Basic Research in Cardiology

, Volume 90, Issue 2, pp 142–159 | Cite as

Neuronal control of coronary blood flow

  • D. Baumgart
  • G. Heusch
Invited Contributions to the Symposium “Regulation of Coronary Blood Flow”, Held at the XV. World Congress of the International Society for Heart Research in Prague
Received:
Accepted:

Abstract

Controversies on acetylcholine-induced increases or decreases in coronary blood flow arise from obvious species differences, the role of endothelium in mediating vascular smooth muscle responses, and the marked negative chronotropic and inotropic effects of acetylcholine. In man, there appears to be a predominant dilation of intact epicardial coronary arteries and a constriction of artherosclerotic segments. However, at present there is no evidence for a vagal initiation of myocardial ischemia.

Coronary vascular β-adrenergic receptors mediate dilation, but appear to be functionally insignificant during sympathetic activation. The β-adrenergic mechanism contributing to myocardial ischemia are indirect, mediated by a tachycardia-related redistribution of blood flow away from the ischemic myocardium. α-Adrenergic receptors mediating epicardial coronary artery constriction in experimental studies appear not to be responsible for the initiation of ischemia in patients with angina at rest. However, α-adrenergic constriction of coronary resistance vessels resulting in the precipitation of poststenotic myocardial ischemia was demonstrated in experimental studies and recently confirmed in patients with effort angina. Non-adrenergic, non-cholinergic neurotransmitters exist; however, their role in regulating coronary blood flow remains entirely unclear.

Key words

Cardiac vagal nerves acetylcholine cardiac sympathetic nerves norepinephrine alpha beta 
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Copyright information

© Steinkopff Verlag 1995

Authors and Affiliations

  • D. Baumgart
    • 1
  • G. Heusch
    • 1
  1. 1.Abteilung für Pathophysiologie Zentrum für Innere MedizinUniversitätsklinikum EssenEssenFRG

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