Lim M, Ziaee A, Kern Morten J
J. Gerard Mudd Cardiac Catheterization Laboratory. St. Louis University Health Sciences Center, St. Louis, Missouri, USA.
Coron Artery Dis. 2004 Nov;15(7):379-88. doi: 10.1097/00019501-200411000-00003.
The existence and recruitment of collateral vessels within the coronary circulation may account for the tremendous variability in presentation, symptoms and outcome in patients with coronary atherosclerosis. Multiple episodes of ischemia have been found to produce the stimuli necessary for the growth of new vessels which result in collateral blood flow. Furthermore, there is also a subset of patients with readily recruitable collateral vessels that function to limit myocardial necrosis during an acute ischemic event. Promising early studies have utilized angiogenic growth factors as a means to stimulate collateral growth, bringing a renewal interest in their assessment and significance. We review, in brief, the significance and understanding of the development of coronary collaterals as well as the available means to assess them.
冠状动脉循环中侧支血管的存在和募集可能是冠状动脉粥样硬化患者临床表现、症状和预后存在巨大差异的原因。已发现多次缺血发作会产生新血管生长所需的刺激,从而导致侧支血流。此外,还有一部分患者具有易于募集的侧支血管,这些血管在急性缺血事件中发挥作用,限制心肌坏死。早期有前景的研究利用血管生成生长因子来刺激侧支生长,这重新引发了人们对其评估和意义的关注。我们简要回顾冠状动脉侧支发育的意义和理解,以及评估它们的现有方法。