Hemodynamic Factors Influencing Regional Ischemia and Infarction of the Myocardium: Difference Between Right and Left Ventricular Myocardial Infarction
The limitations of myocardial infarct size have been studied both experimentally and clinically [1, 2]. Infarct size depends on the size of the area at risk or the extent of perfusion in the occluded vessel [3, 4]. The infarcted area inside the risk area is modified by collateral blood flow [5, 6], timing of reperfusion , and hemodynamic factors which determine the level of myocardial oxygen consumption [8, 9]. Myocardial perfusion through the preexisting collateral channels is often inadequate to the extent that myocardial necrosis is virtually a foregone conclusion . Thus, myocardial necrosis begins approximately 20 min after coronary occlusion and spreads as a “wavefront” from the endocardium to epicardium with increasing duration of ischemia . These concepts were derived from studies on the occlusion of a branch of the left coronary artery in a canine model. The potential applicability of these concepts in the right ventricle was not received full approval.
KeywordsLeft Ventricle Infarct Size Myocardial Blood Flow Risk Area Myocardial Necrosis
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