The effect of tilt (head-up and head-down) tests, LBNP tests, and 7-d head-down tilt (at -15 degrees) on coronary circulation was investigated in healthy male volunteers. Catheters were implanted into the coronary sinus and brachial artery. The Ganz catheter in the coronary sinus was used to measure volume flow in the area (constant thermodilution), pressure, and to withdraw samples of outflowing blood for biochemical analysis (acid-base equilibrium and oxygenation). Transfer from supine to upright body position, lower body negative pressure (-30 mm Hg for 20 min), as well as 15 degrees head-down (by day 5-6) produced similar changes in the basic parameters of coronary circulation-reduction of blood flow and oxygen consumption, decrease of pressure in the coronary sinus, and increase of coronary resistance. Transfer from head-up to head-down position caused opposite changes of the above parameters. The changes in coronary circulation were adequate for myocardial metabolic requirements since the biochemical composition of the outflowing blood remained essentially constant during the gravitational exposures described.
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Catheter Cardiovasc Interv
January 2025
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Background: The coronary atrial circulation is the network of vessels that supply blood to the atria, originating from the left circumflex and right coronary arteries. Current descriptions of this arterial system are based on anatomical studies with a limited number of patients, predominantly male. In addition, there is a lack of consensus its angiographic nomenclature.
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January 2025
Cardiology Department, Kabul University of Medical Science and Ariana Medical Complex, Afghanistan Cardiovascular Association, Kabul (A.W.S., D.D.Z., N.A.E.).
Circulation
January 2025
Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland (A.L., M.V.).
Circulation
January 2025
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK (D.G.).
Circ Rep
January 2025
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine Chiba Japan.
Owing to recent advances in early reperfusion and pharmacological therapies, the prognosis of patients with acute myocardial infarction (AMI) has considerably improved over the past decades. However, the mortality rate remains high at ~40-50% after AMI when complicated by cardiogenic shock. Although immediate coronary revascularization of the infarct-related artery has been the only evidence-based treatment, temporary mechanical circulatory support with a microaxial flow pump (Impella) has become another therapeutic option supported by randomized trial data in highly selected patients.
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