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Physiology and Pathophysiology of Coronary Circulation

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PanVascular Medicine

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Abstract

Coronary blood flow (CBF) is regulated in order to match oxygen requirements by myocardial cells and may increase up to fivefold, compared to baseline (coronary flow reserve), due to maximal myocardial oxygen demand, as a result of maximal dilatation of small resistance coronary arteries (arterioles and pre-arterioles). The regulation of CBF is mediated by metabolic, neural, circulating, and physical (vascular and extravascular) factors. An inadequate CBF for myocardial oxygen requirement results in myocardial ischemia. The pathophysiologic mechanisms responsible for myocardial ischemia (either in conditions of increased oxygen requirement or at rest) include atherosclerotic coronary flow-limiting stenosis, epicardial coronary artery spasm, coronary microvascular dysfunction and coronary thrombosis.

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Abbreviations

Coronary flow reserve:

Ratio between CBF achieved during maximal dilatation of resistance coronary arteries and CBF in basal conditions.

Fractional flow reserve:

Ratio between pressures distal and proximal to a coronary stenosis during maximal vasodilatation (usually induced by adenosine).

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Authors and Affiliations

  1. Department of Cardiovascular Sciences, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy

    Gaetano Antonio Lanza M.D., Dr. Stefano Figliozzi M.D. & Dr. Rossella Parrinello M.D.

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  1. Gaetano Antonio Lanza M.D.
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  3. Dr. Rossella Parrinello M.D.
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Correspondence to Gaetano Antonio Lanza M.D. .

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  1. Akademisches Lehrkrankenhaus MLU, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Lanza, G.A., Figliozzi, S., Parrinello, R. (2014). Physiology and Pathophysiology of Coronary Circulation. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37393-0_58-1

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  • DOI: https://doi.org/10.1007/978-3-642-37393-0_58-1

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  • Online ISBN: 978-3-642-37393-0

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