Skip to main content

Coronary Microcirculation

  • Chapter
Textbook of Angiology
  • 87 Accesses

Abstract

Although the term coronary microcirculation includes all the vessels from small arteries to small veins, it is currently used to define the precapillary vasculature, because common knowledge of coronary physiology localizes the main site of flow regulation at the precapillary level, and there is difficulty in identifying possible dysfunction of capillary or postcapillary vessels in humans.71

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Baroldi G, Camerini F, Goodwin JF. Advances in Cardiomyopathies. Berlin: Springer-Verlag; 1990:7–175.

    Book  Google Scholar 

  2. Bassan M, Ganz W, Marcus HS, Swan HJC. The effect of in-tracoronary injection of contrast medium upon coronary blood flow. Circulation. 1975;51:442–445.

    Article  PubMed  CAS  Google Scholar 

  3. Camici PG, Cecchi F, Gistri R, et al. Dipyridamole-induced subendocardial underperfusion in hypertrophic cardiomyopathy assessed by positron emission tomography. Coron Artery Dis. 1991;2:837–841.

    Google Scholar 

  4. Camici PG, Chiriatti G, Lorenzoni R, et al. Coronary vasodilation is impaired both in hypertrophied and nonhy-pertrophied myocardium of patients with hypertrophic cardiomyopathy: a study with 13N-ammonia and positron emission tomography. J Am Coll Cardiol. 1991;17:879–886.

    Article  PubMed  CAS  Google Scholar 

  5. Camici PG, Marraccini P, Gistri R, Salvadori PA, Sorace O, L’Abbate A. Adrenergically-mediated coronary vasodilation in patients with syndrome X. Cardiovasc Drugs Ther. 1994;8:221–226.

    Article  PubMed  CAS  Google Scholar 

  6. Cannon RO, Cannon RE, Parrillo JE, et al. Dynamic limitation of coronary vasodilator reserve in patients with dilated cardiomyopathy and chest pain. J Am Coll Cardiol. 1987;10:1190–1200.

    Article  PubMed  Google Scholar 

  7. Cannon RO, Rosing DR, Maron BJ, et al. Myocardial ischemia in patients with hypertrophie cardiomyopathy: contribution of inadequate vasodilator reserve and elevated left ventricular filling pressures. Circulation. 1985;71:234–243.

    Article  PubMed  Google Scholar 

  8. Chilian MW. Coronary microcirculation in health and disease. Circulation. 1997;95:522–528.

    Article  PubMed  CAS  Google Scholar 

  9. Cianflone D, Lanza GA, Maseri A. Microvascular angina in patients with normal coronary arteries and with other ischaemic syndromes. Eur Heart J. 1995;16(suppl 1):96–103.

    Article  PubMed  Google Scholar 

  10. Cohen MV, Kirk ES. Differential response of large and small coronary arteries to nitroglycerin and angiotensin: autoregulation and tachyphylaxis. Circ Res. 1973;33:445–453.

    Article  PubMed  CAS  Google Scholar 

  11. Crake T, Canepa-Anson R, Shapiro LM, Poole-Wilson PA. Continuous recording of coronary sinus oxygen saturation during atrial pacing in patients with coronary artery disease and with syndrome X. Br Heart J. 1988;89:31–38.

    Article  Google Scholar 

  12. Crystal GJ, Downey HF, Bashour FA. Small vessel and total coronary blood volume during intracoronary adenosine. Am J Physiol. 1981;241:H194–H201.

    PubMed  CAS  Google Scholar 

  13. Crystal GJ, Downey HF, Bashour FA. Persistent coronary vasodilation during long-term, supramaximal doses of adenosine. Am J Physiol. 1984;247:H869–H873.

    PubMed  CAS  Google Scholar 

  14. Dayanikli F, Grambow D, Muzik O, Mosca L, Rubenfire M, Schwaiger M. Early detection of abnormal coronary flow reserve in asymptomatic men at high risk for coronary artery disease using positron emission tomography. Circulation. 1994;90:808–817.

