Control of coronary blood flow during exercise

Johnathan Tune, Keith Neu Richmond, Mark W. Gorman, Eric O. Feigl

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Under normal physiological conditions, coronary blood flow is closely matched with the rate of myocardial oxygen consumption. This matching of flow and metabolism is physiologically important due to the limited oxygen extraction reserve of the heart. Thus, when myocardial oxygen consumption is increased, as during exercise, coronary vasodilation and increased oxygen delivery are critical to preventing myocardial underperfusion and ischemia. Exercise coronary vasodilation is thought to be mediated primarily by the production of local metabolic vasodilators released from cardiomyocytes secondary to an increase in myocardial oxygen consumption. However, despite various investigations into this mechanism, the mediator(s) of metabolic coronary vasodilation remain unknown. As will be seen in this review, the adenosine, K+ATP channel and nitric oxide hypotheses have been found to be inadequate, either alone or in combination as multiple redundant compensatory mechanisms. Prostaglandins and potassium are also not important in steady-state coronary flow regulation. Other factors such as ATP and endothelium-derived hyperpolarizing factors have been proposed as potential local metabolic factors, but have not been examined during exercise coronary vasodilation. In contrast, norepinephrine released from sympathetic nerve endings mediates a feed-forward β-adrenoceptor coronary vasodilation that accounts for -25% of coronary vasodilation observed during exercise. There is also a feed-forward α-adrenoceptor-mediated vasoconstriction that helps maintain blood flow to the vulnerable subendocardium when heart rate, myocardial contractility, and oxygen consumption are elevated during exercise. Control of coronary blood flow during pathophysiological conditions such as hypertension, diabetes mellitus, and heart failure is also addressed.

Original languageEnglish (US)
Pages (from-to)238-250
Number of pages13
JournalExperimental Biology and Medicine
Volume227
Issue number4
StatePublished - Apr 2002
Externally publishedYes

Fingerprint

Vasodilation
Blood
Oxygen
Oxygen Consumption
Adrenergic Receptors
Adenosine Triphosphate
Nerve Endings
Medical problems
Vasoconstriction
Vasodilator Agents
Cardiac Myocytes
Metabolism
Adenosine
Prostaglandins
Endothelium
Myocardial Ischemia
Norepinephrine
Diabetes Mellitus
Potassium
Nitric Oxide

Keywords

  • α-adrenoceptor vasoconstriction
  • β-feed-forward vasodilation
  • Adenosine
  • K channels
  • Nitric oxide

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Tune, J., Richmond, K. N., Gorman, M. W., & Feigl, E. O. (2002). Control of coronary blood flow during exercise. Experimental Biology and Medicine, 227(4), 238-250.

Control of coronary blood flow during exercise. / Tune, Johnathan; Richmond, Keith Neu; Gorman, Mark W.; Feigl, Eric O.

In: Experimental Biology and Medicine, Vol. 227, No. 4, 04.2002, p. 238-250.

Research output: Contribution to journalArticle

Tune, J, Richmond, KN, Gorman, MW & Feigl, EO 2002, 'Control of coronary blood flow during exercise', Experimental Biology and Medicine, vol. 227, no. 4, pp. 238-250.
Tune J, Richmond KN, Gorman MW, Feigl EO. Control of coronary blood flow during exercise. Experimental Biology and Medicine. 2002 Apr;227(4):238-250.
Tune, Johnathan ; Richmond, Keith Neu ; Gorman, Mark W. ; Feigl, Eric O. / Control of coronary blood flow during exercise. In: Experimental Biology and Medicine. 2002 ; Vol. 227, No. 4. pp. 238-250.
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