Sabri M N, DiSciascio G, Cowley M J, Alpert D, Vetrovec G W
Division of Cardiology, Medical College of Virginia, Richmond 23298.
Am Heart J. 1991 Mar;121(3 Pt 1):876-80. doi: 10.1016/0002-8703(91)90202-s.
Studies in animals and humans have demonstrated the anatomic presence and functional significance of coronary collaterals. The extent of collateralization varies among species and among individuals. Collateral vessels are usually adequate for preserving resting regional and global ventricular function in the face of coronary obstruction. During stress, however, collateral supply may be inadequate. Collateral development is a time-dependent process during both the initial occlusion and following transient reflow and reclosure. Therefore when a previously collateralized coronary occlusion is recanalized and then recloses, the extent of the resulting collateral recruitment will depend, at least in part, upon the period of reflow between the two occlusions. The longer the reflow period, the less enhanced will be the collateralization. This is illustrated in the cases presented and has also been demonstrated in animal studies. The exact mechanisms for this recurrent collateral recruitment need further study.
对动物和人类的研究已经证明了冠状动脉侧支循环的解剖学存在及其功能意义。侧支循环的程度在物种之间和个体之间有所不同。面对冠状动脉阻塞时，侧支血管通常足以维持静息状态下局部和整体心室功能。然而，在应激状态下，侧支供血可能不足。在初始闭塞期间以及短暂再灌注和再闭塞之后，侧支循环的发展是一个时间依赖性过程。因此，当先前已形成侧支循环的冠状动脉闭塞再通然后再次闭塞时，由此产生的侧支募集程度将至少部分取决于两次闭塞之间的再灌注时间。再灌注时间越长，侧支循环增强的程度就越小。这在本文所举的病例中得到了说明，并且在动物研究中也得到了证实。这种反复的侧支募集的确切机制需要进一步研究。
