Summary
The “Gregg phenomenon” implies that myocardial function and oxygen consumption (\(M\dot VO_2 \)) increase when coronary perfusion is enhanced within or above the autoregulatory range. We have recently demonstrated that the “Gregg phenomenon” has no significance for regional myocardial function and\(M\dot VO_2 \) in anesthetized swine in situ. There is, however, some evidence that the “Gregg phenomenon” may exist within stunned myocardium. To test whether coronary hyperperfusion increases regional myocardial function and\(M\dot VO_2 \) in stunned myocardium, in six anesthetized swine the left anterior descending coronary artery (LAD) was cannulated and perfused at constant pressure (CAP) using an extracorporal circuit. The coronary vein which parallels the LAD was cannulated to allow measurement of regional\(M\dot VO_2 \) and regional systolic wall thickening (WT%) of the anterior myocardium was assessed using sonomicrometry. Blood flow (CBF) to the LAD was increased by increasing CAP within the extracorporal circuit or by intracoronary adenosine infusion (150 μg/min). In normal myocardium, increasing CBF from 71.4 ± 19.7 (SD) to 156.7 ± 48.8 ml/min/100 g by increasing CAP from 100 ± 10 to 190 ± 10 mm Hg or increasing CBF from 75.1 ± 29.1 to 189.2 ± 45.8 ml/min/100 g by intracoronary adenosine infusion did not increase WT% (34.3 ± 12.2 % vs 32.1 ± 10.6 % and 32.3 ± 10.7 % vs 30.1 ± 13.2 %, respectively).\(M\dot VO_2 \) was not changed during enhanced CAP (6.94 ± 1.05 vs 8.10 ± 1.08 ml/min/100 g) and during intracoronary adenosine infusion (6.67 ± 1.45 vs 7.30 ± 2.23 ml/min/100 g). Twenty min of hypoperfusion followed by 30 min of reperfusion depressed WT% by 47 % (p < 0.05). However,\(M\dot VO_2 \) was only decreased by 23 % (NS). In the stunned myocardium, increasing CBF from 62.1 ± 36.4 to 157.1 ± 60.0 ml/min by increasing CAP was not associated with an increase in WT%.\(M\dot VO_2 \), however, increased from 5.14 ± 1.07 to 8.88 ± 1.83 ml/min/100 g (p < 0.05). Comparable results were achieved when CBF was increased from 60.3 ± 28.7 to 176.9 ± 48.5 ml/min by intracoronary adenosine infusion. WT% was unaffected, while\(M\dot VO_2 \) increased from 4.69 ± 0.92 to 9.46 ± 3.39 ml/min/100 g (p < 0.05). Thus, increasing coronary perfusion within or above the autoregulatory range increases\(M\dot VO_2 \) in stunned myocardium, but without a simultaneous increase in regional myocardial function.
Similar content being viewed by others
References
Allen DG, Orchard CH (1987) Myocardial contractile function during ischemia and hypoxia. Circ Res 60:153–168
Freeman GL, Colston JT, Hultman J (1990) Influence of adenosine on left ventricular performance in conscious dogs. Am J Physiol 258:H424-H430
Gewirtz H, Salvo A, Sun Y, Most AS (1984) Influence of adenosine on basal myocardial function: Observations in anaesthetized, domestic swine. Cardiovasc Res 18:220–228
Gregg DE (1958) Regulation of collaterals and coronary circulation of the heart. In: Circulation Proceedings, Harvey Tercentenary Congress. Blackwell, Oxford, p 168
Guth BD, Schulz R, Heusch G (1990) Evaluation of parameters for the assessment of regional myocardial contractile function during asynchronous left ventricular contraction. Basic Res Cardiol 85:550–562
Indolfi C, Guth BD, Miura T, Miyazaki S, Schulz R, Ross jr J (1989) Mechanisms of improved ischemic regional dysfunction by bradycardia. Studies on UL-FS 49 in swine. Circulation 80:983–993
Jeremy RW, Stahl L, Gillinov M, Litt M, Aversano TR, Becker LC (1989) Preservation of coronary flow reserve in stunned myocardium. Am J Physiol 256:H1303-H1310
