A Study on Coronary Sinus Occlusion Pressure and the Effect of Coronary Sinus Occlusion on Left Ventricular Function

Cho, Sang Kyoon; Kim, Sam Soo; Kim, Chul Ho; Oh, Byung Hee; Choi, Yoon Sik; Seo, Jung Don; Lee, Young Woo

Abstract

In order to observe the effect of coronary sinus occlusion on left ventricular function, coronary sinus was occluded for 2 minutes using Swan-Ganz catheter in 9 mongrel dogs. The change in gross findings of heart was observed, and coronary sinus pressure, LV pressure, LV dp/dt, and ECG were recorded throughout the experiment. The coronary sinus occlusion pressure(CSOP) rised slowly reaching to the plateau at the 32+/-6th beat and at 11.5+/-3.5 seconds after coronary sinus occlusion, with the pressure 95.4+/-24.7mmHg in systole and 35.9+/-21.3mmHg in end-diastole. End-diastolic CSOP was different significantly from LV end-diastolic pressure(LVEDP; 6.8+/-3.3mmHg). The veins of left ventricle were congested immediately after coronary sinus occlusion, followed by the dilation of coronary sinus and coronary arteries, and the dilation of left ventricle with visible decrease in its contractility. Above changes recovered slowly after the release of coronary sinus occlusion. LV peak systolic pressure, LV peak dp/dt, and LV peak negative dp/dt were decreased, and relaxation time constant was prolonged significantly 30 seconds after coronary sinus occlusion, and they recovered to those of preocclusion period 30 seconds after release of coronary sinus occlusion. LVEDP was increased significantly 30 seconds after coronary sinus occlusion and returned to that of preocclusion period immediately after release of coronary sinus occlusion. heart rate was decreased 1 minute after coronary sinus occlusion and returned to that of preocclusion period immediately after release of coronary sinus occlusion. As a result, there was significant difference between end-diastolic CSOP and LVEDP in the experiment with mongrel dogs, and it should be reevaluated to estimate LVEDP by end-diastolic CSOP in man. Left ventricular systolic and diastolic function was impaired transiently after coronary sinus occlusion lasting more than 30 seconds.