Summary
Atherosclerotic stenosis of the extramural coronary arteries was quantitated for a series of 223 hearts of adults and found to correlate positively with values for stenosis of the intramural coronary arteries of that series. However, minor grades of extramural coronary stenosis may be associated with advanced stenosis of the intramural coronary arteries and myocardial microinfarction, which may explain symptoms of ischemic heart disease in the absence of demonstrable extramural coronary stenosis. Stenosing lesions of extramural and intramural coronary arteries apparently involve the same process, and develop through reorientation, proliferation and migration of pleomorphic smooth muscle cells of the arterial wall, combined with increased formation of mucopolysaccharides, and elastic and collagen fibers. The process corresponds to that by which coronary arterial stenosis appears to develop in swine and other animals.
Zusammenfassung
Bei 223 Herzen adulter Menschen wurden stenosierende atherosklerotische Veränderungen an extra- und intramuralen Arterien quantitativ ausgewertet. Zwischen beiden Arteriensystemen besteht eine positive Korrelation hinsichtlich Grad der stenosierenden Atherosklerose. Einzelne Herzen mit nur geringgradiger Stenose extramuraler Arterien wiesen jedoch eine hochgradige Stenose intramuraler Arterien und gleichzeitig Mikroinfarkte auf. Solche Befunde können Symptome einer ischämischen Herzkrankheit beim Fehlen nachweisbarer extramuraler Coronarstenosen erklären. Stenosierende Veränderungen an extraund intramuralen Coronararterien haben eine gemeinsame Pathogenese und entwickeln sich durch Reorientierung, Proliferation und Migration von pleomorphen glatten Muskelzellen der Arterienwand, kombiniert mit vermehrter Bildung von Mucopolysacchariden, elastischen und kollagenen Fasern. Diese Genese entspricht derjenigen der stenosierenden Coronarsklerose beim Schwein und anderen Species.
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Supported in part by grant HE 01979, National Heart and Lung Institute, Bethesda, Maryland, and in part by a grant from the World Health Organization.
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Ratcliffe, H.L., Redfield, E. Atherosclerotic stenosis of the extramural and intramural coronary arteries of man. Virchows Arch. Abt. A Path. Anat. 357, 1–10 (1972). https://doi.org/10.1007/BF00548212
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DOI: https://doi.org/10.1007/BF00548212