Department of Pathology, Stanford University School of Medicine, San Francisco.
J Exp Med. 1941 Aug 31;74(3):177-86. doi: 10.1084/jem.74.3.177.
After eliminating vascular rigor, perfusing human hearts with kerosene under pressure postmortem gives values for coronary flow which seem an index of the maximum possible flow during life. This is 3.1 cc. per gm. per minute at 100 mm. Hg in normal men under 40. It is 35 per cent lower in the hearts of those 60 to 80 years old, and also falls in hypertrophied hearts. In old people it is 30 per cent lower in hearts over 600 gm. than in those under 350; in patients 40 to 60 years old it is 37 per cent less in hearts over 600 as compared with those under 350 gm. In discussion it is brought out that while the decrease in coronary capacity associated with age or hypertrophy may play a part in predisposing some hearts to congestive failure, there is no evidence that the hypertrophied heart has an inadequate oxygen supply or that its fibers are too thick for adequate oxygen diffusion. Congestive failure cannot be ascribed to anoxia except in the presence of severe anemia, coronary occlusion, or tachycardia with low blood pressure. Decrease in perfusibility with age and growth may be a perfectly normal adaptation to the needs of the tissue; the perfusibility of the heart of the young adult is about half that of an infant at 2 years.
在消除血管僵硬后，在死后用压力将煤油灌注到人体心脏中，可以得到冠状动脉流量的值，这些值似乎是生命中最大可能流量的指标。在 40 岁以下的正常男性中，其值在 100mmHg 时为每克每分钟 3.1 毫升。在 60 至 80 岁的人心肌中，其值降低 35%，在肥大的心肌中也会降低。在老年人中，600 克以上的心脏比 350 克以下的心脏降低 30%；在 40 至 60 岁的患者中，600 克以上的心脏比 350 克以下的心脏降低 37%。在讨论中指出，尽管与年龄或肥大相关的冠状动脉能力下降可能在某些心脏易患充血性心力衰竭方面发挥作用，但没有证据表明肥大的心脏供氧不足，或者其纤维太厚而无法进行充分的氧气扩散。充血性心力衰竭不能归因于缺氧，除非存在严重贫血、冠状动脉阻塞或低血压伴心动过速。随着年龄和生长的灌流能力下降可能是组织需求的完全正常适应；年轻成年人的心脏灌流能力约为 2 岁婴儿的一半。
