Subendocardial Distribution of Coronary Blood Flow and the Effect of Antianginal Drugs
Subendocardial Distribution of Coronary Blood Flow and the Effect of Antianginal Drugs
复制标题
冠状动脉血流的心内膜下分布及抗心绞痛药物的作用
作者：
T. W. Moir
• Histological evidence indicates that the subendocardial layers of the left ventricle are vulnerable to ischemia: areas of necrosis in the subendocardium are greater than they are in the epicardium in transmural infarction (1) and in coronary insufficiency (2), suggesting that antegrade coronary blood flow in the subendocardial layers is less than that in the epicardium because of the proximity of the former to intracavitary left ventricular pressure (3). Initial studies showed a gradient in tissue pressure with systolic pressure in the subendocardium exceeding that in the left ventricular cavity and suggested that systolic extravascular compression could be a significant feature in the transmural distribution of coronary blood flow (3). These findings obtained by indirect methods have been generally confirmed (4-7) by studies using other indirect methods, although the intramyocardial tissue pressure in the inner layers of the left ventricle has not always been found to exceed cavitary pressure (8). Recently, a more direct measurement of myocardial tissue pressure by subminiature pressure transducers (9) has confirmed the presence of a transmural gradient with systolic pressure in the subendocardium of