    Article  PubMed  CAS  Google Scholar 

  15. Downey JM, Kirk ES. Inhibition of coronary blood flow by a vascular waterfall mechanism. Circ Res. 1975;36:753–760.

    Article  PubMed  CAS  Google Scholar 

  16. Dubois-Rande JL, Marlet P, Duval-Moulin AM, et al. Coronary vasodilating action of dobutamine in patients with id-iopatic dilated cardiomyopathy. Am Heart J. 1993;125:1329–1336.

    Article  PubMed  CAS  Google Scholar 

  17. Eliasen P, Amtorp O. Effect of intracoronary adenosine upon regional blood flow, microvascular blood volume and hematocrit in canine myocardium. Int J Microcirc Clin Exp. 1984;3:3–12.

    PubMed  CAS  Google Scholar 

  18. El-Tamimi H, Davies GJ, Crea F, Sritara P, Hackett D, Maseri A. Inappropriate constriction of small coronary vessels as a possible cause of a positive exercise test soon after successful coronary angioplasty. Circulation. 1991;84:2307–2312.

    Article  PubMed  CAS  Google Scholar 

  19. Epstein SE, Cannon RO III. Site of increased resistance to coronary flow in patients with angina pectoris and normal epicardial coronary arteries. J Am Coll Cardiol. 1986;8:459–461.

    Article  PubMed  CAS  Google Scholar 

  20. Feigl EO. Coronary physiology. Physiol Rev. 1983;63:1–205.

    PubMed  CAS  Google Scholar 

  21. Feigl EO, Buffington CW, Nathan HJ. Adrenergic coronary vasoconstriction during myocardial underperfusion. Circulation. 1987;75(suppl I):1–15.

    Google Scholar 

  22. Gallagher KP, Folts JD, Shebuski RJ, Rankin JHG, Rowe GG. Subepicardial vasodilator reserve in the presence of critical coronary stenosis in dogs. Am J Cardiol. 1980;46:67–73.

    Article  PubMed  CAS  Google Scholar 

  23. Gould KL, Lipscomb K, Hamilton GW. Physiologic basis for assessing critical coronary stenosis. Instantaneous flow response and regional distribution during coronary hyperemia as measures of coronary flow reserve. Am J Cardiol. 1974;33:87–94.

    Article  PubMed  CAS  Google Scholar 

  24. Gould KL, Martucci JP, Goldberg DI, et al. Short-term cholesterol lowering decreases size and severity of perfusion abnormalities by positron emission tomography after dipyridamole in patients with coronary artery disease. A potential noninvasive marker of healing coronary endothelium. Circulation. 1994;89:1530–1538.

    Article  PubMed  CAS  Google Scholar 

  25. Gould KL, Westcott RJ, Albro PC, Hamilton GW. Noninvasive assessment of coronary stenoses by myocardial imaging during pharmacologic coronary vasodilatation. II. Clinical methodology and feasibility. Am J Cardiol. 1978;41:279–287.

    Article  PubMed  CAS  Google Scholar 

  26. Hoffman JIE. Maximal coronary flow and the concept of coronary vascular reserve. Circulation. 1984;70:153–159.

    Article  PubMed  CAS  Google Scholar 

  27. Hoffman JIE, Buckberg GD. The myocardial supply: demand ratio. A critical review. Am J Cardiol. 1978;41:327–331.

    Article  PubMed  CAS  Google Scholar 

  28. Hoffman JIE, Spaan JAE. Pressure-flow relations in coronary circulation. Physiol Rev. 1990;70:331–390.

    PubMed  CAS  Google Scholar 

  29. Huang AH, Feigl EO. Adrenergic coronary vasoconstriction helps maintain uniform transmural blood flow distribution during exercise. Circ Res. 1988;62:286–298.

    Article  PubMed  CAS  Google Scholar 

  30. Klocke FJ, Mates RE, Canty JM, Ellis AK. Coronary pressure-flow relationships: controversial issues and probable implications. Circ Res. 1985;56:310–323.

    Article  PubMed  CAS  Google Scholar 

  31. L’Abbate A, Camici P, Trivella MG, et al. Time dependent response of coronary flow to prolonged adenosine infusion: doubling of peak reactive hyperaemic flow. Cardiovasc Res. 1981;15:282–286.

