A comparative study of the coronary arterial structure in the left ventricular free wall in infarcted and non-infarcted human hearts.
The structure and anastomoses of the coronary arteries were studied using coronary arteriography with barium sulfate (Micropaque) and gelatin as well as "cleared preparations" with tetralin. This was done in a total of 50 human autopsied hearts either with or without infarction and the patients had ranged from one to 84 years of age. Special emphasis was placed on the quantitative studies of the coronary anastomoses in the left ventricular free wall of 32 hearts including ten infarcted hearts. In addition histologic investigations were performed on 168 anastomotic channels selected arbitrarily from both the infarcted and non-infarcted hearts. The following results were obtained. 1. In the non-infarcted hearts, three different types of vessels, Type I, Type II and Type III respectively, were recognized in the left ventricular free wall. The number of anastomotic channels did not correlate with age, sex or weight of the heart. The number of anastomoses was closely related to the degree of coronary arterial narrowing and increased in the cases of severe narrowing. Anastomotic channels tended to be more frequent in the intracoronary and in the subendocardial layer and anastomoses of less than 150m in calibre were more numerous. 2. In the infarcted hearts the three types of vessels were changed as follows: localized increase of tree-like branching in the terminal portion of Type I vessels. Intercommunications between Type II vessels coursing parallel to the endocardial surface and between Type I and Type II vessels were found in the region of the endocardial layer up to the middle layer. Elongation of Type III vessels and an increase in their intercommunications were evident. Anastomoses in intercoronary and in the middle layer were found to have increased significantly. The percentage of anastomotic channels with large calibres, especially over 201 mu was increased, as compared with the non-infarcted hearts. 3. The wall thickness of anastomotic channels tended to be thinner in the infarcted hearts than in the non-infarcted ones. In the region adjacent to the infarction foci, attenuation of walls of the vessels was pronounced as compared with the wall thickness in anastomotic channels of similar size in the non-infarcted heats.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003097:Collateral Circulation; D017023:Coronary Angiography; D003327:Coronary Disease / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006349:Heart Valve Diseases / Q000473:pathology; D006352:Heart Ventricles; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology*; D009206:Myocardium / Q000473:pathology