Kloner RA, DeBoer LWV, Darsee JR, Ingwall JS, Braunwald E (1981) Recovery from prolonged abnormalities of canine myocardium salvaged from ischemic necrosis by coronary reperfusion. Proc Natl Acad Sci USA 78:7152–7156
Kobayashi M, Schmidt T, Schaper W (1987) Regional myocardial oxygen consumption and segmental function in “stunned” myocardium of the pig. Circulation 76 Suppl IV:IV-379 (abstr)
Krause S, Hess ML (1984) Characterization of cardiac sarcoplasmic reticulum dysfunction during short-term, normothermic, global ischemia. Circ Res 55:176–184
Krukenkamp IB, Silverman NA, Sorlie D, Pridjian A, Feinberg H, Levitsky S (1986) Characterization of postischemic myocardial oxygen utilization. Circulation 74 (suppl III):III–125-III–129
Laxson DD, Homans DC, Dai X-Z, Sublett E, Bache RJ (1989) Oxygen consumption and coronary reactivity in postischemic myocardium. Circ Res 64:9–20
LeWinter MM, Kent RS, Kroener JM, Carew TE, Covell JW (1975) Regional differences in myocardial performance in the left ventricle of the dog. Circ Res 37:191–199
Liedtke JA, De Maison L, Eggleston AM, Cohen LM, Nellis SA (1988) Changes in substrate metabolism and effects of excess fatty acids in reperfused myocardium. Circ Res 62:535–542
Neely JR, Grotyohann LW (1984) Role of glycolytic products in damage to ischemic myocardium. Dissociation of adenosine triphosphate levels and recovery of function of reperfused ischemic hearts. Circ Res 55:816–824
Pantely GA, Bristow JD, Swenson LJ, Ladley HD, Johnson WB, Anselone CG (1985) Incomplete coronary vasodilation during myocardial ischemia in swine. Am J Physiol 249:H638-H647
Ross jr J (1983) Cardiac function and myocardial contractility: a perspective. J Am Coll Cardiol 1:52–62
Sasayama S, Franklin D, Ross jr J, Kemper WS, McKown D (1976) Dynamic changes in left ventricular wall thickness and their use in analyzing cardiac function in the conscious dog. Am J Cardiol 38:870–879
Schömig A, Dart AM, Dietz R, Mayer E, Kübler W (1984) Release of endogenous catecholamines in the ischemic myocardium of the rat. Part A: Locally mediated release. Circ Res 55:689–701
Schulz R, Guth BD, Heusch G (1991) No effect of coronary perfusion on regional myocardial function within the autoregulatory range in pigs: Evidence against the Gregg phenomenon. Circulation 83:1390–1403
Schulz R, Miyazaki S, Miller M, Thaulow E, Heusch G, Ross jr J, Guth BD (1989) Consequences of regional inotropic stimulation of ischemic myocardium on regional myocardial blood flow and function in anesthetized swine. Circ Res 64:1116–1126
Stahl LD, Aversano TR, Becker LC (1986) Selective enhancement of function of stunned myocardium by increased flow. Circulation 74:843–851
Stahl LD, Weiss HR, Becker LC (1988) Myocardial oxygen consumption, oxygen supply/demand heterogeneity, and microvascular patency in regionally stunned myocardium. Circulation 77:865–872
Theroux P, Franklin D, Ross jr J, Kemper WS (1974) Regional myocardial function during acute coronary artery occlusion and its modification by pharmacological agents in the dog. Circ Res 35:896–908
Whittaker P, Boughner DR, Kloner RA, Przyklenk K (1991) Stunned myocardium and myocardial collagen damage: differential effects of single and repeated occlusions. Am Heart J 121:434–441
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schulz, R., Janssen, F., Guth, B.D. et al. Effect of coronary hyperperfusion on regional myocardial function and oxygen consumption of stunned myocardium in pigs. Basic Res Cardiol 86, 534–543 (1991). https://doi.org/10.1007/BF02190703
Issue Date:
DOI: https://doi.org/10.1007/BF02190703