Intermittent coronary sinus occlusion: hemodynamic and anti-ischemic effects

摘要

To determine the anti-ischemic mechanism of intermittent occlusion of the coronary sinus (ICSO), the authors measured coronary arterial and sinus pressure and coronary arterial oxygen saturation before and after coronary artery litigation, with and without ICSO. In dogs, ICSO produced a systolic pressure gradient between the coronary artery and coronary sinus of -20+or-9 mm Hg (higher venous pressure, p>0.001) and a reduction in the oxygen of 20+or-13% (p>0.005). In parallel studied the authors constructed a mathematical model of known physiology to test the possibility of venoarterial flow. Predicted and experimental data were similar, indicating a reversal of flow at the microcirculatory level of ischemic regions during ISCO. These data indicate that alternating arteriovenous and venoarterial flow over the ischemic territory is the anti-ischemic mechanism of ICSO.