QUANTITATIVE DEMONSTRATION OF DIPYRIDAMOLE-INDUCED CORONARY STEAL ANDALTERATION BY ANGIOPLASTY IN MAN - ANALYSIS BY SIMULTANEOUS, CONTINUOUS DUAL-DOPPLER SPECTRAL FLOW VELOCITY

In the course of studying the effects of coronary angioplasty on branc h vessel flow using two Doppler flow velocity guidewires, we quantitat ed simultaneous blood flow responses proximal and distal to a stenosis . The alterations of flow documented a horizontal epicardial steal ind uced during dipyridamole hyperemia, hyperemic flow reversal by intrave nous aminophylline, and subsequent normalization of distal hyperemia a fter endoluminal enlargement by successful angioplasty. The quantitati ve physiology of the patient described here confirms one postulated me chanism of abnormal myocardial perfusion stress scintigraphy. Continuo us dual flowire spectral coronary flow determinations appear to be a v aluable method in verifying postulated mechanisms of various pharmacol ogic and mechanical stimuli influencing coronary blood flow in patient s with atherosclerotic coronary artery disease. (C) 1993 Wiley-Liss, I nc.