CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

Coronary plaque redistribution after stent implantation is determined by lipid composition: A NIRS-IVUS analysis Subclinical and Device-Detected Atrial Fibrillation: Pondering the Knowledge Gap: A Scientific Statement From the American Heart Association INTERMACS Profiles and Outcomes Among Non–Inotrope-Dependent Outpatients With Heart Failure and Reduced Ejection Fraction Prognostic implications of baseline 6‐min walk test performance in intermediate risk patients undergoing transcatheter aortic valve replacement Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy Association of Circulating Monocyte Chemoattractant Protein-1 Levels With Cardiovascular Mortality: A Meta-analysis of Population-Based Studies Management of Antithrombotic Therapy in Atrial Fibrillation Patients Undergoing PCI: JACC State-of-the-Art Review Coronary artery imaging with intravascular high-frequency ultrasound Cardiac Structural Changes After Transcatheter Aortic Valve Replacement: Systematic Review and Meta-Analysis of Cardiovascular Magnetic Resonance Studies Simple Electrocardiographic Measures Improve Sudden Arrhythmic Death Prediction in Coronary Disease
|<<... 102 103 104 105 106 107 108 ...>>|

Review Article2018 Jun 25.[Epub ahead of print]

JOURNAL：Curr Pharm Des. Article Link

Coronary Microcirculation in Ischemic Heart Disease

Pries AR, Kuebler WM, Habazettl H. Keywords: Angioadaptation; Heterogeneity; Inflammation; Leucocyte-Endothelium Interaction; Microvessels; vascular Permeability

ABSTRACT

BACKGROUND - Ischemic heart disease has long been considered to be exlusively caused by stenosis or occlusion. However, the coronary microcirculation too may play an important role in ischemic conditions. Also, the crucial role of microvessels in not only regulating blood flow on a local level but also mediating vascular permeability or inflammatory responses has been recognized.


OBJECTIVE - To review important physiological and pathophysiological mechanisms of coronary microcirculatory control with focus on heterogeneity of local perfusion, microvascular permeability and inflammation.

METHOD - Selective research of the literature.

RESULTS - Heterogeneity is a characteristic of microvascular networks and affects structural and functional parameters such as vessel diameter, length, and connection pattern, flow velocity, wall shear stress, and oxygenation. The networks are optimized to meet the metabolic demand of all tissue compartments. This requires continuous vascular adaptation regulated by local hemodynamic and metabolic stimuli. Compromising this regulation results in functional arterio-venous shunting and tissue areas with either hyperperfusion or hypoxia in close proximity. In ischemia-reperfusion, increased microvascular permeability may aggravate tissue hypoxia by increasing extravascular pressure and seems to contribute to adverse myocardial remodeling. Transendothelial transport mechanisms and deterioration of the endothelial glycocalyx seem to be major contributors to tissue edema. Also in the context of ischemia-reperfusion, an inflammatory response mediated by venular endothelium expressing specific adhesion molecules contributes to tissue injury. However, anti-inflammatory therapies failed in clinical studies and a multi-targeted approach for cardiac protection has been demanded.

CONCLUSION - Disturbances of the coronary microcirculation are involved in different pathophysiological aspects of reperfusion injury.

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
>CBS CBS 2019

> CBS 2019

> CBS 2019 注册

> CBS 2019 会议日程

> CBS 2019 学术征集

> CBS 2019 热点

 CBSMD

> CBSMD 网站注册

> 教育中心

> 荐读文献

> Top 10 阅读文献

> 文献导读
CBS 2019 CBS 2019 主席团 教育中心 科研动态
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top