Ardehali A, Ports T A
Cardiovascular Research Institute, University of California, San Francisco.
Chest. 1990 Sep;98(3):699-705. doi: 10.1378/chest.98.3.699.
The supply of oxygen to the myocardium is determined by coronary blood flow and oxygen carrying capacity. Coronary blood flow is a dynamic process modulated via multiple parameters. Cardiac metabolism is also affected by several factors. Under normal physiologic conditions, the demand is easily met by the supply of oxygen. In fact, there is a significant reserve on the supply side. Under certain pathologic states such as coronary artery disease, the supply of oxygen may be exhausted and an imbalance between supply and demand occurs which is translated into ischemia. The area of myocardium most susceptible to ischemia is the subendocardium due to mechanical and metabolic forces. In therapy of coronary artery disease, attention should be directed to directional changes in factors influencing supply and demand to improve blood flow to the most susceptible area.
心肌的氧气供应由冠状动脉血流量和携氧能力决定。冠状动脉血流量是一个受多个参数调节的动态过程。心脏代谢也受到多种因素影响。在正常生理条件下，氧气供应能轻松满足需求。实际上，供应方面存在显著储备。在某些病理状态如冠状动脉疾病下，氧气供应可能耗尽，供需之间出现失衡，进而导致心肌缺血。由于机械和代谢因素，最易发生缺血的心肌区域是心内膜下。在冠状动脉疾病治疗中，应关注影响供需的因素的定向变化，以改善最易受损区域的血流。
