Heart 2008;94:1545-1547
VIEWPOINT
What is the role of the aorta in directing coronary blood flow?
1 International Centre for Circulatory Health, Imperial College Healthcare NHS Trust, St Mary’s Hospital Campus, London, UK
2 Physiological Flow Unit, Department of Bioengineering, Imperial College London, London, UK
Dr J E Davies, International Centre for Circulatory Health, Imperial College Healthcare NHS Trust, St Mary’s Hospital Campus, 59–61 North Wharf Road, Paddington, London, W2 1LA, UK; coronarywia@heart123.com
Accepted 10 June 2008
| The first 150 words of the full text of this article appear below. |
Paradoxically the heart, which is solely dedicated to supplying blood to the organs, restricts its own blood supply during peak contraction (fig 1). To overcome this restriction, the heart has numerous mechanisms which delicately balance the blood flow demands of the systemic and coronary circulation.
Figure 1 Striking difference in the flow velocity waveform between the proximal aorta (A) and the biphasic coronary artery (B), despite almost identical pressure waveforms.
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Scaramucci was the first to consider the effects that the contracting heart had on coronary arteries and on coronary blood flow in 1696.1 However, it was more than 250 years later that Gregg and Sabiston reported experimental evidence in a landmark paper which described phasic coronary flow.2 They described how the contracting heart muscle behaves as a "throttling mechanism and impedes coronary flow" by compression of the myocardial vascular bed.
While this work clearly demonstrated that coronary blood flow was
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