von Kodolitsch Y, Ito W D, Franzen O, Lund G K, Koschyk D H, Meinertz T
Clinic of Internal Medicine III, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
Z Kardiol. 2004 Dec;93(12):929-37. doi: 10.1007/s00392-004-0152-7.
Congenital anomalies of the coronary arteries occur in 0.2-1.2% of the general population and may cause substantial cardiovascular morbidity and mortality. We review some of the advances that have been made both, in the understanding of the embryonic development of the coronary arteries (part I) and in the clinical diagnosis and management of their anomalies (part II). In this first part of our review we elucidate basic mechanisms of coronary vasculogenesis, angiogenesis and embryonic arteriogenesis. Moreover, we review the role of cellular progenitors such as epicardium-derived cells, cardiac neural crest cells and cells of the peripheral conduction system. Then we discuss the role of growths factors (such as FGV, HIF 1, PDGF B, TGFbeta1, VEGF, and VEGFR-2) and genes (such as FOG-2, VCAM-1, Bves, and RALDH2) at different states of coronary development. and we discuss the role of the cardiac neural crest in the concurrence of coronary anomalies with aortic root malformations. This part of the article is designed to review major determinants of coronary vascular development to provide a better understanding of the multiplicity of options and mechanisms that may give rise to coronary anomaly. To this end, we highlight results from experiments that provide insight in mechanisms of coronary malformation.
先天性冠状动脉异常在普通人群中的发生率为0.2% - 1.2%，可能导致严重的心血管疾病和死亡。我们回顾了在冠状动脉胚胎发育的理解方面（第一部分）以及其异常的临床诊断和管理方面（第二部分）所取得的一些进展。在本综述的第一部分，我们阐明冠状动脉血管生成、血管新生和胚胎动脉生成的基本机制。此外，我们回顾了细胞祖细胞的作用，如心外膜衍生细胞、心脏神经嵴细胞和外周传导系统的细胞。然后我们讨论生长因子（如FGV、HIF 1、PDGF B、TGFbeta1、VEGF和VEGFR - 2）和基因（如FOG - 2、VCAM - 1、Bves和RALDH2）在冠状动脉发育不同阶段的作用。并且我们讨论心脏神经嵴在冠状动脉异常与主动脉根部畸形并发中的作用。本文的这一部分旨在回顾冠状动脉血管发育的主要决定因素，以便更好地理解可能导致冠状动脉异常的多种选择和机制。为此，我们重点介绍了能深入了解冠状动脉畸形机制的实验结果。
