Coronary flow and left ventricular diastolic function in aortic regurgitation

G. Tamborini, P. Barbier, E. Doria, F. Bortone, E. Sisillo, G. Susini, V. Arena, M. Pepi

Research output: Contribution to journalArticle

Abstract

Background: An abnormal coronary perfusion pressure is probably the major determinant of altered myocardial perfusion in aortic regurgitation; ventricular hypertrophy and diastolic function may also be involved. This study was undertaken to investigate the respective roles of these two variables. Methods: Using multiplane transesophageal echocardiography, we evaluated the coronary Doppler flow velocity in the proximal left anterior descending coronary artery in 15 patients with aortic regurgitation before and immediately after valve replacement. The ratios of diastolic: systolic velocity integral and early: late diastolic velocity integral were correlated against coronary perfusion pressure, pulmonary wedge pressure and Doppler echocardiographic indices of left ventricular diastolic function. Patients were compared with 10 subjects without valvular diseases. Results: Aortic regurgitation was associated with a reduction of the coronary diastolic: systolic velocity integral ratio and increment in the early: late diastolic velocity integral ratio. The latter correlated positively with early: late diastolic ratio of mitral flow velocity, pulmonary wedge pressure and left ventricular mass index. Soon after valve replacement, a decrease in pulmonary wedge pressure and a rise in coronary perfusion pressure were seen. Both the echo-Doppler parameters related to diastolic function and the systodiastolic distribution of coronary flow returned to normal. This indicates that diastolic dysfunction rather than left ventricular mass may be related to a disordered myocardial perfusion. Conclusions: In aortic regurgitation, a relationship exists between diastolic ventricular function and coronary flow phasic distribution. Valve replacement improves the former and normalizes the latter. Echo-Doppler parameters of diastolic dysfunction identify patients with worse coronary perfusion and might represent an additional criterion in the preoperative evaluation of patients with aortic regurgitation.

Original languageEnglish
Pages (from-to)635-643
Number of pages9
JournalCoronary Artery Disease
Volume6
Issue number8
Publication statusPublished - 1995

Keywords

  • aortic valve disease
  • coronary flow
  • multiplane transesophageal echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Coronary flow and left ventricular diastolic function in aortic regurgitation'. Together they form a unique fingerprint.

  • Cite this

    Tamborini, G., Barbier, P., Doria, E., Bortone, F., Sisillo, E., Susini, G., Arena, V., & Pepi, M. (1995). Coronary flow and left ventricular diastolic function in aortic regurgitation. Coronary Artery Disease, 6(8), 635-643.