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J Am Coll Cardiol, 2002; 40:1976-1983
© 2002 by the American College of Cardiology Foundation
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Absence of postprandial surge in coronary blood flow distal to significant stenosis

a possible mechanism of postprandial angina

Woo-Young Chung, MD*, Dae-Won Sohn, MD*,*, Yong-Jin Kim, MD*, Seil Oh, MD*, I. n-H. o Chai, MD*, Young-Bae Park, MD* and Yun-Shik Choi, MD*

* Clinical Research Institute and Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea



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  		Figure 1 Changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and double product after food intake. Controls and patients both showed similar patterns of change. Solid line = patients; dotted line = controls.

 


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  		Figure 2 Changes in time velocity integral of the diastolic coronary flow (Dtvi) and Dtvi x heart rate (HR) after food intake in controls (upper panel) and in patients (lower panel). Dtvi and Dtvi x HR increased in controls after food intake. In patients, Dtvi and Dtvi x HR decreased after food intake. *p < 0.05, {dagger}p < 0.005 compared with the fasting state by the Wilcoxon signed rank test.

 


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  		Figure 3 Coronary flow velocities in a healthy control (left panel) and in a patient (right panel) at the fasting state and 15, 30, 45, and 60 min after food intake. Numbers in each tracing denote the time velocity integral of diastolic flow velocity.

 


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  		Figure 4 Changes in time velocity integral of the diastolic flow velocity (Dtvi) and Dtvi x heart rate (HR) after food intake in six patients before (upper panel) and after (lower panel) successful intervention. Dtvi and Dtvi x HR changed to those of the healthy controls after intervention. *p < 0.05 compared with the fasting state by the Wilcoxon signed rank test.

 


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  		Figure 5 Coronary flow velocities before (left panel) and after (right panel) successful intervention in patients with significant stenosis in the left anterior descending artery in the fasting state and 15, 30, 45, and 60 min after food intake. Numbers in each tracing denote time velocity integral of the diastolic flow velocity.

 


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  		Figure 6 Changes in time velocity integral of the diastolic flow velocity (Dtvi) and Dtvi x heart rate (HR) after sham feeding. No significant changes in Dtvi or Dtvi x HR were observed after sham feeding.

 


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  		Figure 7 Coronary flow velocities in the fasting state and 15, 30, and 45 min after the sham meal. No significant changes in time velocity integral of the diastolic flow velicity occurred after a sham meal. Numbers in each tracing denote time velocity integral of the diastolic flow velocity.

 




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