    Article  PubMed  Google Scholar 

  32. L’Abbate A, Marzilli M, Ballestra AM, et al. Opposite transmural gradients of coronary resistance and extravascular pressure in the working dog’s heart. Cardiovasc Res. 1980;14:21–29.

    Article  PubMed  Google Scholar 

  33. L’Abbate A, Marzilli M, Ballestra AM, Camici P. Myocardial contraction: an additional determinant of transmural flow distribution. In: Maseri A, Klassen G, Lesch M, eds. Primary and Secondary Angina Pectoris. New York: Grune & Stratton; 1978:21.

    Google Scholar 

  34. L’Abbate A, Trivella MG, Camici P, Ballestra AM, Pelosi G, Taddei Le Davies GJ. Beneficial effect on subendocardial perfusion of lowering left ventricular afterload in the absence of coronary reserve. In: Mason DT, Neri Serneri GG, Oliver MF, eds. Florence International Meeting on Myocardial Infarction. Amsterdam: Excerpta Medica; 1979:560.

    Google Scholar 

  35. MacLeod CA, Bahler RC, Davies B. Pacing-induced changes in cardiac venous blood flow in normal subjects and patients with coronary artery disease. Am J Cardiol. 1973;32:686–692.

    Article  PubMed  CAS  Google Scholar 

  36. Marcus M, Wright C, Doty D, et al. Measurements of coronary velocity and reactive hyperemia in the coronary circulation of humans. Circ Res. 1981;49:877–891.

    Article  PubMed  CAS  Google Scholar 

  37. Marzilli M, Goldstein S, Sabbah HN, Lee T, Stein PD. Modulating effect of regional myocardial performance on local myocardial perfusion in the dog. Circ Res. 1979;45:634–641.

    Article  PubMed  CAS  Google Scholar 

  38. Maseri A, ed. Myocardial Blood Flow in Man. Methods and Significance in Coronary Disease. Torino, Italy: Minerva Medica; 1972.

    Google Scholar 

  39. Maseri A, Crea F, Cianflone D. Myocardial ischemia caused by distal coronary vasoconstriction. Am J Cardiol. 1992;79:1602–1605.

    Article  Google Scholar 

  40. Maseri A, Crea F, Kaski JC, Crake T. Mechanisms of angina pectoris in syndrome X. J Am Coll Cardiol. 1991;17:499–506.

    Article  PubMed  CAS  Google Scholar 

  41. Maseri A, L’Abbate A, Michelassi C, et al. Possibilities, limitations, and technique for the study of regional myocardial perfusion in man by xenon-133. Cardiovasc Res. 1977;11:277–290.

    Article  PubMed  CAS  Google Scholar 

  42. Mason Jr, Palac RT, Freeman ML, et al. Thallium scintigra-phy during dobutamine infusion: non-exercise dependent screening test for coronary disease. Am Heart J. 1984;107:481–485.

    Article  PubMed  CAS  Google Scholar 

  43. McGinn AL, White CW, Wilson RF. Interstudy variability of coronary flow reserve: influence of heart rate, arterial pressure and ventricular preload. Circulation. 1990;81:1319–1330.

    Article  PubMed  CAS  Google Scholar 

  44. Muller JM, Davis MJ, Chilian WM. Integrated regulation of pressure and flow in coronary microcirculation. Cardiovasc Res. 1996;32:668–678.

    PubMed  CAS  Google Scholar 

  45. Neglia D, Parodi O, Gallopin M, et al. Myocardial blood flow response to pacing tachycardia and to dipyridamole infusion in patients with dilated cardiomyopathy without overt heart failure. A quantitative assessment by positron emission tomography. Circulation. 1995;92:796–804.

    Article  PubMed  CAS  Google Scholar 

  46. Olsson R.A., Patterson RE. Adenosine as a physiological regulator of coronary blood flow. In: Hahn FE, ed. Progress in Molecular and Subcellular Biology. New York: Springer-Verlag; 1976:227.

