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Updated: Mar 17, 2026
Analysis of Coronary Vessels in Cleared Embryonic Hearts
Published on: December 7, 2016
Transmural distribution and connectivity of coronary collaterals within the human heart
Monique G J T B van Lier1, Elco Oost1, Jos A E Spaan1
1Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
Insights
Human hearts possess abundant coronary collaterals, primarily small intracoronary vessels, crucial for blood flow distribution. These vessels, vital for cardiac health, are often too small to be detected by standard clinical imaging methods.
Area of Science:
- Cardiovascular Anatomy
- Medical Imaging
- Coronary Vasculature
Background:
- Collateral vessels are vital for human heart function, yet their detailed distribution remains poorly understood.
- Existing clinical imaging techniques often fail to detect smaller coronary collaterals.
Purpose of the Study:
- To classify the transmural distribution and connectivity of coronary collaterals in human hearts.
- To analyze collateral vessel characteristics in both normotrophic and hypertrophied hearts.
Main Methods:
- Utilized three-dimensional vascular reconstructions of human hearts (one normotrophic, one hypertrophied).
- Coronary arteries were filled with fluorescent replica material.
- Employed an imaging cryomicrotome for high-resolution, block-face imaging and analysis of collateral distribution, connectivity, and diameter.
Main Results:
- Identified numerous collateral vessels in both hearts, with a higher density in the normotrophic heart.
- The vast majority (92-97%) of collaterals were intracoronary, located within perfusion territories.
- Described specific distributions and diameters of intracoronary and intercoronary collaterals in normotrophic and hypertrophied hearts, noting prevalence between LAD, LCX, and RCA territories.
Conclusions:
- Human hearts contain abundant coronary collaterals throughout all layers and flow territories.
- Small intracoronary collaterals are the most prevalent type and are typically undetectable by clinical imaging.
- Findings highlight the significant, often overlooked, role of these microvasculature components in cardiac physiology.
Abstract:
Despite the importance of collateral vessels in human hearts, a detailed analysis of their distribution within the coronary vasculature based on three-dimensional vascular reconstructions is lacking. This study aimed to classify the transmural distribution and connectivity of coronary collaterals in human hearts. One normotrophic human heart and one hypertrophied human heart with fibrosis in the inferior wall from a previous infarction were obtained. After filling the coronary arteries with fluorescent replica material, hearts were frozen and alternately cut and block-face imaged using an imaging cryomicrotome. Transmural distribution, connectivity, and diameter of collaterals were determined. Numerous collateral vessels were found (normotrophic heart: 12.3 collaterals/cm(3); hypertrophied heart: 3.7 collaterals/cm(3)), with 97% and 92%, respectively, of the collaterals located within the perfusion territories (intracoronary collaterals). In the normotrophic heart, intracoronary collaterals {median diameter [interquartile range (IQR)]: 91.4 [73.0-115.7] μm} were most prevalent (74%) within the left anterior descending (LAD) territory. Intercoronary collaterals [median diameter (IQR): 94.3 (79.9-107.4) μm] were almost exclusively (99%) found between the LAD and the left circumflex artery (LCX). In the hypertrophied heart, intracoronary collaterals [median diameter (IQR): 101.1 (84.8-126.0) μm] were located within both the LAD (48%) and LCX (46%) territory. Intercoronary collaterals [median diameter (IQR): 97.8 (89.3-111.2) μm] were most prevalent between the LAD-LCX (68%) and LAD-right coronary artery (28%). This study shows that human hearts have abundant coronary collaterals within all flow territories and layers of the heart. The majority of these collaterals are small intracoronary collaterals, which would have remained undetected by clinical imaging techniques.
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