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Histomorphometric investigations of the human heart microvasculature in coronary disease
1Department of Pathomorphology, Military University School of Medicine, Lódź.
Insights
Chronic coronary atherosclerosis significantly alters the heart
Area of Science:
- Cardiovascular Morphology
- Vascular Biology
- Heart Muscle Physiology
Background:
- Human left ventricle microvasculature morphometrics are crucial for understanding heart function.
- Chronic coronary atherosclerosis impacts myocardial tissue and blood supply.
Purpose of the Study:
- To compare the microvasculature of the human left ventricle in healthy hearts versus those with chronic coronary atherosclerosis.
- To investigate the impact of atherosclerosis on capillary and collateral networks within the heart muscle.
Main Methods:
- Morphometric analysis of human left ventricle heart wall muscle microvasculature.
- Utilized digital image analysis on microscopical slides from autopsied cases.
- Compared 11 non-atherosclerotic hearts (control) with 13 atherosclerotic hearts.
Main Results:
- Atherosclerotic hearts showed significantly reduced capillary number and area, especially in the subendocardial zone.
- Collateral vessel number and area were markedly increased in atherosclerotic hearts.
- Muscle fiber/capillary ratio and microvasculature anisotropy increased, indicating impaired muscle fiber nutrition.
Conclusions:
- Chronic atherosclerosis leads to intramyocardial rebuilding of the capillary network.
- This rebuilding process worsens the nutritional conditions for heart muscle fibers.
- Findings highlight the detrimental effects of coronary atherosclerosis on myocardial microcirculation.
Abstract:
Comparative results of morphometric investigations describing the microvasculature of the human left ventricle heart wall muscle have been presented. The control group consisted of 11 autopsied cases of the atherosclerotically non damaged hearts and the second group consisted of 13 autopsied cases of the hearts with double or triple vessel chronic coronary atherosclerosis. The age of subjects ranged from 47 to 85 (median 65). The study was carried out on microscopical slides using digital image analyser. In the control group a significantly lower number and profile area of capillaries was noticed in the subendocardial zone than in the remaining ones. The differences between control and atherosclerotic hearts were most prominent in the subendocardial zone, although they were observed in the subepicardial and intramyocardial zones as well. If the value of each parameter in the subendocardial zone of the control hearts will be fixed equally to 100%, the corresponding values in atherosclerotic group are: the number of capillaries--34%, total area of capillaries--65%, number of collaterals--170%, total area of collaterals--612%, muscle fibre/capillary ratio--137%, the degree of microvasculature anisotropy--164%. On the ground of this study as well as on the qualitative investigations it is postulated that the chronic atherosclerosis of extra-myocardial coronary arteries corresponds to intramyocardial rebuilding of the capillary network worsen the conditions of muscle fibre nutrition.