Sanders M, White F C, Peterson T M, Bloor C M
Am J Physiol. 1978 Nov;235(5):H601-9. doi: 10.1152/ajpheart.1978.235.5.H601.
The relationship between phasic systolic and diastolic coronary blood flow and its transmural distribution has been studied in 29 Yucatan miniature pigs at rest and during heavy exercise, with and without adenosine infusion (1.5 mg . kg-1 . min-1) and with and without a subtotal coronary artery occlusion. Altered factors that affected coronary flow included vascular resistance, perfusion pressure, myocardial oxygen demand, and extra-vascular pressure. The data indicate that, at rest, endomural perfusion is significantly dependent on diastolic blood flow. However, the ability of the myocardial vessels to autoregulate during systole as well as during diastole was clearly shown with the use of adenosine infusion. This ability to regulate flow intrinsically appeared to transcend the endocardial dependency on diastolic perfusion under certain stressful conditions, e.g., during heavy exercise, when the diastolic duration was significantly reduced. Systolic transmural perfusion may then become a significant factor in meeting the blood flow demands of the myocardium. However, due to gradients in vascular resistance, perfusion pressure, and oxygen demand, the coronary reserve of the epicardium appears to be greater than that of the endocardium under any condition.
在29只尤卡坦小型猪处于静息状态以及剧烈运动时,分别在有无腺苷输注(1.5毫克·千克⁻¹·分钟⁻¹)和有无冠状动脉次全闭塞的情况下,研究了阶段性收缩期和舒张期冠状动脉血流及其透壁分布之间的关系。影响冠状动脉血流的改变因素包括血管阻力、灌注压、心肌需氧量和血管外压力。数据表明,在静息状态下,心内膜灌注显著依赖于舒张期血流。然而,使用腺苷输注清楚地显示了心肌血管在收缩期和舒张期进行自身调节的能力。在某些应激条件下,例如在剧烈运动期间舒张期持续时间显著缩短时,这种内在调节血流的能力似乎超越了心内膜对舒张期灌注的依赖性。然后,收缩期透壁灌注可能成为满足心肌血流需求的一个重要因素。然而,由于血管阻力、灌注压和需氧量的梯度,在任何情况下,心外膜的冠状动脉储备似乎都大于心内膜。