In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.


The free consultation period for this content is over.

It is now only available year-round to EHRA Ivory (& above) Members, Fellows of the ESC and Young combined Members

Impaired coronary blood flow at higher heart rates during atrial fibrillation

Session Poster session 3

Speaker Andrea Saglietto

Congress : EHRA 2019

  • Topic : basic science
  • Sub-topic : Basic Science - Vascular Biology and Physiology
  • Session type : Poster Session
  • FP Number : P1401

Authors : A Saglietto (Turin,IT), S Scarsoglio (Turin,IT), C Gallo (Turin,IT), L Ridolfi (Turin,IT), M Anselmino (Turin,IT)

Authors:
A Saglietto1 , S Scarsoglio2 , C Gallo2 , L Ridolfi3 , M Anselmino1 , 1Hospital 'Città della Salute e della Scienza di Torino', Division of Cardiology, Department of Medical Sciences - Turin - Italy , 2Politecnico di Torino, Department of Mechanical and Aerospace Engineering - Turin - Italy , 3Politecnico di Torino, Department of Environmental, Land and Infrastructure Engineering - Turin - Italy ,

Citation:

Background. Different mechanisms have been proposed to explain the association between atrial fibrillation (AF) and coronary flow impairment, even in absence of relevant coronary artery disease (CAD). However, the underlying hemodynamics remains unclear.

Purpose. Aim of the present work was to computationally explore whether and to what extent ventricular rate during AF affects the coronary perfusion.

Methods. AF was simulated at different ventricular rates (50, 70, 90, 110, 130 bpm) through a 0D-1D multiscale validated model, which combines the left heart-arterial tree together with the coronary circulation. Artificially-built RR stochastic extraction mimics the in vivo beating features during AF. All the hemodynamic parameters computed are based on the left anterior descending (LAD) artery and account for the waveform, amplitude and perfusion of the coronary blood flow.

Results. Increasing ventricular rates during AF significantly altered LAD flow rate waveform (p < 0.01), due to the shortening of the diastolic phase and the increasing signal variability, with a substantial relative delay of the diastolic peak (Figure, panel a) and reduction of blood volume per beat (ml/beat). As a consequence, coronary blood flow (CBF), calculated as ml/min, increased up to 90-110 bpm and then decreased, while cardiac oxygen consumption, evaluated by rate-pressure product (RPP), increases monotonically with ventricular rate, thus leading to significant imbalances in oxygen supply-demand ratio (p < 0.01) as ventricular rate increased (Figure, panel b).

Conclusions. Higher ventricular rate during AF exerts an overall coronary blood flow impairment and imbalance of the myocardial oxygen supply-demand ratio.

Figure. a) Average flow rate signals of LAD (QLAD) as function of the adimensionalized time, t, at different ventricular rates; b) Mean values (µ, solid curves) and standard deviation values (in terms of µ ± s, shaded areas) of CBF and RPP as function of HR.



Based on your interests

Three reasons why you should become a member

Become a member now
  • 1Access your congress resources all year-round on the New ESC 365
  • 2Get a discount on your next congress registration
  • 3Continue your professional development with free access to educational tools
Become a member now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are