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- W19814521 abstract "The coronary circulation is regulated by several control mechanisms. The dominant factors are metabolic demand, autoregulation and extravascular compressive forces. Of lesser importance are humoral and neural control mechanisms. There is a tight coupling between myocardial oxygen consumption and coronary blood flow in normal hearts. A change in oxygen demand elicits almost instantaneous proportional changes in coronary blood flow and coronary vascular resistance. Furthermore, the coronary circulation is autoregulated over a wide range of perfusion pressures (40 to 170 mm Hg). Autoregulation is defined as the ability to maintain constant coronary blood flow despite changes in perfusion pressure as long as myocardial oxygen demand is unaltered. When coronary perfusion falls as a result of proximal coronary stenosis the distal small arterioles vasodilate in an attempt to maintain constant flow. Autoregulatory reserve varies across the different layers of the myocardium, more exhausted in the subendocardium than the epicardium; the subendocardial microvasculature is subject to higher intracavitary compressive forces and, therefore, is more vasodilated at base line and has less vasodilatory reserve. The normal subendocardial-to-subepicardial flow ratio is approximately 1.2:1.0. This ratio may decrease to 1:2 with severe ischemia or increase to as high as 3:1 during adenosine infusion [1]." @default.
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- W19814521 date "1993-01-01" @default.
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- W19814521 title "Cardiac output and coronary blood flow during pharmacologic stress testing" @default.
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