(Circulation. 1997;95:522-528.)
© 1997 American Heart Association, Inc.
Articles |
Coronary Microcirculation in Health and Disease
Summary of an NHLBI Workshop
Correspondence to Alfred Small, PhD, Vascular Research Program, Division of Heart and Vascular Diseases, National Heart, Lung, and Blood Institute, Two Rockledge Center, 6701 Rockledge Dr, MSC 7956, Bethesda, MD 20892-7956.
Abstract This article summarizes a 2-day workshop on the coronary microcirculation held in Bethesda, Md, in September 1994 and sponsored by the National Heart, Lung, and Blood Institute of the National Institutes of Health. The workshop explored a variety of topics pertaining to coronary microvascular physiology and pathophysiology. The latest methodologies that are being used to investigate the coronary microvasculature, including endoscopic microscopy of the intramural coronary microvasculature and micro–x-ray computerized tomography, were discussed. The most recent advances in the regulation of the coronary microcirculation—for example, myogenic and flow-dependent responses, KATP channels, and regional heterogeneity—were reported. The workshop touched on the relation of the microcirculation to clinically important conditions and offered recommendations for future research in this important area. Comparisons are made to recent advances in the peripheral circulation and current gaps in our knowledge concerning the coronary microcirculation. In recent years, research on the coronary microcirculation has made substantial advances, in part as a result of investigations in the peripheral microcirculation but also because of the application of unique methodologies. This research is providing new ways to investigate abnormalities of myocardial perfusion, an area of inquiry that until recently has been limited to examination of coronary pressure-flow relationships.
Key Words: microcirculation • ischemia • endothelium-derived factors • syndrome X • myocardium
This article has been cited by other articles:
 |
|
 |
|
  T. Y. Wong, N. Cheung, F. M. A. Islam, R. Klein, M. H. Criqui, M. F. Cotch, J. J. Carr, B. E. K. Klein, and A. R. Sharrett Relation of Retinopathy to Coronary Artery Calcification: The Multi-Ethnic Study of Atherosclerosis Am. J. Epidemiol., January 1, 2008; 167(1): 51 - 58. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Wang, T. Y. Wong, A. R. Sharrett, R. Klein, A. R. Folsom, and M. Jerosch-Herold Relationship Between Retinal Arteriolar Narrowing and Myocardial Perfusion: Multi-Ethnic Study of Atherosclerosis Hypertension, January 1, 2008; 51(1): 119 - 126. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Melikian, M. T. Kearney, M. R. Thomas, B. De Bruyne, A. M. Shah, and P. A. MacCarthy A simple thermodilution technique to assess coronary endothelium-dependent microvascular function in humans: validation and comparison with coronary flow reserve Eur. Heart J., September 2, 2007; 28(18): 2188 - 2194. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Wang, G. Liew, R. Klein, E. Rochtchina, M. D. Knudtson, B. E.K. Klein, T. Y. Wong, G. Burlutsky, and P. Mitchell Retinal vessel diameter and cardiovascular mortality: pooled data analysis from two older populations Eur. Heart J., August 2, 2007; 28(16): 1984 - 1992. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Zhang and S. A. Fisher Conditioning Effect of Blood Flow on Resistance Artery Smooth Muscle Myosin Phosphatase Circ. Res., March 16, 2007; 100(5): 730 - 737. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. P. Gurfinkel, V. S. Lernoud, R. P. Laguens, and R. R. Favaloro Advances in Coronary Heart Disease Surgery in Latin America Circulation, March 6, 2007; 115(9): 1147 - 1153. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. G. Camici and F. Crea Coronary Microvascular Dysfunction N. Engl. J. Med., February 22, 2007; 356(8): 830 - 840. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Y. Wong, A. Kamineni, R. Klein, A. R. Sharrett, B. E. Klein, D. S. Siscovick, M. Cushman, and B. B. Duncan Quantitative Retinal Venular Caliber and Risk of Cardiovascular Disease in Older Persons: The Cardiovascular Health Study Arch Intern Med, November 27, 2006; 166(21): 2388 - 2394. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Westerhof, C. Boer, R. R. Lamberts, and P. Sipkema Cross-talk between cardiac muscle and coronary vasculature. Physiol Rev, October 1, 2006; 86(4): 1263 - 1308. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. K.C. Ng, A. C. Yeung, and W. F. Fearon Invasive Assessment of the Coronary Microcirculation: Superior Reproducibility and Less Hemodynamic Dependence of Index of Microcirculatory Resistance Compared With Coronary Flow Reserve Circulation, May 2, 2006; 113(17): 2054 - 2061. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Y. Wong, W. Rosamond, P. P. Chang, D. J. Couper, A. R. Sharrett, L. D. Hubbard, A. R. Folsom, and R. Klein Retinopathy and Risk of Congestive Heart Failure JAMA, January 5, 2005; 293(1): 63 - 69. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Ensunsa, J. D. Symons, L. Lanoue, H. R. Schrader, and C. L. Keen Reducing Arginase Activity via Dietary Manganese Deficiency Enhances Endothelium-Dependent Vasorelaxation of Rat Aorta Experimental Biology and Medicine, December 1, 2004; 229(11): 1143 - 1153. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. Payne, H.-Y. Zhang, Y. Shirasawa, Y. Koga, M. Ikebe, J. N. Benoit, and S. A. Fisher Dynamic changes in expression of myosin phosphatase in a model of portal hypertension Am J Physiol Heart Circ Physiol, May 1, 2004; 286(5): H1801 - H1810. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. G. Maguire Explaining Gender Differences in Coronary Heart Disease: Hunting for Clues With the Ophthalmoscope Arch Ophthalmol, September 1, 2003; 121(9): 1328 - 1329. [Full Text] [PDF]
