[Relationship between regional flow reserve supplied by the great saphenous vein graft and regional left ventricular...

The relationship between regional flow reserve supplied by a great saphenous vein graft and myocardial infarction and anterior wall motion assessed by left ventriculography was studied in 28 patients with no stenosis in the great saphenous vein graft and the peripheral site of the recipient left anterior descending coronary arteries. The proximal segment to the anastomosis was totally or subtotally occluded. The resting graft blood flow velocity was measured using a Doppler guide wire, then 0.56 mg/kg of dipyridamole was injected for 4 minutes intravenously and the resultant increase in graft blood flow velocity was recorded. The regional flow reserve of the anterior wall supplied by great saphenous vein grafts in 11 patients with anterior myocardial infarction (MI group) was significantly lower than that in 17 patients without myocardial infarction (non-MI group) (1.5 +/- 0.3 vs 2.6 +/- 0.7, p < 0.01). The flow reserve supplied by great saphenous vein grafts in 11 patients with normal anterior wall motion was 2.8 +/- 0.7, 10 with hypokinesis 1.9 +/- 0.3, and with akinesis 1.3 +/- 0.3. Reduced anterior wall motion induced a significant decrease in the flow reserve of the anterior wall supplied by the great saphenous vein graft (p < 0.01). The anterior wall motion score of four segments assessed by left ventriculography showed a significant correlation with the flow reserve of the anterior wall supplied by the great saphenous vein graft (y = -0.24 x + 3.7, r = 0.75, p < 0.001). The results show infarcted myocardium was an important influence on coronary flow reserve.