New PDF release: Coronary Blood Flow: Mechanics, Distribution, and Control

By Jos A. E. Spaan (auth.)

by JULIEN IE HOFFMAN one of many earliest coronary physiologists used to be Scaramucci who, in 1695, postu­ lated that in systole the contracting myocardium inhibited coronary blood circulate. considering the fact that then, the numerous contributions which have been made to our wisdom of the coronary movement might be arbitrarily divided into 3 stages in response to advances in technical equipment. The early part of study into the coronary move, performed with nice hassle with crude equipment, will be considered as finishing within the Forties, and it incorporated significant discoveries made through such popular investigators as Georg von Anrep, Ernest Starling, Carl Wiggers, and Louis Katz, who formulated a lot of our easy figuring out of the sphere. After 1940, the sector of coronary body structure entered a brand new part whilst tools for prime constancy registration of coronary circulate and strain turned to be had. this period used to be domi­ nated via Donald Gregg who mixed cautious recognition to the functionality of those tools (some of which he helped to enhance) with a rare skill to figure mechanisms from it appears minor adjustments in coronary stream and strain styles. His booklet 'The Coronary stream in overall healthiness and affliction' set a brand new typical within the box. After 1960, recommendations for measuring neighborhood myocardial blood circulation turned to be had, and enabled a wide team of eminent investigators to make significant advances in figuring out the body structure and pathophysiology of myocardial blood flow.

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Extra resources for Coronary Blood Flow: Mechanics, Distribution, and Control

Example text

LSJ') by the interplay of mechanical forces related to coronary arterial pressure and stresses in the wall. 10, data on the ratio between subendocardial and subepicardial flow are compiled from several studies selected for the following criteria. Mean coronary arterial pressure had to be close to 100 mm Hg and the coronary vessels had to be dilated maximally by a drug. The result should be read as follows: if the heart is arrested, subendocardial flow exceeds subepicardial flow by as much as 50%.

This, in combination with intercapillary diffusion of oxygen, may uncouple the direct relation between blood flow and oxygen supply to small regions of the heart. It seems important that these relations be established. Another important point that needs more insight and quantification is related to the distribution of the control function of small arteries and arterioles. Under normal physiological conditions pressure starts to fall in epicardial small arteries of 400 110m diameter. The control of flow requires tuning between vascular resistance and metabolism at the local level.

Interaction between systole and diastole should be taken into account [2, 15, 46, 47, 90]. Models which may be very helpful in unravelling these interactions are examined in Chapters 6 and 7. 3 Regulation of coronary flow The tight relation between coronary flow and oxygen consumption of the heart was not well appreciated until the work of Barcroft and Dixon [8] at the beginning of this century. Tuning of flow to oxygen consumption is effectuated by the smooth muscle within the walls of the resistance vessels.

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