Naeye R L, Truong L D
Am J Clin Pathol. 1977 Oct;68(4):493-8. doi: 10.1093/ajcp/68.4.493.
Proliferative lesions, which include collagen, elastic fibers and abnormally oriented muscle fibers, were found to develop in intramyocardial arteries more rapidly with age in cigarette smokers than in nonsmokers. The study attempted to determine whether these lesions reduce perfusion pressures in the subendocardial zone of the left ventricle. The amount of muscle in arterioles appears to reflect perfusing pressures, so measurements were made of decreases in muscle in arterioles between the subepicardial and subendocardial zones of the left ventricle to detect decreases in arteriolar perfusing pressures between the two areas. The decreases in arteriolar muscle between the two zones were then compared with the extents of the intramyocardial arterial lesions. Those individuals who had the most extensive arterial proliferative lesions had the greatest decreases in arteriolar muscle from the subepicardial to the subendocardial zones. In persons less than 60 years old the mean decreases in arteriolar muscle between the two zones were 1% for nonsmokers and 17% for smokers. For those more than 60 years old the values were 21 and 41%.
研究发现，增殖性病变（包括胶原蛋白、弹性纤维和异常定向的肌纤维）在吸烟者的心肌内动脉中随年龄增长比不吸烟者发展得更快。该研究试图确定这些病变是否会降低左心室心内膜下区域的灌注压力。小动脉中的肌肉量似乎反映了灌注压力，因此对左心室心外膜下和心内膜下区域之间小动脉中肌肉的减少进行了测量，以检测这两个区域之间小动脉灌注压力的降低。然后将两个区域之间小动脉肌肉的减少与心肌内动脉病变的程度进行比较。那些动脉增殖性病变最广泛的个体，从心外膜下到心内膜下区域的小动脉肌肉减少最多。在60岁以下的人群中，不吸烟者两个区域之间小动脉肌肉的平均减少率为1%，吸烟者为17%。对于60岁以上的人，这两个数值分别为21%和41%。
