心内膜与心外膜血供模式 Artery DIASTOLE Vein Artery SYSTOLE Vein 80 4-8→ →0120 20-50 0 0 20 20 Epi Epi 5 5 65 上4 165 大下 10 10 120 11120 Endo 下下 Endo 5-10 mm Hg 120 mm Hg LV cavity LV cavity A B Second Clinical Medical College of Southern Medical University
Second Clinical Medical College of Southern Medical University 心内膜与心外膜血供模式 16
©1997 HeartPoint Aorta 心肌的能量 Left Main Coronary Artery 供给？ Left Circumflex Left M=c*volume Anterior Right Descending Volume=V*S Coronary Time Artery 单位时间内提 供氧能力 Second Clinical Medical College of Southern Medical University
Second Clinical Medical College of Southern Medical University 心肌的能量 供给?? M=c * volume Volume= V*S Time 单位时间内提 供氧能力
冠脉供氧VS.需氧 C. Components of O2 Balance in Myocardium Sympathetic stimulation Coronary dilation (coronary reserve) Hypertension Aortic regurgitation etc. Wall tension K >1/Coronary resistance Prontxr Diastolic O2 supply O2 demand 2Xwall thickness perfusion pressure Heart rate Arterial O2 concentration Contractility↑ Coronary insufficiency 冠脉自我调节功能？ Second Clinical Medical College of Southern Medical University
Second Clinical Medical College of Southern Medical University 冠脉供氧 VS. 需氧 冠脉自我调节功能？
血管活性物质 NO(EDRF) PGI2 TXA ET 使[cGMP]i↑ 使[cAMP]i↑ 使[cAMP]i 使[IP3]i↑ 舒张VSMC 舒张VSMC 促血小板粘聚 强收缩VSMC 抗血小板粘聚 抗血小板粘聚 收缩VSMC 促血小板粘聚 稳定溶酶体膜 增强NO效应 促凝血 增强其它缩血管 抗自由基损伤 抑制ET释放 激活中性粒细胞 物质效应 抑制VSMC增殖 及其效应 释放炎症因子促进VSMC增殖 图2-3血管活性物质间平衡关系 Second Clinical Medical College of Southern Medical University
Second Clinical Medical College of Southern Medical University 血管活性物质
LCA Atherosclerosis 动脉粥样硬化 RCA Second Clinical Medical College of Southern Medical University
Second Clinical Medical College of Southern Medical University