Abstract
Phase-controlled vibration at diastole (diastolic vibration) induces a millisecond time scale response in in situ heart, and the magnitude of the induced response (the improvement of the ventricular relaxation) is related to the severity of the impairment of relaxation as well as the amplitude of the vibration applied. However, it is still unknown whether diastolic vibration increases the coronary flow rate in the heart with impaired relaxation. We examined in experimental and clinical studies if external diastolic vibration to the heart with impaired relaxation could result in an improvement of the coronary flow rate and, if so, how to interpret the underlying mechanism of the response observed in the heart with regional ischemia. In an experimental study using an open-chest canine preparation with regional ischemia, the diastolic vibration applied to the ventricular surface increased coronary flow rate without increasing the coronary perfusion pressure and simultaneously shortened the time constant of the ventricular pressure decay. The diastolic vibration improved the nonuniformity of the relaxation by accelerating myocardial relaxation in the ischemic region. In clinical studies the response of the coronary flow velocity was measured by the transesophageal Doppler method in 10 healthy volunteers (8 men, 2 women; 50.6 ± 12.8 years old, mean ± SD) and 10 patients with coronary artery disease (8 men, 2 women; 66.4 ± 8.0 years old). The intracoronary Doppler catheter method was used in three patients with coronary artery disease (two men, one woman; 60.3 ± 10.5 years old). Mechanical diastolic vibration on the precordium has been demonstrated to transmit effectively to the ventricle and cause an increase in coronary flow velocity with no change in the coronary arterial diameter, blood pressure, or heart rate. We concluded that diastolic vibration increased the coronary flow rate in the clinical situation as well as in an experimental preparation. This increase mainly resulted from an acceleration of the ventricular relaxation rate caused by crossbridge detachment, normalization of the nonuniformity of the relaxation, or both.
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© 1996 Springer Japan
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Koiwa, Y., Honda, H., Naya, T., Shirato, K. (1996). Precordial or Epicardial Input of Phase-Controlled Minute Vibration: Effect on Coronary Flow Rate in Regional Ischemia. In: Sasayama, S. (eds) New Horizons for Failing Heart Syndrome. Springer, Tokyo. https://doi.org/10.1007/978-4-431-66945-6_7
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DOI: https://doi.org/10.1007/978-4-431-66945-6_7
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-66947-0
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