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Related Experiment Videos

Interaction between Gregg's phenomenon and coronary flow control: a model study.

J Dankelman1, H G Stassen, J A Spaan

  • 1Man-Machine Systems and Control Group, Faculty of Design, Engineering and Production, Delft University of Technology, The Netherlands. j.dankelman@wbmt.tudelft.nl

Medical & Biological Engineering & Computing
|March 21, 2000
PubMed
Summary

Coronary perfusion pressure influences coronary flow by affecting arterial resistance and oxygen consumption. Their interaction, crucial for heart function, reveals a competitive relationship in regulating blood flow.

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Area of Science:

  • Cardiovascular Physiology
  • Hemodynamics
  • Myocardial Metabolism

Background:

  • Coronary perfusion pressure (Pp) critically influences coronary arterial resistance (Ra) via autoregulation and myocardial oxygen consumption (MVO2) through Gregg's phenomenon.
  • Understanding the interplay between Pp, Ra, and MVO2 is essential for comprehending coronary blood flow regulation.

Purpose of the Study:

  • To investigate the interaction between coronary perfusion pressure and myocardial oxygen consumption in controlling coronary blood flow.
  • To analyze how autoregulation and Gregg's phenomenon compete in coronary flow regulation using a mathematical model.

Main Methods:

  • Development and analysis of a coronary flow control model.
  • Simulation of pressure-flow dynamics under varying conditions of autoregulation and Gregg's sensitivity.

Related Experiment Videos

  • Experimental validation using glibenclamide to assess its impact on coronary flow dynamics.

    • Main Results:

    • Model predictions indicate that the pressure-flow ratio's response to Pp changes depends on tone sensitivity (Ra to oxygen) and Gregg's sensitivity (MVO2 to capillary pressure).
    • High tone sensitivity diminishes Gregg's effect, while high Gregg's sensitivity attenuates autoregulation.
    • Glibenclamide experiments showed a fourfold deceleration in the pressure-flow ratio response, consistent with a tenfold reduction in the rate of change of Ra, attributed to feedback loop interactions.

    Conclusions:

    • Coronary autoregulation and Gregg's phenomenon act antagonistically, competing to control coronary blood flow.
    • The model elucidates the complex feedback mechanisms governing coronary circulation.
    • Pharmacological interventions can modulate the balance between these competing regulatory mechanisms.