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冠状动脉的先天性:血管腔。

The innateness of coronary artery: Vasa vasorum.

机构信息

Department of Neurology, DaeJeon HanKook Hospital, 496-15 SungNam 2 Dong, DaeJeon, ChungCheongNam-Do 300-709, South Korea.

出版信息

Med Hypotheses. 2010 Mar;74(3):443-4. doi: 10.1016/j.mehy.2009.10.001. Epub 2009 Nov 7.

Abstract

Because heart originates from primitive endocardial tube (ventral aorta) embryologically, coronary arteries that supply this tube can be thought as "cardiac vasa vasorum" like arterial vasa vasorum that supply peripheral arteries. Coronary arteries have vasodilative reaction to noradrenaline, different from the most arteries that show vasoconstriction. This phenomenon is similar to vasa vasorum that are insensitive to noradrenaline and has its own vasoregulation. Coronary arteries can supply blood from epicardium, myocardium to endocardium under normal physiological conditions. But heart having a significant myocardial hypertrophy can be susceptible to subendocardial ischemia because the metabolic demands of hypertrophic myocardium cannot be met by a parallel increase of coronary myocardial capillaries. This peculiar characteristic of coronary arteries is similar to vasa vasorum that give rise to ischemic necrosis of media of the host vessel under chronic hypertension. Inherency of coronary arteries is the same endarteries as vasa vasorum. Coronary arteries have many smooth muscle fibers than elastic fibers in media, which protect them to collapse during systole to some extent. This feature also is similar to vasa vasorum. The above similarities support the hypothesis that coronary arteries are a kind of vasa vasorum.

摘要

由于心脏在胚胎学上起源于原始心内膜管(腹主动脉),因此供应该管的冠状动脉可以被认为是类似于供应外周动脉的动脉血管的“心脏血管系统”。冠状动脉对去甲肾上腺素有血管舒张反应,与大多数表现出血管收缩的动脉不同。这种现象类似于对去甲肾上腺素不敏感并具有自身血管调节功能的血管系统。在正常生理条件下,冠状动脉可以从心外膜、心肌向心内膜供血。但是,当心脏发生显著的心肌肥厚时,由于肥厚心肌的代谢需求不能通过冠状动脉心肌毛细血管的平行增加来满足,因此容易发生心内膜下缺血。这种冠状动脉的特殊特征类似于血管系统在慢性高血压下引起宿主血管中膜的缺血性坏死。冠状动脉的固有特性与血管系统相同。冠状动脉的中膜有比弹性纤维更多的平滑肌纤维,这在一定程度上保护它们在收缩期不会塌陷。这个特征也与血管系统相似。上述相似性支持了冠状动脉是一种血管系统的假说。

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