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Figure 4 Simultaneous recording of Doppler coronary flow and diastolic P-V relations. A, This patient has grade III angiographic collateral recruitment during BCO. With the appearance of retrograde Doppler flow distal to the occlusion site (inflation 30 s), the diastolic P-V relation shifted upward (dotted line). B, This patient has grade 0 angiographic collateral recruitment during BCO. There was neither distal coronary Doppler flow (inflation 30 s) nor a diastolic P-V relation shift during BCO. After balloon deflation, hyperemic flow was recorded (deflation <10 s) with a concomitant parallel upward shift of diastolic P-V relations in both patients (interrupted line).