Counterpulsation Effects of Coronary Blood Flow and Cardiac Oxygen Utilization

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Abstract
Counterpulsation in dogs with normal systemic arterial blood pressure produced a reduction in myocardial oxygen consumption without a significant concomitant change in total coronary flow. In dogs with a deteriorating heart and low systemic arterial blood pressure, myocardial oxygen consumption became dependent on coronary flow. Under these circumstances, counterpulsation produced an increase in coronary flow, and with it a secondary augmentation of cardiac oxygen consumption. Counterpulsation reduced the mean systemic arterial blood pressure during ventricular ejection to a greater degree when the control level of this pressure was normal than when it was hypotensive. This lessened effect may also occur when the heart has deteriorated. The mechanisms involved in causing the several effects of counterpulsation are discussed.