Summary
A method was applied in anesthetized dogs enabling the measurement of regional resistances up to and behind the start of collaterals and the collateral resistance.
The studies show that peripheral coronary pressure, i.e. perfusion pressure of the collaterals, can change when the ratio of pre- and post-collateral resistance alters. Drugs can influence collateral blood flow not only by directly effecting the collaterals but also by altering collateral perfusion pressure.
Glyceryl trinitrate given in minor doses improved collateral blood flow by directly dilating the collaterals and also by increasing collateral perfusion pressure. Higher doses did not improve collateral flow due to a decrease of collateral perfusion pressure. A stealphenomenon occurred in some cases.
Adenosine and verapamil had no direct influence on the collateral resistance. Verapamil given in small doses increased perfusion pressure slightly but not enough to improve collateral blood flow. High doses of verapamil, like low doses of adenosine, had no significant influence on collateral perfusion pressure and collateral blood flow. Adenosine given in high dosage led to a diminution of collateral flow by decreasing collateral perfusion pressure, i.e. a steal-phenomenon.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Capurro, N. L., Kent, K. M., Smith, H. J., Aamodt, R., Epstein, S. E.: Acute coronary occlusion: prolonged increase in collateral flow following brief administration of nitroglycerin and methoxamine. Am. J. Cardiol. 39, 679–683 (1977)
Carson, R. P., Wilson, W. S., Nemiroff, M. J., Weber, W. J.: The effects of sublingual nitroglycerin on myocardial blood flow in patients with coronary artery disease or myocardial hypertrophy. Am. Heart. J. 77, 579–584 (1969)
Cohen, M. V., Sonnenblick, E. H., Kirk, E. S.: Coronary steal: its role in detrimental effect of isoproterenol after acute coronary occlusion in dogs. Am. J. Cardiol. 38, 880–888 (1976)
Diemer, H. P., Wichmann, J., Lochner, W.: Über die pharmakologische Beeinflußbarkeit der Kollateraldurchblutung des Herzens unter besonderer Berücksichtigung des Perfusionsdruckes. Verh. Dtsch. Ges. Kreislaufforsch. 42, 318–322 (1976)
Diemer, H. P., Wichmann, J., Lochner, W.: Coronary collateral flow: effect of drugs and perfusion pressure. Basic Res. Cardiol. 72, 332–343 (1977)
Fam, W. M., McGregor, M.: Effect of nitroglycerin and dipyridamole on regional coronary resistance. Circ. Res. 22, 649–659 (1968)
Fam, W. M., McGregor, M.: Effect of vasodilator drugs on retrograde flow in areas of chronic myocardial ischemia. Circ. Res. 15, 355–365 (1964)
Flameng, W., Wüsten, B., Schaper, W.: On the distribution of myocardial flow. Basic Res. Cardiol. 69, 435–446 (1973)
Fleckenstein, A.: On the pharmacological mechanism of nifedipine and its relation to therapeutic efficacy. 3rd International Adalat Symposion, pp. 1–13. Amsterdam-Oxford: Excerpta medica 1976
Fleckenstein-Grün, G., Fleckenstein, A.: Ca-dependent changes in coronary smooth muscle tone and the action of Ca-antagonistic compounds with special reference to adalat. 2nd International Adalat Symposion, pp. 66–76. Berlin, Heidelberg, New York: Springer 1975
Horwitz, L. D., Gorlin, R., Taylor, W. J., Kemp, H. G.: Effects of nitroglycerin on regional myocardial blood flow in coronary artery disease. J. Clin. Invest. 50, 1578–1584 (1971)
Schaper, W., Lewi, P., Flameng, W., Gijpen, L.: Myocardial steal produced by coronary vasodilation in chronic coronary artery occlusion. Basic Res. Cardiol. 68, 3–20 (1973)
Schaper, W., Wüsten, B., Flameng, W., Scholtholt, J., Winkler B., Pasyk, S.: Local dilatory reserve in chronic experimental coronary occlusion without infarction. Quantitation of collateral development. Basic Res. Cardiol. 70, 159–173 (1975)
Schnaar, R. L., Sparks, H. V.: Response of large and small coronary arteries to nitroglycerin, NaNO2 and adenosine. Am. J. Physiol. 223, 223–228 (1972)
Schulz, F. W., Raff, W. K., Meyer, U., Lochner, W.: Messung der Kollateraldurchblutung am Hundeherzen mit Hilfe der selektiven Embolisierung eines Koronargefäßes. Pflügers Arch. 341, 243 (1973)
Simm, F.: Über eine Methode zur Untersuchung regionaler Widerstände des coronaren Gefäßsystems. Dissertation, Universität Düsseldorf 1978
Wichmann, J., Lochner, W., Löser, R., Diemer, H. P.: The pressure-resistance-relationships of regional resistances within the coronary circulation and the steal-phenomenon. Basic Res. Cardiol. 73, 607–617 (1978a)
Wichmann, J., Löser, R., Diemer, H. P., Lochner, W.: Pharmacological alterations of coronary collateral circulation; implication to the steal-phenomenon. Pflügers Arch. 373, 219–224 (1978b)
Winbury, M. W., Howe, B. B., Hefner, M. A.: Effect of nitrates and other coronary dilators on large and small coronary vessels: an hypothesis for the mechanism of action of nitrates. J. Pharmacol. Exp. Ther. 168, 70–95 (1969)
Winbury, M. W., Howe, B. B., Weiss, H. R.: Effect of nitroglycerin and dipyridamole on epicardial and endocardial oxygen tension — further evidence for redistribution of myocardial blood flow. J. Pharmacol. Exp. Ther. 176, 184–199 (1970)
Zuberbuhler, R. C., Bohr, D. F.: Responses of coronary smooth muscle to catecholamines. Circ. Res. 16, 431–440 (1965)
Author information
Authors and Affiliations
Additional information
The paper was supported by the Deutsche Forschungsgemeinschaft, Sonderforschungsbereich 30, Düsseldorf
Rights and permissions
About this article
Cite this article
Ertl, G., Simm, F., Wichmann, J. et al. The dependence of coronary collateral blood flow on regional vascular resistances. Naunyn-Schmiedeberg's Arch. Pharmacol. 308, 265–272 (1979). https://doi.org/10.1007/BF00501392
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00501392