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Coronary Flow Resistance and Reserve

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Interventional Cardiology Imaging

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Abstract

The coronary arteries are the initial vessels off of the aorta and eventually end in a rich capillary bed that provides blood to the myocytes in a one to one fashion (one capillary for each myocyte.) The myocardial oxygen concentration is at maximum such that any increase in myocardial blood flow (MBF) can only be accomplished by increase in coronary blood flow (CBF). As previously mentioned, the CBF is governed by local and systemic factors that help regulate the high demands of the myocardium. The final common pathway is the microvasculature that vasodilates or vasoconstricts to adjust for changes in blood flow.

At resting condition, the CBF is known as the basal flow and resting CBF under normal hemodynamic conditions averages 0.7–1.0 ml/min/g. Regional CBF remains constant as coronary artery perfusion pressure is reduced below aortic pressure over a wide range when the determinants of myocardial oxygen consumption are kept constant, this is known as autoregulation. Earlier studies suggest the lower limit of autoregulation is 70 mmHg, however, canine studies suggest autoregulation may ensue up to as low as a mean of 40 mmHg of coronary pressure.

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Authors and Affiliations

  1. Department of Cardiovascular Disease, Beaumont Health System, Royal Oak, MI, USA

    James L. Smith MD

  2. Department of Cardiology/Research Institute, Beaumont Health System, Royal Oak, MI, USA

    Mark C. Pica BS, CCRP

  3. Department of Cardiovascular Medicine, Beaumont Health, Oakland University/William Beaumont School of Medicine, Royal Oak, MI, USA

    Amr E. Abbas MD,FACC,FSCAI,FSVM,FASE,RPVI

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  1. James L. Smith MD
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  2. Mark C. Pica BS, CCRP
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  3. Amr E. Abbas MD,FACC,FSCAI,FSVM,FASE,RPVI
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Correspondence to Amr E. Abbas MD,FACC,FSCAI,FSVM,FASE,RPVI .

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  1. Interventional Cardiology Research, Beaumonth Health System, Royal Oak, Michigan, USA

    Amr E. Abbas

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© 2015 Springer-Verlag London

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Smith, J.L., Pica, M.C., Abbas, A.E. (2015). Coronary Flow Resistance and Reserve. In: Abbas, A. (eds) Interventional Cardiology Imaging. Springer, London. https://doi.org/10.1007/978-1-4471-5239-2_6

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  • DOI: https://doi.org/10.1007/978-1-4471-5239-2_6

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5238-5

  • Online ISBN: 978-1-4471-5239-2

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