title: Remodeling of left circumflex coronary arterial tree in pacing-induced heart failure.
abstract: Congestive heart failure (CHF) is a very serious heart disease that manifests an imbalance between left ventricle supply and demand. Although the mechanical demand of the failing heart has been well characterized, the systematic remodeling of the entire coronary arterial tree that constitutes the supply of the myocardium is lacking. We hypothesize that the well-known increase in ventricle wall stress during CHF causes coronary vascular rarefaction to increase the vascular flow resistance, which in turn compromises the perfusion of the heart. Morphometric (diameters, length, and numbers) data of the swine left circumflex (LCx) arterial tree were measured in both CHF (n = 6) and control (n = 6) groups, from which a computer reconstruction of the entire LCx tree was implemented down to the capillary level to enable a hemodynamic analysis of coronary circulation. The vascular flow resistance was increased by ∼75% due to a significant decrease of vessel numbers (∼45%) and diameters in the first capillary segments (∼10%) of the LCx arterial tree after 3-4 wk of pacing. The structural remodeling significantly changed the wall shear stress in vessel segments of the entire LCx arterial tree of CHF animals. This study enhances our knowledge of coronary arterial tree remodeling in heart failure, which provides a deeper understanding of the deterioration of supply-demand relation in left ventricle.
authors.affiliation: Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China; State Key Laboratory for Turbulence and Complex Systems, College of Engineering, Peking University, Beijing, China; College of Medicine, Hebei University, Baoding, China; and.
authors.forename: Yunlong
authors.initials: Y
authors.lastname: Huo
authors.affiliation: California Medical Innovations Institute, San Diego, California gkassab@calmi2.org.
authors.forename: Ghassan S
authors.initials: GS
authors.lastname: Kassab
mesh_terms: D000818:Animals; D002196:Capillaries / Q000473:pathology / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D003198:Computer Simulation; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology*; D004195:Disease Models, Animal; D006333:Heart Failure / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D008833:Microcirculation; D008955:Models, Cardiovascular; D013314:Stress, Mechanical; D034421:Sus scrofa; D013997:Time Factors; D066253:Vascular Remodeling; D014655:Vascular Resistance; D016276:Ventricular Function
keywords: LCx; congestive heart failure; structure-function remodeling; ventricular pacing