Pathology of coronary arteriosclerosis∗

Enos, William F.; Holmes, Robert H.; Beyer, James C.

doi:10.1016/0002-9149(62)90152-2

Cited by 25 publications

(4 citation statements)

References 22 publications

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“…26]. Our ultrastructural findings of smooth muscle-like foam cells [6,18,19,28,34] in CECs of obese rabbits are in agreement with the removal of lipid and other infiltrated material within CEC. However, in some cases, calcification could arrest that process leading to irreversible pathological changes.…”

Section: Cec In Diseased Heartssupporting

confidence: 76%

“…These consisted of lipid-like infiltration of connectivetissue between myocytes and the presence o f 'foam cells' [27,28] as described below. Electron Microscopy Electron microscopy of the rabbit CEC confirmed the presence of smooth muscle cells that were surrounded indi vidually by ground substance and interwoven collagen and clastin fibers ( fig.…”

Section: Histologymentioning

confidence: 99%

“…Such segmental trap ping of blood would prevent vascular collapse during sys tole, thus allowing distribution of blood into more periph eral collateral branches. A large pressure load is placed upon the coronary arteries during each systolic contrac tion, which comprises pressure from the blood within the ventricle as well as pressure from the contraction and shortening of the myocardium [37,[48][49][50], CEC may act against this extravascular systolic pressure to assist in pre venting retrograde blood flow and promote adequate per fusion pressure within epicardial. subepicardial, and in tramural coronary arteries and their branches.…”

Section: Functional Aspectsmentioning

confidence: 99%

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Intramyocardial Arterial Cushions of Coronary Vessels in Animals and Humans: Morphology, Occurrence and Relation to Heart Disease

Whelan

Subramanian²,

Jin

et al. 1996

J Vasc Res

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The existence of coronary endoarterial cushions (CEC) in the human heart as nonpathological, functional entities has been debated, and CEC have been sparsely reported in animals. Arterial cushions are localized thickenings that protrude into the lumen of specific arteries. We have identified CEC in the rhesus monkey, dog, sheep, goat, pig, rabbit and rat, and in the human heart. Two distinct types are described: the ovoid CEC arranged singly, in pairs, or in groups of three to four, and the less common polypoid CEC seen primarily in humans. The highest incidence of CEC in rabbits and humans was in the left ventricle in arteries 150–488 µm in diameter. Light and electron microscopy demonstrated intimal location with smooth muscle cells surrounded by ground substance, collagen and elastin fibers in a highly organized pattern. Nerve fibers identified by their immunoreactivity with antiserum to the vasodilatory calcitonin-gene-related peptide contacted the CEC along the tunica media and were occasionally seen within CEC. Arrangement and histological composition of CEC suggest a role in the regulation of local blood flow and myocardial perfusion. In human hearts, the CEC density index correlated highly with the degree of heart disease. In subjects with high heart disease rating, increased connective tissue, lipid-like infiltration and calcification was seen within CEC, and foam cells were present in CEC of obese rabbits. This suggests that CEC in coronary arteries could be predisposed sites of atherosclerosis, and that injured CEC can cause coronary artery spasm and ischemia. We conclude that CEC occur in animals and humans as innervated intimal smooth muscle cushions that might have a role in myocardial perfusion and heart disease.

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Section: Cec In Diseased Heartssupporting

confidence: 76%

Section: Histologymentioning

confidence: 99%

Section: Functional Aspectsmentioning

confidence: 99%

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Intramyocardial Arterial Cushions of Coronary Vessels in Animals and Humans: Morphology, Occurrence and Relation to Heart Disease

Whelan

Subramanian²,

Jin

et al. 1996

J Vasc Res

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“…These signs occurred immediately after the end of injection when the flow of medium was diminishing and were a spiral-shaped greatly narrowed lumen, and secondly, delay in clearance of medium immediately distal to this segment following all injections of the left coronary or anterior descending arteries. It is of interest that the spiral pattern of atherosclerotic disease in this artery has been noted by Enos, Holmes, and Beyer (1962) Left C.A. position, about 400 left anterior oblique.…”

Section: Discussionmentioning

confidence: 98%

Technique and Interpretation of Selective Coronary Arteriography in Man

Hale¹,

Jefferson²

1963

Heart

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The radiographic study of coronary arteries in man has been attempted only in recent years. The earliest workers in this sphere employed thoracic aortography, the opaque medium being introduced by needle puncture (Radner, 1945) (1960), the aim being to fill the aortic sinuses so that a high proportion of the medium enters the coronary arteries. In our animal experiments we found that cardiac arrest induced by acetylcholine (Sloman and Jefferson, 1960) and timed diastolic injections of contrast medium (Michell and Jefferson, 1962) gave encouraging results, but we considered that cardiac arrest was potentially too dangerous to use in man. Although Thal et al. (1958) have applied timed diastolic injections successfully in man, our experience convinced us that it was unreliable in filling diseased coronary arteries. Failure to fill a severely diseased right coronary artery is illustrated by Case 4 ( Fig. 1 and 2). This patient, a man aged 44, had had severe angina of effort for five years. Aortography with 75 ml. opaque medium showed occlusion of the anterior descending artery but failed to outline the right coronary artery (Fig. 1). Selective coronary arteriography was subsequently performed, and the right coronary artery was successfully cannulated and clearly outlined by an injection of only 2 ml. (Fig. 2).Thus, in 1960, faced with the problem of how to improve aortography without increasing the hazards of the procedure, we decided to investigate selective coronary arteriography, introduced by Sones in 1960 and practised by him with success and safety. Apart from Sones, who has had an extensive experience with selective coronary arteriography (Sones and Shirley, 1962), Lang and Sabiston (1961) and Tapia, Bolton, and Mazel (1961) have also reported favourably.

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Proximal Endarterectomy, Arterial Reconstruction for Coronary Occlusion at Aortic Origin

Sabiston¹

1965

Arch Surg

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Pathology of coronary arteriosclerosis∗

Cited by 25 publications

References 22 publications

Intramyocardial Arterial Cushions of Coronary Vessels in Animals and Humans: Morphology, Occurrence and Relation to Heart Disease

Intramyocardial Arterial Cushions of Coronary Vessels in Animals and Humans: Morphology, Occurrence and Relation to Heart Disease

Technique and Interpretation of Selective Coronary Arteriography in Man

Proximal Endarterectomy, Arterial Reconstruction for Coronary Occlusion at Aortic Origin

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