Autoregulation of Coronary Blood Supply in Response to Demand: JACC Review Topic of the Week.
Détails
Etat: Public
Version: Final published version
Licence: CC BY-NC-ND 4.0
ID Serval
serval:BIB_1BE426C9B264
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Autoregulation of Coronary Blood Supply in Response to Demand: JACC Review Topic of the Week.
Périodique
Journal of the American College of Cardiology
ISSN
1558-3597 (Electronic)
ISSN-L
0735-1097
Statut éditorial
Publié
Date de publication
11/05/2021
Peer-reviewed
Oui
Volume
77
Numéro
18
Pages
2335-2345
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Publication Status: ppublish
Résumé
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.
Mots-clé
Coronary Circulation/physiology, Homeostasis/physiology, Humans, autoregulation, resting coronary pressure, resting myocardial perfusion
Pubmed
Web of science
Open Access
Oui
Création de la notice
24/05/2021 14:16
Dernière modification de la notice
09/01/2024 8:17