[The coronary circulation and myocardial ischemia].
In this review concerning the relationship between coronary circulation and myocardial ischemia, the authors focus on the factors influencing myocardial oxygen demand and supply, through the evaluation of the determinants of myocardial oxygen consumption and coronary flow regulation. The concepts of coronary flow reserve and endothelial control, the latter being probably a link among vasoconstriction, thrombosis and inflammation in the genesis of acute ischemic syndromes, have been particularly investigated. Moreover, the hemodynamic effects of coronary artery stenoses have been shortly mentioned. The complex mechanisms involved in the regulation of coronary artery tone and flow and the evolution of atherosclerotic plaques are clinically expressed in the so-called "ischemic cascade" leading from local ischemia to chest pain.
Hoffmann
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Cattedra di Cardiologia, Università degli Studi, Palermo. hoffmann@unipa.it
Sclafani
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R
D003326:Coronary Circulation / Q000502:physiology*; D004730:Endothelium, Vascular / Q000378:metabolism; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D017202:Myocardial Ischemia / Q000503:physiopathology*; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption / Q000502:physiology