Abstract
Background and aims: The effects of CHD on CF are poorly mapped. The aim of this study was to investigate the effects of volume and pressure overload and increased coronary perfusion pressure on coronary flow (CF) in patients with congenital heart disease (CHD).
Methods: Posterior descending coronary artery flow was measured using transthoracic Doppler echocardiography in lesions with right ventricular pressure or volume overload: pulmonary valve stenosis (PS) and atrial septal defects (ASD). Left anterior descending coronary artery flow was measured in lesions with left ventricular pressure or volume overload: coarctation of the aorta (CoA) and ventricular septal defect (VSD). The CF data in each patient group were expressed as the percent of the median for healthy controls from the same age group.
Results: The CF values were 172% in VSD, 185% in ASD, 233% in PS, and 773% in CoA patients. In CoA patients left ventricular mass (r=0.81, p=0.001), systolic blood pressure (r=0.72, p< 0.0001), diastolic blood pressure (r= 0.77, p< 0.0001), systolic wall tension (r= - 0.77, p=0,004), and signs of inflammation (log CRP, r= - 0.75, p=0.007) correlated with CF.
Conclusions: The increase in CF and velocity was most significant in patients with CoA. In newborns, increased coronary perfusion pressure seems to be the most important factor for increased CF, even if the pressure is not assumed to cause a significant increase in flow over the auto-regulatory range of 70-130 mmHg. We also showed that inflammation decreases CF.
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Aburawi, E., Pesonen, E. 625 Pathophysiology of Coronary Blood Flow in Congenital Heart Disease. Pediatr Res 68 (Suppl 1), 320 (2010). https://doi.org/10.1203/00006450-201011001-00625
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DOI: https://doi.org/10.1203/00006450-201011001-00625