Document Detail

Porcine coronary collateral formation in the absence of a pressure gradient remote of the ischemic border zone.
MedLine Citation:
PMID:  21398599     Owner:  NLM     Status:  Publisher    
Background: In the current paradigm on coronary collateral development it is assumed that these vessels develop consequentially from increased fluid shear stress (FSS) through pre-existing collateral arteries. The increased FSS follows from an increase in pressure gradient between the region at risk and well perfused surroundings. Objective: To test the hypothesis that in the heart collateral connections can form in the absence of an increased FFS and consequentially at any depth and region within the ventricular wall. Methods and Results: In Yorkshire pigs, gradual left circumflex coronary artery occlusion was obtained over 6 weeks by an ameroid constrictor, whereas the control group underwent a sham operation. Hearts were harvested and subsequently processed in an imaging cryomicrotome resulting in 40 micron voxel resolution 3D reconstructions of the intramural vascular vessels. Dedicated software segmented the intramural vessels and all continuous vascular pathways containing a collateral connection. In the ameroid group 192 collaterals, 23-1049 µm diameter were detected with 62% within the subendocardium. Sixty percent of collaterals bridged from the LAD to LCX. A novel result is that 25% (n=48) of smaller radius collaterals (p=0.047), connected with both origin and terminus in the non-target area where perfusion was assumed uncompromised. Conclusions: In the porcine heart collateral vessels develop not only in ischemic border zones with increased FSS but also away from such border zones where increased FSS is unlikely. The majority of collaterals were located at the subendocardium, corresponding to the region with highest prevalence for ischemia.
Jeroen Phm van den Wijngaard; Henny Schulten; Pepijn van Horssen; Rene D Ter Wee; Maria Siebes; Mark J Post; Jos Ae Spaan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-11
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  -     ISSN:  1522-1539     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Academic Medical Center - University of Amsterdam.
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