The pathophysiology of chronic ischemic heart disease

Abstract

SummaryWith our success in management of acute coronary syndromes (ACS), aging population and epidemics of diabetes and obesity, the management of patients with chronic coronary artery disease is becoming an increasing important part of clinical practice. Although the rates of death and myocardial infarction (MI) in this group of patients are not high as a group, a subgroup has very high risk but many have poor quality of life related to limiting angina. The purpose of this article is to review the pathophysiology of the chronic angina syndrome to provide an improved understanding of the basis for the comprehensive management required to yield patient benefits. Where possible, targets for novel therapeutic approaches are highlighted.

ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly

“…118 Stiffening of the aorta also negatively influences myocardial perfusion. 119 Because oxygen extraction from blood perfusing myocardium is very high, an increase in myocardial oxygen supply can only be met by an increase in coronary flow. Because most (Ͼ80%) myocardial blood flow occurs in diastole, central aortic DBP amplitude and duration of diastole are the principal noncoronary determinants of myocardial perfusion.…”

ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly

“…Stiffening of the aorta also negatively influences myocardial perfusion (119). Because oxygen extraction from blood perfusing myocardium is very high, an increase in myocardial oxygen supply can only be met by an increase in coronary flow.…”

Sevoflurane post-conditioning protects isolated rat hearts against ischemia-reperfusion injury via activation of the ERK1/2 pathway

“…The prevalence of ischemic heart diseases (IHDs) is continuously increasing around the world [1,2] . Patients suffering from these diseases are often at increased risk of myocardial I/R injury, which is an important reason for increasing perioperative complications and mortality [3] .…”