“…Similarly, myocardial lowfl ow perfusion or hypoxia has been shown to decrease spatial blood fl ow heterogeneity, suggesting a mechanism for more effi cient oxygen delivery to the myocardial regions in response to decreased oxygen supply. 18,19 Both increased workload and decreased oxygen supply are considered to induce vascular adaptation processes for more homogenous regional blood fl ow to reduce mismatch between oxygen supply and consumption (i.e., intracellular dysoxia). Metabolically, Ince et al have demonstrated, using an NADH fl uorescence image technique, that the NADH/NAD + redox state (an indicator of the balance between oxygen supply and consumption) exhibited a large increase in its spatial heterogeneity during the conditions of reoxygenation after hypoxia or increased heart rate and that the heterogeneity pattern of NADH fl uorescence was similar in both conditions, 20 suggesting that at the capillary level, there are certain areas (called "microcirculatory weak units") predisposed to become dysoxic fi rst when exposed to decreased oxygen supply or increased oxygen demand.…”