1. PROTECT: What Have We Learned
Lesson 1: There can be a Mismatch Between Epicardial Flow (hyperemic) and Myocardial Perfusion (stained muscle)
Myocardial Dye Stain (TMPG 1) From Last Injection Before This Injection

2. Coronary Blood Flow - LV Contractility Mismatch Following
Coronary Microembolization
control
1.0
y = 0.89x+0.05
r = 0.87 1h 1h
Systolic Wall Thickening 4h
0.5 4h 8h 8h
microembolization
inflow reduction
0.0
0.0
0.5
1.0
Subendocardial Blood Flow
Dörge et al., Am J Physiol 279:H2587-H2592 (2000)

3. Microembolization is Associated with a Flow – LV Function Mismatch
Increased Microembolization is Associated with Increased Regional Blood Flow (to a point) and A Simultaneous Reduction in Fractional Shortening i.e. As Flow Improves There is a Reduction in LV Function
Hori, Am J Physiol, 1986