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Coronary pressure-flow relationships. Controversial issues and probable implications.

F J Klocke, R E Mates, J M Canty

Circulation Research

|March 1, 1985

Summary

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The minimum back pressure to coronary flow (Pf=0) exceeds coronary outflow pressure, impacting coronary driving pressure calculations. Understanding Pf=0 and curvilinear pressure-flow relationships is crucial for accurate coronary vascular resistance assessment.

Area of Science:

Cardiovascular Physiology
Hemodynamics
Coronary Circulation Research

Background:

Assessing coronary driving pressure is complex due to the minimum back pressure to coronary flow (Pf=0).
Existing models often overlook Pf=0 and the non-linear nature of coronary pressure-flow relationships.

Purpose of the Study:

To re-evaluate the controversial aspects of coronary flow and pressure dynamics.
To emphasize the importance of Pf=0 and curvilinear pressure-flow relationships in determining coronary vascular resistance.

Main Methods:

Analysis of diastolic pressure-flow relationships in coronary circulation.
Consideration of vascular tone, left ventricular preload, and capacitive effects.

Main Results:

Related Experiment Videos

Pf=0 is consistently higher than coronary outflow pressure, particularly in vasodilated beds and with elevated preload.
Coronary pressure-flow relationships are curvilinear, not linear, especially at lower pressures.
Coronary vascular resistance is pressure-dependent due to the curvilinear relationship.

Conclusions:

Pf=0 must be incorporated into coronary driving pressure calculations.
The curvilinear nature of diastolic pressure-flow relationships and capacitive effects require quantitative consideration.
Accurate assessment of coronary vascular resistance necessitates accounting for pressure-dependency and reactive effects.