Diastolic Suction During Acute Coronary Occlusion

Abstract

To the Editor: We congratulate Bell et al on the recent publication of their study1 that presents evidence indicating a decrease in forces responsible for diastolic suction during an acute occlusion of the left anterior descending coronary artery in dogs. Their experimental preparation is elegant, and we agree with their principal interpretation of their data: the acute loss of regional cardiac contractile function due to myocardial ischemia can result in a decrease in the mechanical generation and storage of elastic forces available to induce ventricular suction during early diastole. In our view, the authors’ introductory remark that “One determinant of filling that may be altered during coronary occlusion but has not previously been studied is the ability of the LV to fill by suction” is an incomplete representation of the literature. In a previous publication,2 we described in detail the form of intraventricular pressure gradients found in the normal canine left ventricle during early diastole. In that report, we argued that the pattern of these early diastolic pressure gradients could only be present in a structure that filled by the process of mechanical suction. In a follow-up to that study, we hypothesized …