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Prog Cardiovasc Dis. 2015 Mar-Apr;57(5):409-22. doi: 10.1016/j.pcad.2014.12.002. Epub 2014 Dec 2.

Regulation of coronary blood flow in health and ischemic heart disease.

Author information

1
Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Cardiovascular Research Institute COEUR, Erasmus MC, University Medical School, Rotterdam, The Netherlands. Electronic address: d.duncker@erasmusmc.nl.
2
Department of Pathophysiology and Gerontology, Medical School, University of Pécs, Hungary; Department of Physiology, New York Medical College, Valhalla, NY, USA.
3
Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Cardiovascular Research Institute COEUR, Erasmus MC, University Medical School, Rotterdam, The Netherlands.
4
Division of Cardiovascular Medicine, University at Buffalo and the Western New York Department of Veterans Affairs Health System, Buffalo, NY, USA.

Abstract

The major factors determining myocardial perfusion and oxygen delivery have been elucidated over the past several decades, and this knowledge has been incorporated into the management of patients with ischemic heart disease (IHD). The basic understanding of the fluid mechanical behavior of coronary stenoses has also been translated to the cardiac catheterization laboratory where measurements of coronary pressure distal to a stenosis and coronary flow are routinely obtained. However, the role of perturbations in coronary microvascular structure and function, due to myocardial hypertrophy or coronary microvascular dysfunction, in IHD is becoming increasingly recognized. Future studies should therefore be aimed at further improving our understanding of the integrated coronary microvascular mechanisms that control coronary blood flow, and of the underlying causes and mechanisms of coronary microvascular dysfunction. This knowledge will be essential to further improve the treatment of patients with IHD.

KEYWORDS:

Coronary artery disease; Coronary blood flow; Hypertrophy; Ischemic heart disease; Microvascular dysfunction

PMID:
25475073
PMCID:
PMC5856234
DOI:
10.1016/j.pcad.2014.12.002
[Indexed for MEDLINE]
Free PMC Article

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