Duncker Dirk J, Koller Akos, Merkus Daphne, Canty John M
Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Cardiovascular Research Institute COEUR, Erasmus MC, University Medical School, Rotterdam, The Netherlands.
Department of Pathophysiology and Gerontology, Medical School, University of Pécs, Hungary; Department of Physiology, New York Medical College, Valhalla, NY, USA.
Prog Cardiovasc Dis. 2015 Mar-Apr;57(5):409-22. doi: 10.1016/j.pcad.2014.12.002. Epub 2014 Dec 2.
The major factors determining myocardial perfusion and oxygen delivery have been elucidated over the past several decades, and this knowledge has been incorporated into the management of patients with ischemic heart disease (IHD). The basic understanding of the fluid mechanical behavior of coronary stenoses has also been translated to the cardiac catheterization laboratory where measurements of coronary pressure distal to a stenosis and coronary flow are routinely obtained. However, the role of perturbations in coronary microvascular structure and function, due to myocardial hypertrophy or coronary microvascular dysfunction, in IHD is becoming increasingly recognized. Future studies should therefore be aimed at further improving our understanding of the integrated coronary microvascular mechanisms that control coronary blood flow, and of the underlying causes and mechanisms of coronary microvascular dysfunction. This knowledge will be essential to further improve the treatment of patients with IHD.
在过去几十年中，已阐明了决定心肌灌注和氧输送的主要因素，并且这一知识已被纳入缺血性心脏病（IHD）患者的管理中。对冠状动脉狭窄流体力学行为的基本理解也已应用于心脏导管实验室，在该实验室中常规获取狭窄远端的冠状动脉压力和冠状动脉血流测量值。然而，由于心肌肥厚或冠状动脉微血管功能障碍导致的冠状动脉微血管结构和功能扰动在IHD中的作用正日益受到认可。因此，未来的研究应旨在进一步增进我们对控制冠状动脉血流的综合冠状动脉微血管机制以及冠状动脉微血管功能障碍的潜在原因和机制的理解。这些知识对于进一步改善IHD患者的治疗至关重要。
