Читать книгу Practical Cardiovascular Medicine - Elias B. Hanna - Страница 23

The determination of LVEDP is critical in patients with ACS and insignificant CAD. Elevated LVEDP from acute diastolic dysfunction or severe HTN is a common cause of mild troponin elevation in patients with normal coronary arteries. Microvascular coronary flow is driven by the gradient between diastolic blood pressure and LVEDP; thus, microvascular flow is impeded by an elevated LVEDP. In fact, a gradient of 40 mmHg between diastolic blood pressure and CVP, or by extrapolation, LVEDP, is a zero-flow gradient, as at least 40 mmHg is required to overcome the microvascular resistance.³⁵