Myocardial ischemia: lack of coronary blood flow, myocardial oxygen supply-demand imbalance, or what?
Myocardial ischemia: lack of coronary blood flow, myocardial oxygen supply-demand imbalance, or what?
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DOI：
10.1152/ajpheart.00139.2019
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发表时间：
2019-06-01
影响因子：
4.8
通讯作者：
Heusch, Gerd
中科院分区：
文献类型：
--
作者：
Heusch, Gerd
这篇自以为是的文章回顾了目前心肌缺血的概念。具体地说，简要介绍了历史背景。然后，由于需求是一个无法测量的虚拟参数，而心肌血流量和收缩功能的测量数据支持流量和功能之间的匹配，因此对流行的心肌氧供需失衡范式提出了批评。最后，提出了心肌缺血的概念，即冠状动脉血流量降至8-10 mU L/克/热以下，从而对心肌的电、代谢、收缩和形态特征产生影响。
This opinionated article reviews current concepts of myocardial ischemia. Specifically, the historical background is briefly presented. Then, the prevailing paradigm of myocardial oxygen-supply-demand imbalance is criticized since demand is a virtual parameter that cannot be measured and data on measurements of myocardial blood flow and contractile function rather support matching between flow and function. Finally, a concept of myocardial ischemia that focusses on the reduction of coronary blood flow to below 8-10 mu l/g per heat with consequences for myocardial electrical, metabolic, contractile and morphological features is advocated.