This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Skalidis, E. I. Articles by Vardas, P. E. Search for Related Content PubMed PubMed Citation Articles by Skalidis, E. I. Articles by Vardas, P. E.

CLINICAL STUDY: LEFT ATRIAL PERFUSION AND FUNCTION

Phasic coronary blood flow velocity pattern and flow reserve in the atrium: regulation of left atrial myocardial perfusion

^* Cardiology Department, University Hospital of Heraklion, Crete, Greece

Manuscript received August 19, 2002; revised manuscript received October 8, 2002, accepted October 10, 2002.

^* Reprint requests and correspondence: Prof. Panos E. Vardas, Cardiology Department, Heraklion University Hospital, P.O. Box 1352, 71110 Heraklion, Greece.
cardio{at}med.uoc.gr

OBJECTIVES: The purpose of this study was to assess rest and stress atrial coronary blood flow (CBF) velocity and flow reserve.

BACKGROUND: Because of the limitations of the methods used until now for assessing myocardial perfusion (MP) in the small mass of atrial tissue, data are lacking for human atrial MP.

METHODS: Seventeen patients with suitable coronary anatomy underwent CBF velocity measurements with the use of a Doppler guide wire in the proximal left circumflex coronary artery (LCx) and left atrial circumflex branch (LACB), at baseline and after adenosine administration. All measurements were performed at resting heart rate and at 100 and 120 beats/min.

RESULTS: Coronary blood flow velocity in the LACB showed a predominant systolic pattern in contrast to the diastolic pattern of the LCx. There was a disproportionate increase in baseline time-averaged peak coronary flow velocity (cm/s) between the LACB and LCx during the two levels of pacing-induced stress (16.8 ± 5.5 vs. 16.2 ± 5.1 at rest; 22.9 ± 7.9 vs. 18.4 ± 5.2 at 100 beats/min; and 27.1 ± 8.0 vs. 20.4 ± 5.1 at 120 beats/min; significant interaction, p < 0.001), but there were no significant differences in coronary flow reserve (CFR).

CONCLUSIONS: Coronary blood flow in the left atrium is out of phase with that in the ventricular myocardium, showing a predominant systolic pattern. Although atrial and ventricular CFR show no significant differences at rest and with two levels of stress, the disproportionate increase in atrial blood flow velocity during stress indicates a peculiarity of atrial perfusion regulation.

Abbreviations and Acronyms   APV   time-averaged peak coronary flow velocity   CBF   coronary blood flow   CFR   coronary flow reserve   DSVIR   diastolic to systolic flow velocity integral ratio   FVI   flow velocity integral   HR   heart rate   LACB   left atrial circumflex branch   LCx   left circumflex coronary artery   LV   left ventricle or ventricular   MP   myocardial perfusion

This article has been cited by other articles:

				E. I. Skalidis, M. I. Hamilos, I. K. Karalis, G. Chlouverakis, G. E. Kochiadakis, and P. E. Vardas Isolated Atrial Microvascular Dysfunction in Patients With Lone Recurrent Atrial Fibrillation J. Am. Coll. Cardiol., May 27, 2008; 51(21): 2053 - 2057. [Abstract] [Full Text] [PDF]

				N. Westerhof, C. Boer, R. R. Lamberts, and P. Sipkema Cross-talk between cardiac muscle and coronary vasculature. Physiol Rev, October 1, 2006; 86(4): 1263 - 1308. [Abstract] [Full Text] [PDF]

				M. H. Aazami and M. Salehi Atrial fibrillation after off-pump versus on-pump: Are we not missing a common pathophysiological pathway? Eur. J. Cardiothorac. Surg., October 1, 2005; 28(4): 659 - 660. [Full Text] [PDF]