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Effect of a Mechanical vs a Pharmacologic Increase in Aortic Pressure on Coronary Blood Flow and Thrombolysis Induced by IV Administration of a Thrombolytic Agent

Richard M. Prewitt; Shian Gu; Usha Schick; John Ducas
Author and Funding Information

From the Department of Medicine, University of Manitoba, Section of Cardiology, Health Sciences Centre, Winnipeg, Manitoba, Canada


1997 by the American College of Chest Physicians


Chest. 1997;111(2):449-453. doi:10.1378/chest.111.2.449
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Abstract

This study was designed to compare the effect of a mechanical vs a pharmacologic increase in BP on coronary artery blood flow and thrombolysis induced by IV administration of recombinant tissue plasminogen activator. We employed a canine model of coronary thrombosis induced by injection of radioactive blood clot in the left anterior descending coronary artery. Subsequently, all dogs underwent phlebotomy to decrease systolic BP to 75 mm Hg and this decreased coronary blood flow by 50%. BP was increased to 130 mm Hg by norepinephrine (NE) infusion or by inflation of a Fogarty catheter placed in the descending aorta. Interventions with NE or with a Fogarty balloon catheter increased coronary artery blood flow to similar values and rates of coronary thrombolysis were similar. However, cardiac output was significantly higher with NE. These results indicate coronary clot lysis is dependent on perfusion pressure and coronary blood flow, not cardiac output.


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  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543