Tone-dependent waterfall behavior during venous pressure elevation in isolated canine hearts

We examined the 'vascular waterfall' hypothesis, which proposes that coronary flow is unaffected by elevations in outflow pressure until the latter reaches a critical threshold level, in 29 isolated canine hearts. In fibrillating hearts vasodilated with adenosine or carbocromen, coronary flow and the coronary pressure-flow relation were not affected by changes in great cardiac vein pressure (P(GCV)) below a threshold value of 11±0.9 (mean ± SEM) mm Hg. Further elevations of P(GCV) reduced flow and shifted the pressure-flow relation to the right, increasing its pressure-axis intercept (P(f=0)). When vasomotor tone was augmented with vasopressin, threshold P(GCV) increased to 25±2.7 mm Hg (p<0.001). Once again, the pressure-flow relation was unaffected by changes in P(GCV) below the threshold value and shifted to the right when this value was exceeded. The amount by which spontaneous values of P(f=0) exceeded threshold values of P(GCV) was greater when vasomotor tone was augmented than during vasodilation. P(f=0) continued to exceed P(GCV) when the latter was raised above the threshold level. Both P(f=0) and threshold values of P(GCV) were less during a long diastole than during ventricular fibrillation. We reached the following conclusions. 1) During changes in P(GCV) below a threshold value, the coronary circulation exhibits traditional waterfall behavior. 2) The threshold pressure for altering waterfall behavior is affected by vascular tone and mechanical activity. 3) P(f=0) remains above P(GCV) when the latter is increased above the threshold value needed to alter flow.