| Popis: |
The control of myocardial blood flow is orchestrated by multiple regulatory processes, which result in close spatial and temporal coupling between myocardial oxygen supply and demand. The magnitude of coronary flow is a function of the driving pressure and the resistance of the vascular bed. Local control of coronary blood flow is mediated by alterations in vascular resistan ce in response to changes in the balance between myocardial oxygen supply and demand. In turn, coronary vascular resistance is adjusted by multiple interacting mechanisms including myocardial metabolism (metabolic control), endothelial control, autoregulation, myogenic control, extra-vascular compressive forces, and neural control. Coronary autoregulation and metabolic vasodilation are two basic forms of local coronary flow regulation. This review will discuss the local determinants of blood flow regulation to the myocardium, and will focus on the role of adenosine in this process. |
