Coronary oxygen uptake (${\dot{V}}_{{\mathrm{O}}_2}$)

Coronary oxygen uptake is the net rate at which a specified myocardial region removes oxygen from its supplying blood. For matched inflow and outflow with negligible oxygen storage change, the regional Fick principle balance isHere $Q$ is volume flow, $C_a$ arterial oxygen content and $C_v$ venous oxygen content. The arteriovenous oxygen content difference measures removal per blood volume; multiplying by flow gives removal per time.

In an original example, $Q=250\mathrm{mL}\mathrm{mi}{\mathrm{n}}^{-1}$, $C_a=0.20$ and $C_v=0.08\mathrm{mL}{\mathrm{O}}_2\mathrm{m}{\mathrm{L}}^{-1}$ give uptake $30\mathrm{mL}{\mathrm{O}}_2\mathrm{mi}{\mathrm{n}}^{-1}$. Coronary oxygen delivery is instead $Q{C}_a=50$ in the same amount-per-time units. The remaining oxygen leaves in the venous outflow.

The complete control-volume statement makes the assumptions explicit:where $M_{{\mathrm{O}}_2}$ is stored oxygen in the represented region. If input and output carry $50$ and $20\mathrm{mL}{\mathrm{O}}_2\mathrm{mi}{\mathrm{n}}^{-1}$, while storage increases at $5$, tissue uptake is $25$, not $30$. Thus an inflow–outflow difference during accumulation is not automatically a steady metabolic rate.

The required quantities also come from different observations. The primary coronary thermodilution study estimated volumetric flow using saline infusion and pressure/temperature sensing.^[ref] A separate primary whole-blood oximeter used red and infrared illumination, a photodetector and computation to obtain hemoglobin concentration and saturation.^[ref] Neither instrument alone supplies every term of the balance.

Territory matching is essential. A flow measured in one coronary branch and a venous mixture draining a different region need not define that branch's oxygen uptake. Sampling time, represented tissue, measurement units and storage assumptions must accompany the numerical result.