Autoregulation of Coronary Blood Supply in Response to Demand: JACC Review Topic of the Week.

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State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_1BE426C9B264
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Autoregulation of Coronary Blood Supply in Response to Demand: JACC Review Topic of the Week.
Journal
Journal of the American College of Cardiology
Author(s)
Johnson N.P., Gould K.L., De Bruyne B.
ISSN
1558-3597 (Electronic)
ISSN-L
0735-1097
Publication state
Published
Issued date
11/05/2021
Peer-reviewed
Oui
Volume
77
Number
18
Pages
2335-2345
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Although our coronary circulation evolved to meet demands during marked physical exertion for "fight or flight" survival, complex and multilayered control mechanisms reduce flow during other periods. Understanding homeostasis of resting flow provides essential insights into clinical pathophysiology. Several homeostatic mechanisms (myogenic, metabolic, endothelial, and neural) maintain sufficient baseline flow regardless of driving pressure (in aggregate, "autoregulation"). As a result, ventricular dysfunction does not arise until coronary perfusion pressure decreases to ∼40 mm Hg. Straightforward clinical parameters explain approximately one-half of observed absolute resting perfusion but with wide imprecision. Resting perfusion does not associate with clinical outcomes and remains unaffected by revascularization, recovery after myocardial infarction, and treating severe aortic stenosis, thereby supporting the notion that the heart was designed for peak performance.
Keywords
Coronary Circulation/physiology, Homeostasis/physiology, Humans, autoregulation, resting coronary pressure, resting myocardial perfusion
Pubmed
Web of science
Open Access
Yes
Create date
24/05/2021 13:16
Last modification date
09/01/2024 7:17
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