Knieriem H J
Radiologe. 1976 Mar;16(3):84-8.
Atherosclerosis and insufficiency of the coronary arteries and their sequelae are summarized in the term "coronary heart disease". For the evaluation of the coronary arteries the knowledge of malformations, variants and supply areas is of importance. Extension and severity of atherosclerosis of the coronary arteries and their insufficiency is being influenced by hyperlipidemia, hypertension and diabetes mellitus. The process of atherosclerosis as a cause of the proliferation of vascular smooth muscle cells in complicated by ulceration, parietal and obliterative thrombosis as well by intramural hemorrhages. Relative ischemia leeds to disseminated cell necrosis; total ischemia causes large myocardial tissue necrosis, called infarction. Localization and extension of infarction and the later scars correspond to the caliber of the obliterated coronary artery and to the significance of the collaterals. Postmortem coronary angiography can detect cause and extension of the damaged cardiac area. Functional significance of chronic coronary heart disease is related to the "critical connective tissue content" of the heart. After surgical treatment qualitative and quantitative morphology may help to explain postoperative cardiac failure.
“冠心病”一词概括了动脉粥样硬化、冠状动脉供血不足及其后遗症。对于冠状动脉的评估，了解其畸形、变异和供血区域非常重要。冠状动脉粥样硬化的范围和严重程度及其供血不足会受到高脂血症、高血压和糖尿病的影响。动脉粥样硬化过程中血管平滑肌细胞增殖会并发溃疡、壁内和闭塞性血栓形成以及壁内出血。相对缺血会导致弥漫性细胞坏死；完全缺血会导致大面积心肌组织坏死，即梗死。梗死的定位和范围以及后期的瘢痕与闭塞冠状动脉的管径和侧支循环的意义相对应。尸检冠状动脉造影可检测受损心脏区域的病因和范围。慢性冠心病的功能意义与心脏的“关键结缔组织含量”有关。手术治疗后，定性和定量形态学有助于解释术后心力衰竭的原因。
