Myocardial ischemia - lack of coronary blood flow, myocardial oxygen supply-demand imbalance or what ?

Authors:
Gerd Heusch
Gerd Heusch
Universitätsklinikum Essen
Germany

Am J Physiol Heart Circ Physiol 2019 Apr 19. Epub 2019 Apr 19.

Institut fur Pathophysiologie, Universitatsklinikum Essen, Germany.

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 which 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 which focusses on the reduction of coronary blood flow to below 8 -10µl/g x cardiac cycle with consequences for myocardial electrical, metabolic, contractile and morphological features is advocated.

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Source
https://www.physiology.org/doi/10.1152/ajpheart.00139.2019
Publisher Site
http://dx.doi.org/10.1152/ajpheart.00139.2019DOI Listing
April 2019
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References

(Supplied by CrossRef)
Article in Rev Physiol Biochem Pharmacol
Rev Physiol Biochem Pharmacol 1990
Article in Curr ProblCardiol
Braunwald E et al.
Curr ProblCardiol
Article in Welch GHJ. Hemodynamic
Braunwald E et al.
Welch GHJ. Hemodynamic
Article in Ross Jr. J. Regional
Gallagher KP et al.
Ross Jr. J. Regional
Article in J. Effect of
Gallagher KP et al.
J. Effect of

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