Evora Paulo Roberto Barbosa, Schmidt Andre, Arcêncio Livia, Marin-Neto José Antonio
Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, Av. Bandeirantes, 3900 - Monte Alegre - CEP: 14049-900 Ribeirão Preto/SP. Brazil.
Department of Surgery and Anatomy (Division of Cardiothoracic Surgery); Department of Medicine (Division of Cardiology); Ribeirão Preto School of Medicine, University of São Paulo, SP. Brazil.
Curr Cardiol Rev. 2017;13(3):217-222. doi: 10.2174/1573403X13666170317121721.
Enigmas often lead to hypotheses and speculations. For this reason, especially for the sake of the reader's motivation, we opted for the plain discussion of some cardiology enigmas.
The present text was aimed to discuss speculatively some cardiology enigmas.
Text was freely designed in the context of coronary artery and heart valve diseases.
The results were presented as the combination enigma/hypothesis. 1) The absence of arteriosclerosis in intramyocardial coronary arteries/ endothelium-myocardial interaction (crosstalk); 2) The unique and always confirmed superior evolution of the internal thoracic artery as coronary graft/ higher NO basal release 3) The prophylactic left internal thoracic artery graft in mildlystenosed coronary lesions/need of more accurate functional imaging techniques; 4) The high incidence of perioperative atrial fibrillation in patients with coronary artery disease/atrial ischemia associated to left circumflex coronary lesions; 5) The handling of disease-free saphenous vein grafts at the time of reoperation/biological serendipity with graft vein segments; 6) The possible aortic stenosis protection against coronary artery disease/ endothelium-myocardium interaction (crosstalk) improving NO release.
The discussed topics associated with their respective speculative hypothesis remain as enigmas, but would become motivations for investigations.
谜团常常引发假设和推测。因此,特别是为了激发读者的兴趣,我们选择了对一些心脏病学谜团进行直白的讨论。
本文旨在对一些心脏病学谜团进行推测性讨论。
本文在冠状动脉和心脏瓣膜疾病的背景下自由构思。
结果以谜团/假设相结合的形式呈现。1)心肌内冠状动脉无动脉硬化/内皮-心肌相互作用(串扰);2)胸廓内动脉作为冠状动脉移植物独特且始终得到证实的优越演变/基础一氧化氮释放量更高;3)在轻度狭窄的冠状动脉病变中预防性使用左胸廓内动脉移植物/需要更精确的功能成像技术;4)冠心病患者围手术期房颤的高发病率/与左旋支冠状动脉病变相关的心房缺血;5)再次手术时无病变大隐静脉移植物的处理/移植物静脉段的生物学意外发现;6)主动脉瓣狭窄可能对冠状动脉疾病起到保护作用/内皮-心肌相互作用(串扰)改善一氧化氮释放。
所讨论的主题及其各自的推测性假设仍是谜团,但将成为研究的动力。