Hypertension, Vol 13, 598-606, Copyright © 1989 by American Heart Association
LF Wexler, WN Grice, M Huntington, JF Plehn and CS Apstein
Acute pulmonary edema during hypertensive crisis has been attributed to
acute left ventricular systolic failure secondary to increased afterload.
We tested the hypothesis that the increase in coronary artery perfusion
pressure associated with systemic hypertension could also contribute to
increased left ventricular filling pressures by acutely increasing coronary
intravascular volume and decreasing left ventricular diastolic compliance.
Isolated isovolumic (balloon in left ventricle) normal rabbit hearts (n =
13) with pericardium removed and right ventricle vented were blood perfused
at an initial coronary artery perfusion pressure of 100 mm Hg; left
ventricular balloon volume was adjusted to produce an initial left
ventricular end-diastolic pressure of 15 +/- 1 mm Hg; left ventricular
systolic pressure was 102 +/- 3 mm Hg. When coronary perfusion pressure was
increased to 130 +/- 1 mm Hg to simulate a hypertensive crisis, coronary
flow increased from 2.0 +/- 0.2 to 3.0 +/- 0.2 ml/min/g left ventricle (p
less than 0.001), left ventricular systolic pressure increased to 116 +/- 4
mm Hg, and isovolumic left ventricular end-diastolic pressure increased to
21 +/- 1 mm Hg (p less than 0.001), which indicated a decrease in left
ventricular diastolic compliance. When coronary perfusion pressure was
decreased to a physiological level of 70 mm Hg, coronary flow rate
decreased to 1.4 +/- 0.1 ml/min/g left ventricle (p less than 0.001), left
ventricular systolic pressure fell to 82 +/- 4 mm Hg, and left ventricular
end-diastolic pressure fell to 14 +/- 1 mm Hg (p less than 0.001).(ABSTRACT
TRUNCATED AT 250 WORDS)
ARTICLES
Coronary hypertension and diastolic compliance in isolated rabbit hearts
Cardiovascular Institute, Boston University School of Medicine, Massachusetts.
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