[Effect of hemorheological factors on coronary flow during myocardial ischemia]

Intracoronary infusion of some drugs may induce superimposed coronary vasodilation upon endogenous vasodilation during myocardial ischemia, which was suggested as coronary vasodilator reserve. For an investigation of this phenomenon, 8 pigs were anesthetized, chest-opened, LAD (left anterior descending coronary artery)-dissected and instrumented. The LAD pressure was reduced to 4.67 kPa (35mmHg), and then intracoronary infusion of adenosine, saline, or anisodamine (at the same rate of 2ml/min) was started and maintained for 9 minutes. The three solutions all produced a significant increase in the coronary flow, including the saline (compared with the control, P < 0.05). The hemorheological examination of the distal coronary blood revealed a reduced hematocrit, plasma viscosity and whole blood viscosity during the saline and anisodamine infusion periods (P < 0.05), but in the adenosine infusion, the statistical analysis on hemorheological data revealed no significance compared with the control (P > 0.05). The results showed that the coronary vasodilator reserve induced by intracoronary drugs during myocardial ischemia might be partly accounted by regional hemodilution in the LAD bed. The study suggested that a decrease in blood viscosity might play an important role in the improvement of the narrowed coronary circulation, even more important than vasodilator drugs.