Myocardial ischaemia: what happens to the coronary arteries?

Study of the effects of myocardial ischaemia and reperfusion has largely been confined to the impairment of cardiac contractility. However, emerging recognition of the importance of endothelium-derived vasoactive factors in blood flow regulation has stimulated interest in the effect of pathological states such as ischaemia on coronary vascular function and is discussed in this review by Christopher Sobey and Owen Woodman. Neutrophils may play a key role in impaired reperfusion and endothelial damage, and pharmacological intervention to preserve endothelial function could significantly improve coronary blood flow and cardiac function after an ischaemic attack.