Myocardial Vasculature during Ischemia and Reperfusion
Although ischemic injury to the myocyte has being the focus of much attention, interest is increasingly being shown in the realm of coronary microcirculation. There is now considerable evidence that ischemia can precipitate adverse structural and functional alterations in blood vessels. The extent to which, and the rate at which, vascular tissue can recover from the adverse consequences of ischemia is still unclear. Furthermore, there are differing opinions as to whether ischemia- and reperfusion-induced injury to the vascular system lags behind, or precedes, that which occurs in the myocyte. Some investigators now argue (Maxwell and Gavin, 1991) that endothelial dysfunction is a very early event and, in terms of its ability to compromise the recovery of cardiac function, precedes myocyte necrosis. There can be, therefore, little doubt that microvascular injury has the potential to amplify the detrimental consequences of ischemia and reperfusion. Thus, the microcirculation should represent an important target for innovative pharmacological interventions, particularly in the context of clinical conditions such as thrombolysis and cardiac surgery.
KeywordsVascular Endothelial Growth Factor Capillary Density Angiogenic Growth Factor Coronary Vasospasm Coronary Microcirculation
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