Coronary Blood Flow and Myocardial Oxidative Metabolism at Rest and during Exercise in Subjects with Severe Aortic Valve Disease

Abstract

Systemic and coronary hemodynamic observations have been made in a group of subjects with severe aortic stenosis, aortic insufficiency, and mixed stenosis and insufficiency. Determinations were done by the Fick principle for cardiac output and the nitrous oxide method for coronary blood flow. Resting coronary blood flow per unit weight of muscle was in the same range as is found in normal subjects. During exercise, the cardiac index, cardiac work, and coronary blood flow increased significantly. Those who were subject to angina pectoris increased their coronary flow in response to exercise, as did those who were not. The mechanism of anginal pain in aortic valve disease was not discovered by this study although the coronary blood flow/unit of heart weight at rest and during exercise indicates that the explanation is probably not simple.