CORONARY COLLATERAL DEVELOPMENT IN SWINE AFTER CORONARY-ARTERY OCCLUSION
CORONARY COLLATERAL DEVELOPMENT IN SWINE AFTER CORONARY-ARTERY OCCLUSION
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DOI：
10.1161/01.res.71.6.1490
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发表时间：
1992-12-01
影响因子：
20.1
通讯作者：
BLOOR, CM
中科院分区：
文献类型：
--
作者：
WHITE, FC;CARROLL, SM;BLOOR, CM
我们量化了猪冠状动脉侧枝循环的发展。侧枝循环是通过在左旋冠状动脉上放置一个ameroid闭塞器来诱导生长的。ameroid放置后2至16周，冠状动脉和主动脉注射几种颜色的有机硅聚合物后，可以确定冠状动脉侧枝循环。我们确定了冠状动脉间支和心外支，并量化了它们的数量、位置、大小和壁厚。在静止状态下，冠状动脉间侧支血流量增加到正常侧支血流量的14倍，这与没有冠状动脉闭塞的动物相比。心外侧枝可能提供大约30%的静息血流。心外侧枝的来源是支气管动脉和乳腺内动脉。同时检测了猪心脏冠状动脉侧枝形态和DNA合成。冠状动脉侧枝的平滑肌明显少于正常小动脉。这可能部分解释了冠状动脉侧枝对血管扩张剂反应降低的原因。我们观察到内皮细胞和平滑肌细胞在缺血的前2或3周内强烈的DNA合成。然而，DNA合成在这段时间后迅速停止，与冠状动脉侧枝储备值（最大血管舒张期间的缺血/非缺血区域血流量比）达到最大水平一致。这表明血管继续增殖的失败是血流量水平停滞的原因。
We have quantified the development of the coronary collateral circulation in the pig. The collateral circulation was induced to grow by placing an ameroid occluder on the left circumflex coronary artery. Two to 16 weeks after ameroid placement, the coronary collateral circulation was identified after the injection of several colors of a silicone polymer into the coronary arteries and the aorta. We identified intercoronary and extracardiac collaterals and quantified their number, location, size, and wall thickness. Intercoronary collaterals grew to a level that represents a 14-fold increase in normal collateral blood flow under resting conditions compared with the values in an animal not subjected to coronary artery occlusion. Extracardiac collaterals could potentially supply approximately 30% of resting flow. The sources of the extracardiac collaterals were the bronchial and internal mammary arteries. Coronary collateral morphometry and DNA synthesis in the pig heart also were examined. Coronary collaterals had significantly less smooth muscle than did normal arterioles. This may account, in part, for the reduced response of the coronary collaterals to vasodilators. We observed intense DNA synthesis in endothelial and smooth muscle cells in the first 2 or 3 weeks of ischemia. However, DNA synthesis rapidly ceased after this time, coincident with coronary collateral reserve values (ischemic/nonischemic regional blood flow ratios during maximal vasodilation) reaching their maximum level. This suggests that failure of the vessels to continue proliferating accounts for the occurrence of the plateau in blood flow levels.