[Adaptation of myocardial function to conditions of myocardial insufficiency in patients with marked coronary arteriosclerosis].

Relationships between myocardial blood flow, myocardial contractility, anaerobic metabolic products, and myocardial oxygen requirement and uptake were investigated in 52 coronary atherosclerotic patients. Myocardial functioning under the conditions of inadequate myocardial perfusion, where blood supply requirement, determined by myocardial activity, exceeds actual magnitude of coronary blood flow, is shown to be basically possible in patients with marked atherosclerosis of coronary arteries. Specific features of myocardial performance under the circumstances are its partially reduced effectiveness and activated anaerobic carbohydrate oxidation pathway, as evidenced by a negative arteriovenous difference between lactic and pyruvic acid levels in blood from the aorta and the coronary sinus.