Hutchins G M, Moore G W, Hatton E V
Circulation. 1986 Dec;74(6):1195-202. doi: 10.1161/01.cir.74.6.1195.
The mechanism by which myocardial blood flow varies in response to metabolic demand is obscure. One hypothesis is a countercurrent regulation of arterial caliber by diffusible substances carried in venous blood. To study the anatomic basis for blood flow regulation, we performed combined arterial and venous injections in 20 human hearts and studied left ventricular intramyocardial vessels with radiography, 100 micron thick sections, and reconstructions of serial histologic sections. Penetrating arteries lie in interstitial spaces and are closely related to accompanying veins. These interstitial veins partially surround and are indented by branch arteries. A second system of veins lies within muscle fascicles between interstitial spaces and is not related to arteries. The isolated veins have collateral connections with interstitial veins and join them in the subepicardium. This vascular anatomy could allow arterial caliber to be regulated by diffusible substances carried in the interstitial veins. Arterial dilatation might prolong this effect by partial obstruction of interstitial veins, with the isolated venous system providing an alternative pathway for venous drainage and washout. The study shows that a vascular arrangement is present in human left ventricular myocardium that could provide a countercurrent regulation of blood flow with diffusible substances carried in venous blood.
心肌血流量随代谢需求而变化的机制尚不清楚。一种假说是静脉血中携带的可扩散物质对动脉管径进行逆流调节。为了研究血流调节的解剖学基础，我们对20颗人类心脏进行了动脉和静脉联合注射，并通过射线照相、100微米厚切片以及连续组织学切片重建来研究左心室心肌内血管。穿通动脉位于间质间隙中，与伴行静脉密切相关。这些间质静脉部分环绕分支动脉并被其压出凹陷。第二个静脉系统位于间质间隙之间的肌束内，与动脉无关。孤立的静脉与间质静脉有侧支连接，并在心肌外膜下与之汇合。这种血管解剖结构可能使动脉管径受间质静脉中携带的可扩散物质调节。动脉扩张可能通过部分阻塞间质静脉来延长这种效应，孤立的静脉系统为静脉引流和清除提供了另一条途径。该研究表明，人类左心室心肌中存在一种血管排列，可利用静脉血中携带的可扩散物质对血流进行逆流调节。
