Understanding the coronary circulation through studies at the microvascular level

Circulation. 1990 Jul;82(1):1-7. doi: 10.1161/01.cir.82.1.1.

Abstract

Studies of the coronary circulation have divided vascular resistances into three large components: large vessels, small resistance vessels, and veins. Studies of the epicardial microcirculation in the beating heart using stroboscopic illumination have suggested that resistance is more precisely controlled in different segments of the circulation. Measurements of coronary pressure in different sized arteries and arterioles have indicated that under normal conditions, 45-50% of total coronary vascular resistance resides in vessels larger than 100 microns. This distribution of vascular resistance can be altered in a nonuniform manner by a variety of physiological (autoregulation, increases in myocardial oxygen consumption, sympathetic stimulation) and pharmacological stimuli (norepinephrine, papaverine, dipyridamole, serotonin, vasopressin, nitroglycerin, adenosine, and endothelin). Studies of exchange of macromolecules in the microcirculation using fluorescent-labeled dextrans have also identified the size of the small pore (35-50 A) in coronary microvessels that can be altered by myocardial ischemia. Studies of the coronary microcirculation have demonstrated that the control of vascular resistance is extremely complex, and mechanisms responsible for these heterogeneous responses need further examination.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Animals
  • Blood Pressure
  • Coronary Circulation* / drug effects
  • Coronary Vessels / physiology
  • Homeostasis
  • Humans
  • Microcirculation
  • Nervous System Physiological Phenomena
  • Nifedipine / pharmacology
  • Nitroglycerin / pharmacology
  • Vascular Resistance
  • Vasodilation / physiology

Substances

  • Nitroglycerin
  • Nifedipine