Matching coronary blood flow to myocardial oxygen consumption

Johnathan Tune, Mark W. Gorman, Eric O. Feigl

Research output: Contribution to journalArticle

205 Citations (Scopus)

Abstract

At rest the myocardium extracts ∼75% of the oxygen delivered by coronary blood flow. Thus there is little extraction reserve when myocardial oxygen consumption is augmented severalfold during exercise. There are local metabolic feedback and sympathetic feedforward control mechanisms that match coronary blood flow to myocardial oxygen consumption. Despite intensive research the local feedback control mechanism remains unknown. Physiological local metabolic control is not due to adenosine, ATP-dependent K+ channels, nitric oxide, prostaglandins, or inhibition of endothelin. Adenosine and ATP-dependent K+ channels are involved in pathophysiological ischemic or hypoxic coronary dilation and myocardial protection during ischemia. Sympathetic β-adrenoceptor-mediated feedforward arteriolar vasodilation contributes ∼25% of the increase in coronary blood flow during exercise. Sympathetic α-adrenoceptor-mediated vasoconstriction in medium and large coronary arteries during exercise helps maintain blood flow to the vulnerable subendocardium when cardiac contractility, heart rate, and myocardial oxygen consumption are high. In conclusion, several potential mediators of local metabolic control of the coronary circulation have been evaluated without success. More research is needed.

Original languageEnglish (US)
Pages (from-to)404-415
Number of pages12
JournalJournal of Applied Physiology
Volume97
Issue number1
DOIs
StatePublished - Jul 2004
Externally publishedYes

Fingerprint

Oxygen Consumption
Adenosine
Adrenergic Receptors
Adenosine Triphosphate
Coronary Circulation
Endothelins
Vasoconstriction
Research
Vasodilation
Prostaglandins
Dilatation
Coronary Vessels
Myocardium
Nitric Oxide
Ischemia
Heart Rate
Oxygen

Keywords

  • Adenosine
  • ATP-dependent K channels
  • Feedback control
  • Feedforward control
  • Nitric oxide
  • Norepinephrine

ASJC Scopus subject areas

  • Physiology
  • Endocrinology
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Matching coronary blood flow to myocardial oxygen consumption. / Tune, Johnathan; Gorman, Mark W.; Feigl, Eric O.

In: Journal of Applied Physiology, Vol. 97, No. 1, 07.2004, p. 404-415.

Research output: Contribution to journalArticle

Tune, Johnathan ; Gorman, Mark W. ; Feigl, Eric O. / Matching coronary blood flow to myocardial oxygen consumption. In: Journal of Applied Physiology. 2004 ; Vol. 97, No. 1. pp. 404-415.
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