    Chapter  Google Scholar 

  47. Opherk D, Schwartz F, Mall G, Manthey J, Baller D, Kubler W. Coronary dilatory capacity in idiopathic dilated cardiomyopathy: analysis of 16 patients. Am J Cardiol. 1983;51:1657–1662.

    Article  PubMed  CAS  Google Scholar 

  48. Opherk D, Zede H, Weihe E, et al. Reduced coronary dilatory capacity and ultrastructural changes of the myocardium in patients with angina pectoris but normal coronary arteries. Circulation. 1981;63:817–825.

    Article  PubMed  CAS  Google Scholar 

  49. Opherk G, Mall G, Zede H, et al. Reduction of coronary reserve: a mechanism for angina pectoris in patients with arterial hypertension and normal coronary arteries. Circulation. 1984;69:1–7.

    Article  PubMed  CAS  Google Scholar 

  50. Parodi O, De Maria R, Oltrona I, et al. Myocardial blood flow distribution in patients with ischemic heart disease or dilated cardiomyopathy undergoing heart transplantation. Circulation. 1993;88:509–522.

    Article  PubMed  CAS  Google Scholar 

  51. Parodi O, Neglia D, Palombo C, et al. Regional myocardial blood flow response to pacing tachycardia and dipyri-damole in arterial hypertension: a quantitative study by positron emission tomography [abstract]. Circulation. 1990;82(suppl 2):478.

    Google Scholar 

  52. Parodi O, Sambuceti G. The role of coronary microvascular dysfuction in the genesis of cardiovascular diseases. J Nucl Med. 1996;40:9–16.

    CAS  Google Scholar 

  53. Pelosi G, L’Abbate A, Trivella MG, et al. Persistence of subendocardial perfusion after subtotal coronary embolisation. Cardiovasc Res. 1988;22:113–121.

    Article  PubMed  CAS  Google Scholar 

  54. Pelosi G, Saviozzi G, Trivella MG, L’Abbate A. Transmural redistribution of coronary resistance during embolization: a clue to intramyocardial small artery architecture. Microvasc Res. 1990;39:322–340.

    Article  PubMed  CAS  Google Scholar 

  55. Pupita G, Maseri A, Kaski JC, Galassi AR, Gavrielides S, Dacies G, Crea F. Myocardial ischemia caused by distal coronary constriction in stable angina pectoris. N Engl J Med. 1990;323:514–520.

    Article  PubMed  CAS  Google Scholar 

  56. Rosano GMC, Lindsay DC, Pool-Wilson PA. Syndrome X: an hypothesis for cardiac pain without ischaemia. Cardiologia. 1991;36:885–895.

    PubMed  CAS  Google Scholar 

  57. Rossen JD, Oskarsson H, Stenberg RG, Braun P, Talman CL, Winniford MD. Simultaneous measurement of coronary flow reserve by left anterior descending coronary artery Doppler and great cardiac vein thermodilution methods. J Am Coll Cardiol. 1992;20:402–407.

    Article  PubMed  CAS  Google Scholar 

  58. Rubio R, Berne RM. Regulation of coronary blood flow. Prog Cardiovasc Dis. 1975;18:105–122.

    Article  PubMed  CAS  Google Scholar 

  59. Sambuceti G, Marzullo P, Giorgetti A, et al. Global alteration in perfusion response to increasing oxygen consumption in patients with single vessel coronary artery disease. Circulation. 1994;90:1696–1705.

    Article  PubMed  CAS  Google Scholar 

  60. Sambuceti G, Parodi O, Marcassa C, et al. Alteration in regulation of myocardial blood flow in one vessel coronary artery disease determined by positron emission tomography. Am J Cardiol. 1993;72:538–543.

    Article  PubMed  CAS  Google Scholar 

  61. Schwartzkopff B, Motz W, Frenzel H, Vogt M, Knauer S, Strauer BE. Structural and functional alterations of the intramyocardial coronary arterioles in patients with arterial hypertension. Circulation. 1993;88:993–1003.

