Strauer B E
Department of Medicine, Clinic B, University of Düsseldorf, Germany.
J Cardiovasc Pharmacol. 1992;19 Suppl 5:S67-80.
Coronary reserve has been defined as the ratio of coronary resistance under control (rest) conditions and of coronary resistance after maximal coronary vasodilation. The latter can be achieved by various interventions, the most important and clinically relevant example being intravenous administration of dipyridamole at 0.5 mg/kg of body weight. For patients without coronary artery disease, the coronary reserve is about 400 to 500%, i.e., the normal heart is capable of reducing its coronary resistance to minimal values of 0.18 to 0.2 mm Hg/ml/min/100 g or to increase coronary flow by approximately four- to fivefold. The determination of coronary reserve in humans implies the availability of adequate methods. Systematic analyses of different coronary blood flow measurements have proved the gas chromatographic argon method to be the most appropriate and accurate method for clinical conditions, as previously described in detail. In this report, our findings on the coronary reserve analysis in various clinical conditions are described as follows: (a) coronary artery disease, (b) inflammatory disturbances of the microcirculation, (c) hypertensive microangiopathy, (d) rheologic abnormalities of the heart, and (e) pressure and volume overload due to hypertension and heart valve lesions (metabolic overload).
冠状动脉储备被定义为对照（静息）状态下的冠状动脉阻力与最大冠状动脉血管扩张后的冠状动脉阻力之比。后者可通过各种干预措施实现，最重要且与临床相关的例子是静脉注射体重0.5mg/kg的双嘧达莫。对于无冠状动脉疾病的患者，冠状动脉储备约为400%至500%，即正常心脏能够将其冠状动脉阻力降低至0.18至0.2mmHg/ml/min/100g的最小值，或使冠状动脉血流增加约四至五倍。在人体中测定冠状动脉储备意味着要有合适的方法。如前所述，对不同冠状动脉血流测量方法的系统分析已证明气相色谱氩气法是临床条件下最合适、最准确的方法。在本报告中，我们在各种临床条件下对冠状动脉储备分析的结果如下所述：（a）冠状动脉疾病，（b）微循环炎症紊乱，（c）高血压性微血管病，（d）心脏血液流变学异常，以及（e）高血压和心脏瓣膜病变（代谢过载）导致的压力和容量过载。
