As noted by Voge1 and co-workers1 in this issue of the Archives, cardiac catheterization and coronary cineangiography have become the primary means by which physicians have evaluated the significance of coronary stenoses during the past two decades. The evolution of techniques has made the procedure relatively safe and the information gained is invaluable in managing the disease. However, most of the data gathered during cardiac catheterization remain primarily anatomic and not functional.
See also p 1773.
With the classic work of Gould et al2 in the mid-1970s, we began to understand the pathophysiologic importance of a specific anatomic lesion in a coronary artery. The authors applied incremental constrictions to coronary arteries of open-chested dogs that had electromagnetic flow probes implanted distal to the constrictions. They found that, at rest, the flow rate did not change until the luminal diameter was reduced to approximately 80% to 85% of normal.
Lancaster LD, Goldman S. Coronary Artery Blood Flow: Measurement and Importance. Arch Intern Med. 1984;144(9):1742–1744. doi:10.1001/archinte.1984.00350210054005
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