Microcirculation of the Heart

A. Physiological, Biochemical and Morphological Aspects.- 1. The Arterial Wall - Transport Properties.- Discussion.- 2. Morphology of the Myocardial Microcirculation.- Discussion.- 3. Flow Properties of the Blood.- 3.1 Flow Properties of the Blood: Erythrocytes.- 3.2 Platelets in the Haemostatic Process.- Discussion.- 3.3 Platelet Vessel Wall Interaction in Coronary Artery Disease.- Discussion.- 4. Coronary Microcirculation.- 4.1 Extravascular and Intravascular Resistance.- 4.1.1 The Effect of Increases in Cardiac Oxygen Need on Adenosine Formation and Coronary Blood Flow in the Steady State and During the Cardiac Cycle 39.- 4.1.2 Sites of Adenosine Formation in the Heart During Hypoxia.- 4.2 Flow in the Terminal Vascular Bed of the Myocardium.- 4.2.1 Methods for the Direct Evaluation of the Terminal Vascular Bed of the Yen tricular Myocardium.- 4.2.2 Pressures and Dimensions in the Terminal Vascular Bed of the Myocardium Determined by an New Free-Motion Technique.- 4.2.3 Patterns of Regional Blood Flow Following Reperfusion of Ischemic Myocardium.- Discussion.- 5. Changes in Capillary Permeability.- 5.1 Changes in Capillary Fine Structure and Function in Acute Myocardial Ischemic Injury.- Discussion.- 5.2 Microcirculatory Impairment Follwing Transient Myocardial Ischemia.- 5.3 Endothelial Diffusion Limitation of Cardiac Substrate Supply and Transport Mechanismus Supporting Substrate Exchange.- Discussion.- 5.4 Myocardial Capillary Recruitment Studied by Indicator Dilution Curves.- Discussion.- 6. Oxygen and Substrate Supply of the Myocardium.- 6.1 Oxygen.- 6.1.1 Oxygen Supply to the Myocardium.- 6.2 Substrates.- 6.2.1 Substrate Delivery in Ischemic Myocardium.- Discussion.- 6.2.2 Pyruvate Oxidation in the Hemoglobin-Free Perfused Guinea Pig Heart: Effects of Pressure, Work, and Noradrealine.- 6.2.3 Metabolic Changes in the Ischemic Myocardium. A Tool for Detection and Quantification of Ischemic Areas in the Heart?.- B. Clinical Implication of Disturbances in Coronary Microcirculation.- 1. Pathophysiology.- 1.1 Microcirculatory Determinants of Infarct Dimensions.- 1.2 The Three-Dimensional Geometry of Regional Myocardial Ischemia: The Role of the Coronary Microcirculation in Determining Patterns of Injury.- Discussion.- 2. Diagnosis - Methods for Evaluating Myocardial Microcirculation in Patients.- Discussion.- 2.2 Assessment of Regional Myocardial Perfusion.- 2.2.1 N-13 Ammonia for the Noninvasive Evaluation of Myocardial Blood Flow by Positron Emission Computed Tomography.- Discussion.- 2.2.3 The Relationship Between Coronary Artery Disease, Myocardial Ischemia and Angina.- 2.3 Relative Regional Fractional Myocardial Oxygen Extraction in Dogs Using Oxygen-15-Water and Either Oxygen-15 Deoxyhemoglobin or Oxygen-15-0xyhemoglobin.- Discussion.- 2.4 Noninvasive Measurement of Regional Myocardial Glucose Metabolism by Positron Emission Computed Tomography.- Discussion.- 2.5 Regional Myocardial Metabolism of Free Fatty Acids.- C. Clinical Manifestations in Disturbance of Coronary Microcirculation.- 1. Small Vessel Disease.- 1.1 Morphology.- 1.1.1 Small Vessel Disease, Morphology.- Discussion.- 1.2 Clinical Diagnosis.- 1.1.2 Structural Changes of the Coronary Microcirculation Coarctation of the Aorta.- Discussion.- 1.2.1 Clinical Diagnosis of Small Vessel Disease.- 1.2.2 Coronary Hemodynamics in Systemic Arteriopathies.- Discussion.- 2. Syndrome X.- 2.1 Morphology.- 2.1.1 Morphology of Heart Muscle Cells and Myocardial Microcirculature in Patients with Angina Pectoris but Normal Coronary Arteries (Syndrome X).- 2.1.2 Studies in Patients with Abnormal Electrocardiogram of Unknown Etiology 288 288.- 2.2 Clinical Diagnosis.- 2.2.1 Reduced Coronary Reserve and Impaired Exercise Left Ventricular Performance in Patients with Syndrome X.- Discussion.- D. Therapeutic Implications.- 1. Effect of Drugs on Myocardial Microcirculation.- 1.1 The Effect of Coronary Vasodilators on the Microcirculation of the Ventricular Myocardium.- Discussion.-