Abstract
The term microcirculation refers to arterioles, capillaries, and venules with a diameter between 5 and 250 μ(mu)m, with important autocrine and paracrine functions involved in the regulation of normal vascular tone. The methods used to assess microcirculation are noninvasive and invasive techniques demonstrating induced myocardial ischemia, myocardial perfusion defects, coronary flow response to hyperemia, and coronary flow reserve (CFR). Microcirculation dysfunction can accompany lesions of epicardial coronary arteries and of myocytes, or may occur in the absence of other vascular or myocardial lesions. During coronary graft surgery the vascular endothelium and vascular smooth muscle cells are damaged, microemboli appear, and acute thrombosis is favored. Over time, grafts subjected to increased pressure suffer persistent endothelial injury. It is considered that the persistence of microvascular dysfunction explains angina after percutaneous or surgical revascularization. The study of microcirculation may provide important contributions to the understanding of the pathophysiological substrate of myocardial ischemia in patients with coronary artery graft.
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McGown CC, Brookes ZLS. Beneficial effects of statins on the microcirculation during sepsis: the role of nitric oxide. Br J Anaesth. 2007;98(2):163–75.
Kajiya F, Goto M. Integrative physiology of coronary microcirculation. Jpn J Physiol. 1999;49:229–41.
Leung DY, Leung M. Significance and assessment of coronary microvascular dysfunction. Heart. 2011;97:587–95.
Carnici PG, Crea F. Coronary microvascular dysfunction. N Engl J Med. 2007;356:830–40.
Marzille M, Sambuceti G, Fedele S, L’Abbate A. Coronary microcirculatory vasoconstriction during ischemia in patients with unstable angina. J Am Coll Cardiol. 2000;35(2):327–33.
Wilson RF, Lesser JF, White CW. Intense microvascular constriction after angioplasty in acute thrombotic arterial lesions. Lancet. 1989;1:807–11.
Pupita G, Maseri A, Kaski JC, et al. Myocardial ischemia caused by distal coronary artery constriction instable angina pectoris. N Engl J Med. 1990;323:514–20.
Golono P, Piscione F, Willerson JT, et al. Divergent effects of serotonin on coronary-artery dimensions and blood flow in patients with coronary atherosclerosis and control patients. N Engl J Med. 1991;324:641–8.
Shuhaiber JH, Evans AN, Massaad MG, Geha AS. Mechanisms and future directions for prevention of vein graft failure in coronary bypass surgery. Eur J Cardiothorac Surg. 2002;22:387–96.
Ghista DN, Kabinejadian F. Coronary artery bypass grafting hemodynamics and anastomosis design: a biomedical engineering review. Biomed Eng Online. 2013;12:129.
Tripodaki E-S, Tasoulis A, Koliopoulou A, Vasileidas I, Vastaridis L, Giannis G, Argiriou M, Charitos C, Nanas S. Microcirculation and macrocirculation in cardiac surgical patients. Crit Care Res Pract. 2012; article ID 654381.
Chamuleau SA, Tio RA, de Cock CC, de Muinck ED, Pijls NH, van Eck-Smit BL, et al. Prognostic value of coronary blood flow velocity and myocardial perfusion in intermediate coronary narrowing and multivessel disease. J Am Coll Cardiol. 2002;39:852–8.
Novo S, Graceffa A, Sucato V, Quagliana A, Evola S, Bronte E, Novo G. Coronary microvascular dysfunction: an update www.escardio.org/E-journal of the ESC Council for Cardiology Practice. 2014;13(5).
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Nanea, I.T., Gheorghe, G.S. (2016). Microcirculation in Graft Failure. In: Ţintoiu, I., Underwood, M., Cook, S., Kitabata, H., Abbas, A. (eds) Coronary Graft Failure. Springer, Cham. https://doi.org/10.1007/978-3-319-26515-5_34
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DOI: https://doi.org/10.1007/978-3-319-26515-5_34
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