second, to determine "critical pressure", which was defined as the perfusion pressure below which reactive hyperaemia was abolished completely, the RCA and LAD were perfused through a shunt from the carotid artery, perfusion pressure was varied in the range of 100 to 20 mmHg and reactive hyperaemia was induced. Critical pressure in the RCA was significantly lower than in the LAD: 32.2 +/- 5.7 mmHg versus 41.5 +/- 5.0 mmHg. These results suggest that the RCA has a greater flow reserve than the LAD. These results were consistent with the difference of oxygen metabolism between the right and left ventricles. The difference of oxygen metabolism between the two ventricles would, at least partly, account for these results.
反应性充血是心血管系统对血管短暂阻塞的反应,在开胸狗的同一心脏中,对右冠状动脉(RCA)和左前降支冠状动脉(LAD)的反应性充血进行了检查和比较。首先,为了研究RCA和LAD中反应性充血与阻塞时间的关系,测量了各自的血流量,并在不同的阻塞时间诱导反应性充血。RCA达到最大峰值反应性充血流量百分比(%PRH)一半时所需的阻塞时间t1/2约为LAD的两倍:分别为11.4±2.3秒和5.9±1.4秒。RCA的最大%PRH显著高于LAD,而RCA的偿还百分比低于LAD。右心室氧耗增加会缩短t1/2并显著提高偿还百分比。其次,为了确定“临界压力”(定义为低于该压力反应性充血完全消失的灌注压力),通过颈动脉分流对RCA和LAD进行灌注,灌注压力在100至20 mmHg范围内变化并诱导反应性充血。RCA的临界压力显著低于LAD:分别为32.2±5.7 mmHg和41.5±5.0 mmHg。这些结果表明,RCA比LAD具有更大的血流储备。这些结果与左右心室之间的氧代谢差异一致。两个心室之间的氧代谢差异至少部分可以解释这些结果。