[Morphology of myocardial perfusion (author's transl)]

Area of Science:

• Cardiovascular pathology
• Coronary artery disease
• Myocardial perfusion imaging

Background:

• Myocardial perfusion disturbances are predominantly caused by obstructive coronary atherosclerosis.
• The morphology of the narrowed lumen in coronary arteries is variable.
• Risk factors do not influence the location of severe coronary stenoses.

Purpose of the Study:

• To investigate the characteristics of obstructive coronary atherosclerosis and its impact on myocardial perfusion.
• To examine the relationship between atherosclerotic changes in large coronary arteries and intramural vessels.
• To correlate the extent of atherosclerosis with infarct size and perfusion areas.

Main Methods:

• Analysis of coronary artery morphology and lumen narrowing.
• Assessment of atherosclerotic lesion localization.
• Correlation of stenosis severity with infarct size and perfusion deficits.
• Histopathological examination of intramural coronary arteries and arterioles.

Main Results:

• Obstructive coronary atherosclerosis is the main cause of myocardial perfusion issues.
• Severe stenoses' localization is independent of risk factors.
• Atherosclerotic changes are more prevalent in epicardial coronary arteries than in their branches.
• A strong correlation exists between stenosis location/severity and infarct size/perfusion area.
• Minimal atherosclerotic lesions are found in small intramural arteries and arterioles.
• No positive correlation was observed between atherosclerosis in large coronary arteries and intramural arterioles.

Conclusions:

• Obstructive coronary atherosclerosis significantly impairs myocardial perfusion.
• The distribution and severity of atherosclerotic lesions in large coronary arteries correlate with myocardial damage.
• Intramural coronary arteries and arterioles show limited atherosclerotic changes, independent of epicardial disease extent.