by JULIEN IE HOFFMAN One of the earliest coronary physiologists was
Scaramucci who, in 1695, postu- lated that during systole the
contracting myocardium inhibited coronary blood flow. Since then, the
many contributions that have been made to our knowledge of the coronary
circulation can be arbitrarily divided into three phases based on
advances in technical methods. The early phase of research into the
coronary circulation, done with great difficulty with crude methods, may
be regarded as ending in the 1940s, and it included major discoveries
made by such well known investigators as Georg von Anrep, Ernest
Starling, Carl Wiggers, and Louis Katz, who formulated much of our basic
understanding of the field. After 1940, the field of coronary physiology
entered a new phase when instruments for high fidelity registration of
coronary flow and pressure became available. This era was domi- nated by
Donald Gregg who combined careful attention to the function of these
instruments (some of which he helped to develop) with an extraordinary
ability to discern mechanisms from apparently minor changes in coronary
flow and pressure patterns. His book 'The Coronary Circulation in Health
and Disease' set a new standard in the field. After 1960, techniques for
measuring regional myocardial blood flow became available, and enabled a
large group of eminent investigators to make major advances in
understanding the physiology and pathophysiology of myocardial blood
flow.