Downstream Influence of Coronary Stenoses on Microcirculatory Remodeling: A Histopathology Study.
Arterioscler Thromb Vasc Biol
; 40(1): 230-238, 2020 01.
Article
en En
| MEDLINE
| ID: mdl-31665906
ABSTRACT
OBJECTIVE:
Inducible myocardial ischemia is influenced by contributions of both the epicardial artery and the coronary microcirculation. Experimental studies have found adverse microcirculatory remodeling to occur downstream of severe coronary stenoses. Coronary physiology studies in patients contradict the experimental findings, as the minimal microvascular resistance is not modified by stenoses. The objective was to determine whether microcirculatory remodeling occurs downstream of coronary stenoses in the human coronary circulation. Approach andResults:
Myocardium corresponding to 115 coronary arteries of 55 deceased patients was investigated. Histopathologic staining of the microcirculation was performed using antibodies against SMA-α (smooth muscle actin-α) and CD31, to stain arterioles and capillaries, respectively. The following parameters were analyzed ratio between lumen and vesel area, ratio between lumen and vessel diameter (both ratios for arterioles of <40, 40-100, and 100-200 µm diameter), arteriolar density, and capillary density. From the 55 patients, 32 pairs of an unobstructed coronary artery and a coronary artery with a stenosis were formed. No statistically significant differences between any of the microcirculatory parameters were found. A confirmatory unpaired analysis compared 3 groups (1) coronary arteries in patients without coronary artery disease (n=53), (2) unobstructed coronary arteries in patients with a stenosis in one of the other coronary arteries (n=23), and (3) coronary stenoses (n=39). No statistically significant differences were observed between the groups.CONCLUSIONS:
The microcirculation distal to noncritical stenoses does not undergo structural remodeling in the human coronary circulation.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Flujo Sanguíneo Regional
/
Circulación Coronaria
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Vasos Coronarios
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Estenosis Coronaria
/
Remodelación Vascular
/
Microcirculación
Tipo de estudio:
Observational_studies
Límite:
Aged
/
Female
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Humans
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Male
Idioma:
En
Revista:
Arterioscler Thromb Vasc Biol
Asunto de la revista:
ANGIOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Países Bajos