Browsing by Author "MARCHANT, E"
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- ItemABNORMAL REGIONAL MYOCARDIAL FLOW IN MYOCARDIAL BRIDGING OF THE LEFT ANTERIOR DESCENDING CORONARY-ARTERY(1981) PICHARD, AD; CASANEGRA, P; MARCHANT, E; RODRIGUEZ, JA
- ItemACUTE EFFECT OF SYSTEMIC VERSUS INTRACORONARY DIPYRIDAMOLE ON CORONARY CIRCULATION(1986) MARCHANT, E; PICHARD, A; RODRIGUEZ, JA; CASANEGRA, PDipyridamole has been proposed as an ideal agent to evaluate coronary vascular reserve because it produces selective coronary vasodilation without systemic hemodynamic effect. The actions of intracoronary (IC) and intravenous (IV) dipyridamole on coronary blood flow and systemic hemodynamics were compared in 15 patients with chest pain syndrome and normal coronary arteries. They received IC dipyridamole, followed 10 minutes later by 0.5 mg/kg of IV dipridamole. IC dipyridamole produced a 73% increase in coronary sinus flow without hemodynamic changes, except for a slight increase in pulmonary systolic and diastolic pressures. IV dipyridamole administration produced an additional 88% increase in coronary sinus flow, reaching 172% over baseline; it was also associated with a significant (p < 0.01) increase in heart rate (78 .+-. 14 vs 102 .+-. 19 beats/min), cardiac index (4 .+-. 0.7 vs 6.3 .+-. 1.7 liters/min/m2), and pulmonary artery systolic (27 .+-. 5 vs 34 .+-. 7 mm Hg) and diastolic pressure (12 .+-. 4 vs 19 .+-. 7 mm Hg). These data suggest that the coronary vasodilatory effect seen after IV dipyridamole administration is related to mechanisms other than direct coronary vasodilation.
- ItemACUTE MYOCARDIAL-INFARCTION WITH NORMAL CORONARY-ARTERIES - INVIVO DEMONSTRATION OF CORONARY-THROMBOSIS DURING THE ACUTE EPISODE(1983) FERNANDEZ, MS; PICHARD, AD; MARCHANT, E; LINDSAY, J
- ItemASSOCIATION OF CORONARY-ARTERY DISEASE AND VALVULAR HEART-DISEASE IN CHILE(1983) MARCHANT, E; PICHARD, A; CASANEGRA, P
- ItemEFFECT OF INTRAVENOUS DIPYRIDAMOLE ON REGIONAL CORONARY BLOOD-FLOW WITH 1-VESSEL CORONARY-ARTERY DISEASE - EVIDENCE AGAINST CORONARY STEAL(1984) MARCHANT, E; PICHARD, AD; CASANEGRA, P; LINDSAY, JThe effects of i.v. dipyridamole were studied in 9 patients with isolated total left anterior descending coronary artery (LAD) obstruction, in 6 patients with isolated 90-99% diameter reduction of the LAD and in 10 patients with normal coronary arteries and normal left ventricular function. Coronary sinus and great cardiac vein flows were determined by continuous thermodilution. Flows were measured at rest and 1, 3, 5 and 10 min after i.v. dipyridamole. Great cardiac vein flow represents the venous outflow from the LAD territory. In the presence of coronary steal from the LAD territory, great cardiac vein flow is expected to decrease while coronary sinus flow increases. I.v. dipyridamole induced a similar flow increase in the coronary sinus and the great cardiac vein in all 3 groups (P < 0.001 between rest and dipyridamole, difference not significant among groups), suggesting that no coronary steal was induced. The maximal increase in great cardiac vein flow was 118 .+-. 74% in the control group, 86 .+-. 74% in the group with 90-99% LAD obstruction and 102 .+-. 29% in the group with total LAD obstruction (difference not significant). Evidently, i.v. dipyridamole produces a similar increase in coronary flow in ischemic and nonischemic areas and an increase in collateral flow is the underlying mechanism for increased flow to the ischemic area.
- ItemLARGE V-WAVES IN THE PULMONARY CAPILLARY WEDGE PRESSURE TRACING WITHOUT MITRAL REGURGITATION - THE INFLUENCE OF THE PRESSURE VOLUME RELATIONSHIP ON THE V-WAVE SIZE(1983) PICHARD, AD; DIAZ, R; MARCHANT, E; CASANEGRA, P