DETERMINANTS OF CORONARY COLLATERAL DEVELOPMENT

本申请中描述的研究的具体目的是： (1)确定未成熟冠状动脉侧支循环的功能能力 （无肌层的薄壁血管）冠状动脉造影后即刻 动脉闭塞和闭塞的最初几周内。 (2)确定成熟冠状动脉侧支循环的功能能力 （血管已形成肌壁，并具有自动调节功能） 在冠状动脉闭塞后的几个月内。 (3)确定从未成熟到成熟所需的时间 冠状动脉闭塞后冠状动脉侧支血管的形成。 (4)定量冠状动脉侧支循环的形态学变化 未成熟和成熟形式的血管。 (5)为了确定各种介入治疗对冠状动脉粥样硬化的影响， 侧支循环、局部心肌功能和冠状动脉侧支循环 血管形态测量学 (6)为了确定是否有一个积极的增长过程中的发展， 冠状动脉侧支血管造影。 这些关于冠状动脉功能和结构意义的研究 侧支循环的目的是检查三个假设，即，（一） 当冠状动脉侧支重塑成小动脉或小动脉时， 肌肉动脉，它们变得功能重要;（2）有 冠状动脉闭塞后，有存活功能的组织处于危险中;和（3） 冠状动脉侧支循环的生长速度， 危险床和危险床中的活功能组织的量 冠状动脉闭塞后，通过运动和药物增强。

The specific aims of the research described in this application are: (1) To determine the functional capacity of immature coronary collaterals (thinwalled vessels without muscular coats) immediately after coronary artery occlusion and during the first few weeks of occlusion. (2) To determine the functional capacity of mature coronary collaterals (vessels that have developed a muscular wall and have autoregulatory capacity) during the months after coronary artery occlusion. (3) To determine the time necessary for development from immature to mature forms of coronary collateral vessels after the onset of coronary occlusion. (4) To quantitate the morphologic changes occurring in coronary collateral vessels in both immature and mature forms. (5) To determine the effects of various interventions on coronary collateral flow, regional myocardial function and coronary collateral vessel morphometry. (6) To determine if there is an active growth process in the development of coronary collateral vessels using triated thymidine. These studies of the functional and structural significance of the coronary collateral circulation are designed to examine three hypotheses, i.e., (1) when coronary collaterals remodel themselves into arterioles or small muscular arteries, they becomes functionally significant; (2) there is viable functional tissue in bed at risk after coronary occlusion; and (3) the rate of growth of coronary collaterals, the mechanical function of the bed at risk and the amount of viable functional tissue in the bed at risk after coronary occlusion are augmented by exercise and drugs.