| Myocardial oxygen supply in left ventricular hypertrophy and coronary heart disease. | |
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MedLine Citation:
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PMID: 158305 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Coronary arteriolar dilation adjusts blood flow according to local fluctuating metabolic needs of the myocardium. Because of high extravascular compression during systole, the subendocardial layer of the left ventricle is especially dependent on the duration and the perfusion pressure of the diastolic period. In patients with obstructive coronary artery disease, regional arteriolar dilation is utilized to compensate for focal arterial stenoses. Coronary blood flow may be compensated with the patient at rest, but loss of reserve arteriolar dilation limits further adjustment to superimposed transient increases in metabolic needs. Subendocardial perfusion in the region supplied by the stenosed artery is especially vulnerable to shortened diastolic time during tachycardia. In patients with chronic aortic valve disease, the metabolic rate of the left ventricle is increased in proportion to the increases in myocardial mass and work. Coronary blood flow and metabolic rate per gram of the hypertrophied myocardium are normal when the patient is at rest, at the expense of diminished coronary arteriolar reserve. High tissue pressure relative to the diastolic perfusion pressure probably contributes to the diffuse subendocardial ischemia that occurs in these patients during tachycardia. |
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Authors:
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W A Neill; J H Fluri-Lundeen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of cardiology Volume: 44 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1979 Oct |
Date Detail:
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Created Date: 1979-11-29 Completed Date: 1979-11-29 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 746-53 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Arterial Occlusive Diseases
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physiopathology Cardiomegaly / complications* Coronary Circulation Coronary Disease / complications* Coronary Vessels / physiopathology Heart / physiopathology* Humans Mitochondria, Heart / enzymology Myocardial Contraction Oxygen Consumption* Vascular Resistance |
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