This paper discusses three specific aspects of coronary circulation as they relate to the patient with coronary artery disease. Firstly, the normal autoregulatory and metabolic control of the coronary circulation is considered in the light of current understanding of the relevant processes. Secondly, the implications of microcirculatory heterogeneities are discussed. Thirdly, the implications of the current debate on the impact of cardiac contraction for our understanding of the perfusion of the myocardium in compromised circumstances are analysed in an attempt to provide the clinician with a tool for assessing current therapy.
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http://dx.doi.org/10.1111/j.0954-6820.1985.tb08796.x | DOI Listing |
Circ J
January 2025
Department of Frontier Cardiovascular Science, Graduate School of Medicine, The University of Tokyo.
Background: Comprehensive management of acute coronary syndrome (ACS) requires seamless treatment across institutions, including intensive care centers and local clinics. However, maintaining guideline-directed medical therapy remains challenging. One promising option to improve the situation may be the implementation of regional collaborative clinical pathways.
View Article and Find Full Text PDFJACC Cardiovasc Interv
January 2025
Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA; Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA. Electronic address:
JACC Cardiovasc Interv
January 2025
Department of Cardiology of The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, China. Electronic address:
Background: The association between coronary microcirculation and clinical outcomes in patients with intermediate stenosis remains unclear.
Objectives: The aim of this study was to assess the prognostic significance of angiography-derived index of microcirculatory resistance (angio-IMR) in patients with intermediate coronary stenosis.
Methods: This post hoc analysis included 1,658 patients from the FLAVOUR (Fractional Flow Reserve and Intravascular Ultrasound for Clinical Outcomes in Patients with Intermediate Stenosis) trial, with angio-IMR measured in each vessel exhibiting intermediate stenosis.
Eur Heart J Acute Cardiovasc Care
January 2025
Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT.
Background: In acute coronary syndrome, ST-segment elevation in lead aVR (STE-aVR) indicates global myocardial ischemia, often related to multivessel or severe left main disease, and correlates with increased mortality. The prevalence and prognostic significance of STE-aVR in cardiac arrest (CA) patients is unknown.
Methods: We identified patients (≥18 years) with CA between 2011 to 2022 who achieved return of spontaneous circulation (ROSC).
Circulation
January 2025
Divisions of Cardiac Surgery (H.T., A.Q., R.E., R.V., M.M., J.H.C., S.V.), Li Ka Shing Knowledge Institute, St. Michael's Hospital of Unity Health Toronto, Ontario, Canada.
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