Effect of perfusate rheology on the diastolic coronary pressure-flow relationship

Abstract

The hypothesis that rheological properties of the coronary perfusate account for the curvilinearity and high zero-flow pressure (Pf = 0) of the diastolic coronary-pressure flow relationship (DCPFR) was tested by measuring these relationships using coronary perfusates of varying rheological character. In 16 open-chest, heart-blocked dogs the left circumflex coronary artery was cannulated and perfused using an extra-corporeal circuit, and autoregulation was abolished with intracoronary adenosine. DCPFRs were constructed from data obtained at multiple steady-state levels of coronary pressure during long diastoles while left ventricular diastolic pressure was held constant. Although isovolumic hemodilution reduced hematocrit from 46 +/- 3% to 32 +/- 3% and increased coronary conductance, it neither abolished the curvilinearity nor changed Pf = 0, which remained significantly higher than left ventricular diastolic pressure. In 10 additional animals, DCPFRs obtained during blood perfusion were compared with those obtained using crystalloid perfusate. Crystalloid perfusion increased coronary conductance and failed to abolish curvilinearity. However, with crystalloid perfusate, Pf = 0 was reduced to a value essentially equal to left ventricular diastolic pressure. We conclude that while the rheological properties of coronary perfusates do not fully account for the curvilinearity of the DCPFR, they do importantly influence coronary conductance and Pf = 0.