Cardiovascular Division, King's College London British Heart Foundation Centre of Excellence, The Rayne Institute, St. Thomas' Hospital Campus, London, United Kingdom (H.Z.R.M., M.M., A.C., S.R.R., B.D.P.).
Department of Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec, Canada (P.P.).
Circ Cardiovasc Interv. 2019 Aug;12(8):e007547. doi: 10.1161/CIRCINTERVENTIONS.118.007547. Epub 2019 Aug 16.
Aortic stenosis is a heterogeneous disorder. Variations in the pathological and physiological responses to pressure overload are incompletely understood and generate a range of flow and pressure gradient patterns, which ultimately cause varying microvascular effects. The impact of cardiac-coronary coupling depends on these pressure and flow effects. In this article, we explore important concepts concerning cardiac physiology and the coronary microcirculation in aortic stenosis and their impact on myocardial remodeling, aortic valve flow patterns, and clinical progression.
主动脉瓣狭窄是一种异质性疾病。人们对压力超负荷的病理和生理反应的变化了解甚少，导致出现一系列的血流和压力梯度模式，最终导致不同的微血管效应。心脏-冠状动脉耦联的影响取决于这些压力和血流的影响。本文探讨了主动脉瓣狭窄中心脏生理学和冠状动脉微循环的重要概念及其对心肌重构、主动脉瓣血流模式和临床进展的影响。
