ReviewBasic research in cardiology2014
The role of capillary transit time heterogeneity in myocardial oxygenation and ischemic heart disease.
Review in Basic research in cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers.
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Who cites it
40 citing papers in PubMed, 70 citations in OpenAlex.
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- Myocardial ischemia: no supply/demand mismatch but reduced blood flow per beat.Basic research in cardiology · 2026Review
- Coronary microvascular dysfunction is a determinant of perfusion-contraction matching during ischemia.Basic research in cardiology · 2026Article
- Underrecognized Interaction Between PICO Dressings and Pacemakers: A Case From the ICU.Case reports in anesthesiology · 2026Article
- No-Reflow During Coronary Interventions: A Narrative Review.Journal of clinical medicine · 2025Review
- Vascular (dys)function in the failing heart.Nature reviews. Cardiology · 2025Review
- Molecular Mechanisms of Microvascular Obstruction and Dysfunction in Percutaneous Coronary Interventions: From Pathophysiology to Therapeutics-A Comprehensive Review.International journal of molecular sciences · 2025Review
- Pericytes and Diabetic Microangiopathies: Tissue Resident Mesenchymal Stem Cells with High Plasticity and Regenerative Capacity.International journal of molecular sciences · 2025Review
- The role of coronary microcirculation in heart failure with preserved ejection fraction: An unceasing odyssey.Heart failure reviews · 2025Review
- Heterogeneity of coronary vascular function and myocardial oxygenation in women with angina and non-obstructive coronary artery disease.European heart journal. Cardiovascular Imaging · 2024Article
- Mechanisms of coronary sinus reducer for treatment of myocardial ischemia: in silico study.Journal of applied physiology (Bethesda, Md. : 1985) · 2024Article
- Simulation of coronary capillary transit time based on full vascular model of the heart.Computer methods and programs in biomedicine · 2024Article
- Coronary No-Reflow after Primary Percutaneous Coronary Intervention-Current Knowledge on Pathophysiology, Diagnosis, Clinical Impact and Therapy.Journal of clinical medicine · 2023Review
- Red Blood Cell Partitioning Using a Microfluidic Channel with Ladder Structure.Micromachines · 2023Article
- A local-saturation-and-delay MRI method for evaluation of red blood cells aggregationFrontiers in bioengineering and biotechnology · 2023Article
- The coronary capillary bed and its role in blood flow and oxygen delivery: A review.Anatomical record (Hoboken, N.J. : 2007) · 2022Review
- Can EAT be an INOCA goalkeeper.Frontiers in endocrinology · 2022Review
- Empagliflozin inhibits coronary microvascular dysfunction and reduces cardiac pericyte loss in db/db mice.Frontiers in cardiovascular medicine · 2022Article
- Elucidating the combined effect of intermittent hypoxia training and acetazolamide on hypoxia induced hematological and physiological changes.Current research in physiology · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Ischemic heart disease (IHD) is characterized by an imbalance between oxygen supply and demand, most frequently caused by coronary artery disease (CAD) that reduces myocardial perfusion. In some patients, IHD is ascribed to microvascular dysfunction (MVD): microcirculatory disturbances that reduce myocardial perfusion at the level of myocardial pre-arterioles and arterioles. In a minority of cases, chest pain and reductions in myocardial flow reserve may even occur in patients without any other demonstrable systemic or cardiac disease. In this topical review, we address whether these findings might be caused by impaired myocardial oxygen extraction, caused by capillary flow disturbances further downstream. Myocardial blood flow (MBF) increases approximately linearly with oxygen utilization, but efficient oxygen extraction at high MBF values is known to depend on the parallel reduction of capillary transit time heterogeneity (CTH). Consequently, changes in capillary wall morphology or blood viscosity may impair myocardial oxygen extraction by preventing capillary flow homogenization. Indeed, a recent re-analysis of oxygen transport in tissue shows that elevated CTH can reduce tissue oxygenation by causing a functional shunt of oxygenated blood through the tissue. We review the combined effects of MBF, CTH, and tissue oxygen tension on myocardial oxygen supply. We show that as CTH increases, normal vasodilator responses must be attenuated in order to reduce the degree of functional shunting and improve blood-tissue oxygen concentration gradients to allow sufficient myocardial oxygenation. Theoretically, CTH can reach levels such that increased metabolic demands cannot be met, resulting in tissue hypoxia and angina in the absence of flow-limiting CAD or MVD. We discuss these predictions in the context of MVD, myocardial infarction, and reperfusion injury.
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