Coronary collateral growth--back to the future.
Coronary collateral growth--back to the future.
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DOI：
10.1016/j.yjmcc.2011.12.006
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发表时间：
2012-04
影响因子：
5
通讯作者：
Yin L
中科院分区：
文献类型：
--
作者：
Chilian WM;Penn MS;Pung YF;Dong F;Mayorga M;Ohanyan V;Logan S;Yin L
冠脉侧支循环作为心脏的一种适应机制，对于防止缺血损伤具有重要意义。在它们的天然状态下，心脏中的侧支被归类为微循环的一部分，以动脉-动脉吻合连接的形式存在，直径在30到100μM之间。然而，这些血管也表现出重塑为大循环组成部分的倾向，并可以成为直径超过1000μM的动脉。这种向外重构的过程在心脏对缺血的适应中至关重要，因为血流阻力与血管直径的四次方成反比。因此，将容器从100μM扩大到1000 M时，将把阻力(在回路的这一部分)减少到可以忽略不计的程度，并使流量能够输送到危险区域。我们在这篇综述中的目标是强调在理解这种对缺血的适应-冠脉侧支循环的增长方面的空白。在此过程中，我们讨论了刺激侧支循环增长的原因因素的争议和未知方面，遗传学的作用，以及内源性干细胞和祖细胞在正常、生理情况下以及在缺血性心脏病的更多病理条件下或与一些潜在的危险因素(如糖尿病)的作用。这篇综述的主要结论是，我们对冠状动脉侧支循环生长的了解存在许多空白，在实现刺激患者心脏侧支循环的潜力之前，这一知识是至关重要的。
The coronary collateral circulation is critically important as an adaptation of the heart to prevent the damage from ischemic insults. In their native state, collaterals in the heart would be classified as part of the microcirculation, existing as arterial-arterial anastomotic connections in the range of 30 to 100 μM in diameter. However, these vessels also show a propensity to remodel into components of the macrocirculation and can become arteries larger than a 1000 μM in diameter. This process of outward remodelling is critically important in the adaptation of the heart to ischemia because the resistance to blood flow is inversely related to the fourth power of the diameter of the vessel. Thus, an expansion of a vessel from 100 to 1000 μM would reduce resistance (in this part of the circuit) to a negligible amount and enable delivery of flow to the region at risk. Our goal in this review is to highlight the voids in understanding this adaptation to ischemia—the growth of the coronary collateral circulation. In doing so we discuss the controversies and unknown aspects of the causal factors that stimulate growth of the collateral circulation, the role of genetics, and the role of endogenous stem and progenitor cells in the context of the normal, physiological situation and under more pathological conditions of ischemic heart disease or with some of the underlying risk factors, e.g., diabetes. The major conclusion of this review is that there are many gaps in our knowledge of coronary collateral growth and this knowledge is critical before the potential of stimulating collateralization in the hearts of patients can be realized.
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DOI：
10.1161/atvbaha.109.186189
发表时间：
2009-06
期刊：
Arteriosclerosis, thrombosis, and vascular biology
影响因子：
--
作者：
Belmadani S;Matrougui K;Kolz C;Pung YF;Palen D;Prockop DJ;Chilian WM
通讯作者：
Chilian WM
影响因子：
20.1
作者：
Agarwal, Udit;Ghalayini, Wael;Penn, Marc S.
通讯作者：
Penn, Marc S.
影响因子：
2.7
作者：
Fujita, M;Nakae, I;Sasayama, S
通讯作者：
Sasayama, S
影响因子：
168.9
作者：
Askari, AT;Unzek, S;Penn, MS
通讯作者：
Penn, MS
影响因子：
56.9
作者：
DAMERON, KM;VOLPERT, OV;BOUCK, N
通讯作者：
BOUCK, N