为什么冠状动脉的心肌内部分能够免受动脉硬化的影响？临床意义。
Why are the intramyocardial portions of the coronary arteries spared from arteriosclerosis? Clinical implications.
作者信息
Botta Donald M, Elefteriades John A
机构信息
Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.
出版信息
Int J Angiol. 2009 Summer;18(2):59-61. doi: 10.1055/s-0031-1278325.
Experienced cardiac surgeons are aware that the intramyocardial portions of the coronary arteries are rarely affected by arteriosclerosis. This is a striking and reliable finding in the operating room that is present even when the preceding and subsequent segments of the arteries are diseased. The present review describes the published evidence of embryological, anatomical and physiological differences between intramyocardial coronary arteries and their epicardial counterparts. Possible mechanisms of these differences are explored, and hypotheses are advanced as to how one may capitalize on these differences to provide better diagnosis and treatment of coronary artery disease. The absence of vasa vasorum in the intramyocardial coronary arteries appears to play a major role in their protection from arteriosclerosis. Fully understanding this peculiar phenomenon - the sparing of the intramyocardial coronary arteries - would be one giant step closer to unlocking the remaining mysteries of arteriosclerosis in general.
经验丰富的心脏外科医生都知道，冠状动脉的心肌内部分很少受到动脉硬化的影响。这是手术室中一个显著且可靠的发现，即使动脉的前后段患病，该现象依然存在。本综述描述了已发表的关于心肌内冠状动脉与其心外膜对应部分在胚胎学、解剖学和生理学差异的证据。探讨了这些差异可能的机制，并提出了关于如何利用这些差异来更好地诊断和治疗冠状动脉疾病的假设。心肌内冠状动脉中缺乏血管滋养管似乎在其免受动脉硬化影响方面起着主要作用。全面理解这一特殊现象——心肌内冠状动脉不受影响——将朝着解开一般动脉硬化的其余谜团迈进一大步。
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