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Coronary Circulation and Myocardial Ischemia pp 3–10Cite as

Local Control of Coronary Blood Flow and Adenosine

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Part of the book series: Update in Intensive Care Medicine ((UICMSOFT,volume 32))

Abstract

The control of myocardial blood flow is orchestrated by multiple regulatory processes, which result in close spatial and temporal coupling between myocardial oxygen supply and demand. The magnitude of coronary flow is a function of the driving pressure and the resistance of the vascular bed. Local control of coronary blood flow is mediated by alterations in vascular resistan ce in response to changes in the balance between myocardial oxygen supply and demand. In turn, coronary vascular resistance is adjusted by multiple interacting mechanisms including myocardial metabolism (metabolic control), endothelial control, autoregulation, myogenic control, extra-vascular compressive forces, and neural control. Coronary autoregulation and metabolic vasodilation are two basic forms of local coronary flow regulation. This review will discuss the local determinants of blood flow regulation to the myocardium, and will focus on the role of adenosine in this process.

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Authors and Affiliations

  1. University of Pittsburgh, Pittsburgh, Pennsylvania, USA

    F. S. Villanueva

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  1. F. S. Villanueva
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Editors and Affiliations

  1. University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    Michael R. Pinsky MD, CM, FCCP, FCCM (Director of Research Division of Critical Care Medicine Professor of Anesthesiology and Critical Care Medicine) (Director of Research Division of Critical Care Medicine Professor of Anesthesiology and Critical Care Medicine)

  2. Department of Cell Biology and Physiology, Autonomous University, Barcelona, Spain

    Antonio Artigas MD, PhD (Director of Critical Care Center Sabadell Hospital Associate Professor) (Director of Critical Care Center Sabadell Hospital Associate Professor)

  3. Paris, France

    Jean-Francois Dhainaut MD, PhD (Director of Medical Intensive Care Unit Dean of Cochin Port-Royal Medical School Vice-President of Paris University) (Director of Medical Intensive Care Unit Dean of Cochin Port-Royal Medical School Vice-President of Paris University)

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© 2002 Springer-Verlag Berlin Heidelberg

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Villanueva, F.S. (2002). Local Control of Coronary Blood Flow and Adenosine. In: Pinsky, M.R., Artigas, A., Dhainaut, JF. (eds) Coronary Circulation and Myocardial Ischemia. Update in Intensive Care Medicine, vol 32. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-57212-8_1

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  • DOI: https://doi.org/10.1007/978-3-642-57212-8_1

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-42588-5

  • Online ISBN: 978-3-642-57212-8

  • eBook Packages: Springer Book Archive

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