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European Heart Journal 1995 16(1):1860-1871;
Copyright © 1995 by the European Society of Cardiology.
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© 1995 The European Society of Cardiology

Comparison between regional myocardial perfusion reserve and coronary flow reserve in the canine heart

M. J. A. GELDOF*, M. J. SCHALU*, V. MANGER CATS*,, P. M. J. VAN DER ZWET{dagger}, P. STEENDUK*, E. T. VAN DER VELDE*, E. M. NAGTEGAAL*, J. H. C. REIBER{dagger} and A. V. G. BRUSCHKE*

*Department of Cardiology, Leiden University Hospital The Netherlands
{dagger}Diagnostic Radiology and Nuclear Medicine, Leiden University Hospital The Netherlands

revised 5 April 1995; accepted 26 April 1995.

Correspondence: V. Manger Cats, MD, Department of Cardiology, C5-P32. Leiden University Hospital, Postbox 9600, 2300 RC Leiden. The Netherlands

Abstract

Diameter stenosis and flow reserve are indices of morphological and functional severity of coronary artery stenosis. Flow reserve can be determined at coronary arterial or at myocardial level. In the presence of functional collateral circulation, coronary flow reserve and myocardial perfusion reserve may differ.

We studied coronary flow, coronary flow reserve and myocardial perfusion reserve in an open chest dog model with intact collateral circulation, before and after induction of coronary artery stenosis. Coronary flow was determined with perivascular ultrasonic flow probes and myocardial perfusion reserve from digital angiographic images, in the stenotic as well as the adjacent non-stenotic coronary arteries.

Before induction of a stenosis, a significant correlation existed between coronary flow reserve and myocardial perfusion reserve of the left anterior descending (r=0·59; P<0·005) and the left circumflex arteries (r=0·84, P<0·005). In stenotic arteries, coronary flow reserve and myocardial perfusion reserve decreased significantly (P<0·005), but in the adjacent non-stenotic arteries coronary flow reserve was not affected Myocardial perfusion reserve in the non-stenotic adjacent left anterior descending artery decreased significantly (P<0·05) and no correlation was found between coronary flow reserve and myocardial perfusion reserve, whereas in the adjacent non-stenotic left circumflex artery there was no statistically significant decrease (4·1 ± 1·6 -> 3·5 ± 1·4) but there was a good correlation between coronary flow reserve and myocardial perfusion reserve (r=0·85; P<0·005).

This study demonstrates that, in the presence of a stenosis and functioning collateral circulation, coronary flow reserve is not a reliable predictor of myocardial perfusion reserve; both parameters provide mutually complementary information.

Key Words: Myocardial perfusion reserve • digital subtraction angiography • coronary artery stenosis • collateral circulation


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