Related Experiment Videos
[Stenoses of arterioles and small intramural arteries of human hearts. A quantitative study (author's transl)]
Insights
Severe coronary arteriosclerosis may protect small arteries from lesions. Narrowing in these small arteries rarely causes ischemic myocardial damage, even with age.
Area of Science:
- Cardiovascular Pathology
- Vascular Biology
- Myocardial Histology
Context:
- Investigates the relationship between coronary arteriosclerosis and lesions in smaller intramural arteries and arterioles.
- Utilizes postmortem coronary angiographies and myocardial sectioning for detailed analysis.
- Examines 50 human hearts with varying degrees of coronary artery disease.
Purpose:
- To determine the frequency and severity of stenosing intimal lesions in small intramural arteries and arterioles.
- To assess the correlation between these lesions, arterial diameter, age, heart weight, and overall coronary arteriosclerosis.
- To evaluate the potential impact of these lesions on causing ischemic myocardial damage.
Summary:
- Stenosing intimal lesions were most frequent in small arteries (100-200 μm diameter), but typically mild.
- Lesion frequency increased with age but was lower in the right ventricular wall and inversely correlated with severe coronary arteriosclerosis.
- Severe coronary arteriosclerosis might offer protection against intimal lesions in smaller arteries.
Impact:
- Findings suggest that stenosis in small intramural arteries and arterioles infrequently leads to ischemic myocardial lesions.
- Highlights the complex interplay between different levels of arterial disease within the heart.
- Provides insights into the pathology of small vessel disease in the context of atherosclerosis.
Abstract:
Postmortem coronary angiographies with a pressure of 100 mm Hg were performed on 50 human hearts with various degrees of coronary arteriosclerosis. The frequency and degree of narrowing of arterioles and small intramural arteries up to diameters of 400 mu were investigated by giant sections through the whole myocardium. The frequency of stenosing intimal lesions depended on the diameter of the arteries. Mostly (1.8%) small arteries with a diameter between 100 and 200 mu were affected. As a rule the degree of narrowing was unimportant. Only in 23% it surmounted 20%, in nearly 5% it exceeded 30% and only in 0.5% the level of 50% was surmounted. In the different layers of the left ventricular myocardium and of the ventricular septum no significant differences in the frequency of stenosing intimal lesions could be found. But in the right ventricular wall an evidently inferior frequency was determined. There was a significant increase of stenosing lesions with age but not with increasing heart weight. As a rule we observed an inversed correlation between the degree of coronary arteriosclerosis and the frequency of stenosing lesions of arterioles and small intramural arteries. Perhaps a severe coronary atherosclerosis protects the small intramural arteries against intimal lesions. We conclude from our results that only very seldom a stenosis of small intramural arteries and arterioles causes ischemic myocardial lesions.