CORONARY MICROCIRCULATION IN HEALTH AND DISEASE - SUMMARY OF AN NHLBIWORKSHOP

This article summarizes a 2-day workshop on the coronary microcirculat ion held in Bethesda, Md, in September 1994 and sponsored by the Natio nal Heart, Lung, and Blood Institute of the National Institutes of Hea lth. The workshop explored a variety of topics pertaining to coronary microvascular physiology and pathophysiology. The latest methodologies that are brine used to investigate the coronary microvasculature, inc luding endoscopic microscopy of the intramural coronary microvasculatu re and micro-x-ray computerized tomography, were discussed. The most r ecent advances in the regulation of the coronary microcirculation-for example, myogenic and flow-dependent responses. K-ATP channels. and re gional heterogeneity-were reported. The workshop touched on the relati on of the microcirculation to clinically important conditions and offe red recommendations for future research in this important area. Compar isons are made to recent advances in the peripheral circulation and cu rrent. gaps in our knowledge concerning the coronary microcirculation. In recent years, research on the coronary microcirculation has made s ubstantial advances, in part as a result of investigations in the peri pheral microcirculation but also because of the application of unique methodologies. This research is providing new ways to investigate abno rmalities of myocardial perfusion, an area of inquiry that until recen tly has been limited to examination of coronary pressure-flow relation ships.