    Article  PubMed  CAS  Google Scholar 

  62. Tomanek RJ, Palmer PJ, Pfeiffer GL, Schreiber KL, Eastham CL, Maecus ML. Morphometry of canine coronary arteries, arterioles and capillaries during hypertension and left ventricular hypertrophy. Circ Res. 1986;58:38–46.

    Article  PubMed  CAS  Google Scholar 

  63. Treasure CB, Vita JA, Cox DA, et al. Endothelium dependent dilation of the coronary microvasculature is impaired in dilated cardiomyopathy. Circulation. 1990;81:772–779.

    Article  PubMed  CAS  Google Scholar 

  64. Trivella MG, Broten TP, Feigl EO. β-Receptor subtypes in the canine coronary circulation. Am J Physiol. 1990;259: H1575–H1585.

    PubMed  CAS  Google Scholar 

  65. Trivella MG, Pelosi G, Nevola E, et al. Functional components and adenosine vasodilation: complex behavior of minimal coronary resistance [abstract]. Clin Res. 1992;40(2)AFCR:257A.

    Google Scholar 

  66. Uren N, Crake T, Lefroy DC, De Silva R, Davies GJ, Maseri A. Delayed recovery of coronary resistive vessel function after coronary angioplasty. J Am Coll Cardiol. 1993;21:612–621.

    Article  PubMed  CAS  Google Scholar 

  67. Uren N, Crake T, Lefroy DC, De Silva R, Davies GJ, Maseri A. Reduced coronary vasodilator response in infarcted and normal myocardium after infarction. N Engl J Med. 1994;331:222–227.

    Article  PubMed  CAS  Google Scholar 

  68. Uren NG, Marraccini P, Gistri R, De Silva R, Camici PG. Altered coronary vasodilator reserve and metabolism in myocardium subtended by normal arteries in patients with coronary artery disease elsewhere. J Am Coll Cardiol. 1993;22:650–658.

    Article  PubMed  CAS  Google Scholar 

  69. Van Winkle DM, Feigl EO. Acetylcholine causes coronary vasodilation in dogs and baboons. Circ Res. 1989;65:1580–1593.

    Article  Google Scholar 

  70. Warltier DC, Gross GJ, Brooks HL. Pharmacologie-vs. ischemia-induced coronary artery vasodilation. Am J Physiol. 1981;240:H767–H774.

    PubMed  CAS  Google Scholar 

  71. Wiedeman MP, Tuma RF, Mayrovitz HN. An Introduction to Microcirculation. New York: Academic Press; 1981:30.

    Google Scholar 

  72. Wilson RF, Lesser JF, Laxson DD, White CW. Intense microvascular constriction after angioplasty of acute throm-botic arterial lesions. Lancet. 1989;1:807–811.

    Article  PubMed  CAS  Google Scholar 

  73. Winbury MM, Howe BB, Hefner MA. Effect of nitrates and other coronary dilators on large and small coronary vessels: hypothesis for the mechanism of action of nitrates. J Pharmacol Exp Ther. 1969;168:70–95.

    PubMed  CAS  Google Scholar 

  74. Wusten B, Buss DD, Deist H, Schaper W. Dilatory capacity of the coronary circulation and its correlation to the arterial vasculature in the canine left ventricle. Basic Res Cardiol. 1977;72:636–650.

    Article  PubMed  CAS  Google Scholar 

  75. Yipintsoi T, Dobbs WA Jr., Scanlon PD, Knopp TJ, Bass-ingthwaighte JB. Regional distribution of diffusible tracers and carbonized microspheres in the left ventricle of isolated dog hearts. Circ Res. 1973;33:573–587.

    Article  PubMed  CAS  Google Scholar 

  76. Zeiher AM, Drexler H, Wollschlaeger, Just H. Endothelial dysfunction of coronary microvasculature is associated with impaired flow regulation in patients with early atherosclerosis. Circulation. 1991;84:1984–1992.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer Science+Business Media New York

About this chapter

Cite this chapter

Trivella, M.G., Pelosi, G. (2000). Coronary Microcirculation. In: Chang, J.B. (eds) Textbook of Angiology. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1190-7_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-1190-7_10

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7039-3

  • Online ISBN: 978-1-4612-1190-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics