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Review
. 2014 Jan 21;3(1):e000285.
doi: 10.1161/JAHA.113.000285.

The myocardial oxygen supply:demand index revisited

Julien I E Hoffman  1 , Gerald D Buckberg
Affiliations
Free PMC article
Review

The myocardial oxygen supply:demand index revisited

Julien I E Hoffman et al. J Am Heart Assoc. .
Free PMC article
No abstract available

Keywords: animal models; ischemia; myocardial blood flow.

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Figures

Figure 1.
Figure 1.
The measurement of diastolic (DPTI) and systolic (SPTI) indexes and their relation to phasic coronary blood flow (CBF) in a dog. B.P. indicates blood pressure; DPTI, diastolic pressure‐time index; SPTI, systolic pressure‐time index. Reproduced from Hoffman and Buckberg.
Figure 2.
Figure 2.
Relative subendocardial blood flow related to the supply:demand ratio (DPTI/SPTI). AS indicates aortic stenosis; AV, arteriovenous; LV, left ventricle; DPTI, diastolic pressure‐time index; SPTI, systolic pressure‐time index. Redrawn from Hoffman and Buckberg.
Figure 3.
Figure 3.
Regional autoregulation in the conscious dog. The failure of autoregulation to maintain subendocardial blood flow occurs below a perfusion pressure of about 38 mm Hg, whereas in the subepicardium flow is maintained down to about 28 mm Hg. Based on data published by Canty.
Figure 4.
Figure 4.
Left panel relates the myocardial oxygen supply:demand ratio to the endo:epi ratio, and shows poor correlation. Right panel shows a better relationship between the endo:epi ratio and the myocardial oxygen supply:demand ratio multiplied by arterial oxygen content. In this panel the critical value at which the endo:epi ratio begins to decrease is 8 to 10. AS indicates aortic stenosis; LV, left ventricle; DPTI, diastolic pressure‐time index; SPTI, systolic pressure‐time index. Redrawn from Brazier et al.
Figure 5.
Figure 5.
Relation of resting left ventricular myocardial oxygen consumption (LVO2) to LV mass, based on data from Strauer. The regression line has the equation LVO2=0.1036 LV−2.12 mass. The dashed lines show the 95% confidence limits for points, and the standard deviation from regression is 2.22.
Figure 6.
Figure 6.
Relation between anatomic and calculated left ventricular mass (LVM). IVST indicates interventricular septum; MMT, mean myocardial thickness; PWT, posterior free wall. Reproduced with permission of the publishers.
Figure 7.
Figure 7.
Left panel: Using a central arterial tracing underestimates SPTI (shaded area) and overestimates DPTI (cross‐hatched area). Right panel: Added effect of raised left ventricular diastolic pressure. DPTI indicates diastolic pressure‐time index; SPTI, systolic pressure‐time index.
Figure 8.
Figure 8.
Effect of sudden strenuous exercise (cold run) and similar exercise after a warm‐up period (warm‐up run). In the cold run SPTI was increased by a higher peak pressure and a longer duration of systole, and DPTI was reduced by the shortened diastole. A typical ischemic pattern ECG is shown for the cold run. Adapted from Barnard et al. Note the prolonged systole shown during the cold run. DPTI indicates diastolic pressure‐time index; SPTI, systolic pressure‐time index.
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References

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    1. Hoffman JIE, Buckberg GD. Transmural variations in myocardial perfusion. Prog Cardiol. 1976; 5:37-89
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