Naeye R L, Liedtke A J
Am J Pathol. 1976 Dec;85(3):569-80.
Proliferative lesions, which included collagen deposition, developed with age in intramyocardial arteries of 27 patients with aortic stenosis and matched controls. Those with the most extensive intramyocardial artery lesions developed massive subendocardial infarcts during surgery. Using histologic quantitation, the percent of intramyocardial arteries with lesions in a patient was correlated with decreases in the amount of muscle in arterioles between the subepicardial and subendocardial zones of the left ventricle. The mean decrease in arteriolar muscle was 43% in patients with aortic stenosis and 19% in controls. Blood pressures correlate with the amount of muscle in arterioles, so subendocardial perfusing pressures were presumably low in those with aortic stenosis. Patients with the greatest decrease in arteriolar muscle across the myocardium had the most impaired left ventricular function, i.e., highest end diastolic pressures, lowest ejection fractions, and lowest mean fiber shortening rates.
在27例主动脉瓣狭窄患者及匹配的对照组中，增殖性病变（包括胶原沉积）随年龄增长出现在心肌内动脉。那些心肌内动脉病变最广泛的患者在手术期间发生了大量心内膜下梗死。通过组织学定量分析，患者中出现病变的心肌内动脉百分比与左心室心外膜下和心内膜下区域小动脉中肌肉量的减少相关。主动脉瓣狭窄患者小动脉肌肉平均减少43%，对照组为19%。血压与小动脉中的肌肉量相关，因此主动脉瓣狭窄患者的心内膜下灌注压可能较低。心肌中小动脉肌肉减少最多的患者左心室功能受损最严重，即舒张末期压力最高、射血分数最低和平均纤维缩短率最低。
