Coronaryaortic interaction during ventricular isovolumic contraction
In earlier work, we suggested that the start of the isovolumic contraction period could be detected in arterial pressure waveforms as the start of a temporary pre-systolic pressure perturbation (AICstart, start of the Arterially detected Isovolumic Contraction), and proposed the retrograde coronary blood volume flow in combination with a backwards traveling pressure wave as its most likely origin. In this study, we tested this hypothesis by means of a coronary artery occlusion protocol. In six YorkshireLandrace swine, we simultaneously occluded the left anterior descending (LAD) and left circumflex (LCx) artery for 5s followed by a 20-s reperfusion period and repeated this sequence at least two more times. A similar procedure was used to occlude only the right coronary artery (RCA) and finally all three main coronary arteries simultaneously. None of the occlusion protocols caused a decrease in the arterial pressure perturbation in the aorta during occlusion (P>0.20) nor an increase during reactive hyperemia (P>0.22), despite a higher deceleration of coronary blood volume flow (P=0.03) or increased coronary conductance (P=0.04) during hyperemia. These results show that the pre-systolic aortic pressure perturbation does not originate from the coronary arteries.
coronaryaortic interaction isovolumic contraction coronary occlusion pulse wave analysis