Lluri Gentian, Aboulhosn Jamil
Ahmanson/UCLA Adult Congenital Heart Disease Center, Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, California.
Clin Cardiol. 2014 Feb;37(2):126-30. doi: 10.1002/clc.22237. Epub 2014 Jan 7.
Coronary artery development is a delicate, complex, and finely tuned process that includes multiple interactions among many pathways, especially in the pericardium and the developing myocardium. There still exists some controversy on the exact origin of certain cellular components. Nevertheless, an understanding of this extremely important developmental process is paramount in identifying some of the causes of anomalous coronary development. There are different patterns of anomalous coronary arteries, with variable risk of myocardial ischemia, malignant arrhythmias, and sudden cardiac death. These anomalies can be broadly categorized into 2 basic anatomic subsets: those with origin of the anomalous coronary artery from the opposite aortic sinus, and those with origin of the anomalous coronary artery from the pulmonary artery. Diagnosis and management of such patterns continues to be challenging. A good knowledge of the normal and abnormal coronary artery development could potentially help us explore new avenues in the treatment of ischemic heart disease as well as anomalous coronary arteries.
冠状动脉发育是一个精细、复杂且高度协调的过程，涉及许多信号通路之间的多重相互作用，尤其是在心包和发育中的心肌中。某些细胞成分的确切起源仍存在一些争议。然而，了解这一极其重要的发育过程对于确定冠状动脉发育异常的一些原因至关重要。冠状动脉异常有不同的模式，其发生心肌缺血、恶性心律失常和心源性猝死的风险各不相同。这些异常可大致分为两个基本的解剖学亚组：异常冠状动脉起源于对侧主动脉窦的情况，以及异常冠状动脉起源于肺动脉的情况。对这些模式的诊断和管理仍然具有挑战性。深入了解正常和异常的冠状动脉发育可能有助于我们探索治疗缺血性心脏病以及冠状动脉异常的新途径。