|
|
|
|
|
|
J. L. Houghton, D. S. Strogatz, M. T. Torosoff, V. E. Smith, S. A. Fein, P. A. Kuhner, E. F. Philbin, and A. A. Carr African Americans With LVH Demonstrate Depressed Sensitivity of the Coronary Microcirculation to Stimulated Relaxation Hypertension, September 1, 2003; 42(3): 269 - 276. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. F. Fearon, L. B. Balsam, H. M. O. Farouque, R. C. Robbins, P. J. Fitzgerald, P. G. Yock, and A. C. Yeung Novel Index for Invasively Assessing the Coronary Microcirculation Circulation, July 1, 2003; 107(25): 3129 - 3132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Vasan, A. Beiser, R. B. D'Agostino, D. Levy, J. Selhub, P. F. Jacques, I. H. Rosenberg, and P. W. F. Wilson Plasma Homocysteine and Risk for Congestive Heart Failure in Adults Without Prior Myocardial Infarction JAMA, March 12, 2003; 289(10): 1251 - 1257. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K Shimada, Y Sakanoue, Y Kobayashi, S Ehara, M Hirose, Y Nakamura, D Fukuda, H Yamagishi, M Yoshiyama, K Takeuchi, et al. Assessment of myocardial viability using coronary zero flow pressure after successful angioplasty in patients with acute anterior myocardial infarction Heart, January 1, 2003; 89(1): 71 - 76. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Symons, A. E. Mullick, J. L. Ensunsa, A. A. Ma, and J. C. Rutledge Hyperhomocysteinemia Evoked by Folate Depletion: Effects on Coronary and Carotid Arterial Function Arterioscler. Thromb. Vasc. Biol., May 1, 2002; 22(5): 772 - 780. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Y. Wong, R. Klein, A. R. Sharrett, B. B. Duncan, D. J. Couper, J. M. Tielsch, B. E. K. Klein, and L. D. Hubbard Retinal Arteriolar Narrowing and Risk of Coronary Heart Disease in Men and Women: The Atherosclerosis Risk in Communities Study JAMA, March 6, 2002; 287(9): 1153 - 1159. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Prasad, J. P. J. Halcox, M. A. Waclawiw, and A. A. Quyyumi Angiotensin type 1 receptor antagonism reverses abnormal coronary vasomotion in atherosclerosis J. Am. Coll. Cardiol., October 1, 2001; 38(4): 1089 - 1095. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Mohlenkamp, T. R. Behrenbeck, A. Lerman, L. O. Lerman, V. S. Pankratz, P. F. Sheedy II, A. L. Weaver, and E. L. Ritman Coronary Microvascular Functional Reserve: Quantification of Long-term Changes with Electron-Beam CT—Preliminary Results in a Porcine Model Radiology, October 1, 2001; 221(1): 229 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Balaban and A. Arai Function, Metabolic, and Flow Heterogeneity of the Heart : The View Is Getting Better Circ. Res., February 16, 2001; 88(3): 265 - 267. [Full Text] [PDF]
|
|
|
|
|
|
S. Mohlenkamp, L. O. Lerman, A. Lerman, T. R. Behrenbeck, Z. S. Katusic, P. F. Sheedy II, and E. L. Ritman Minimally Invasive Evaluation of Coronary Microvascular Function by Electron Beam Computed Tomography Circulation, November 7, 2000; 102(19): 2411 - 2416. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Schwartzkopff, M. Brehm, M. Mundhenke, and B. E. Strauer Repair of Coronary Arterioles After Treatment With Perindopril in Hypertensive Heart Disease Hypertension, August 1, 2000; 36(2): 220 - 225. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. R. Hellstrom, L. Gregorini, G. Battista Anguissola, J. Marco, I. Marco, M. Bernies, B. Cassagneau, I. M. Bossi, J. Fajadet, T. France, et al. {alpha}-Adrenergic Blockade in Myocardial Infarction • Response Circulation, February 29, 2000; 101 (8): e87 - e88. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Kleen, O. Habler, F. Meisner, G. Kemming, A. Pape, and K. Messmer Effects of primary resuscitation from shock on distribution of myocardial blood flow J Appl Physiol, February 1, 2000; 88(2): 373 - 385. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Prasad, S. Husain, and A. A. Quyyumi Abnormal flow-mediated epicardial vasomotion in human coronary arteries is improved by angiotensin-converting enzyme inhibition: A potential role of bradykinin J. Am. Coll. Cardiol., March 1, 1999; 33(3): 796 - 804. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kleen, M. Welte, P. Lackermeier, O. Habler, G. Kemming, and K. Messmer Myocardial blood flow heterogeneity in shock and small-volume resuscitation in pigs with coronary stenosis J Appl Physiol, December 1, 1997; 83(6): 1832 - 1841. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. K. Bowles, Q. Hu, M. H. Laughlin, and M. Sturek Heterogeneity of L-type calcium current density in coronary smooth muscle Am J Physiol Heart Circ Physiol, October 1, 1997; 273(4): H2083 - H2089. [Abstract] [Full Text] [PDF]
|
|