Functional characteristics of the coronary microcirculation

Daphne Merkus, William M. Chilian, David W. Stepp

Research output: Contribution to journalReview article

11 Scopus citations

Abstract

For over 50 years, it has been recognized that coronary blood flow is precisely matched to cardiac metabolism. The interactions which govern this matching remain unknown. In the current review, 3 specific aspects of coronary flow regulation will be discussed: Specialization of function in different microvascular domains, influence of cardiac region on microvascular function and the interactions of vasoactive agents in control of coronary blood flow. Each level of the coronary microcirculation is affected by different physical and chemical forces within the heart. These forces place special demands on these vessels and are in turn met by specialized vasodilator responses, including metabolic and flow-mediated vasodilation. Perfusion of the heart is also profoundly affected by the region perfused. The endocardium is affected by forces, notably cardiac contraction, in a different manner than the epicardium. Thus, the microcirculation has specialized to meet these demands. Finally, the factors determining microvascular tone appear to be coordinated such that the loss of any individual dilator, such as nitric oxide, can be compensated for by the increased contribution of another, such as adenosine. This interplay may serve to protect the heart from ischemia during the early phases of coronary vascular disease when individual dilators may be impaired.

Original languageEnglish (US)
Pages (from-to)496-508
Number of pages13
JournalHerz
Volume24
Issue number7
DOIs
StatePublished - Nov 1999
Externally publishedYes

Keywords

  • Calium channel blocker
  • Coronary flow reserve
  • Coronary microcirculation
  • Coronary vasomotion
  • NO

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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