Ausência de arteriosclerose na porção intramiocárdica das artérias coronárias

Abstract

Ausência de arteriosclerose na porção intramiocárdica das artérias coronárias: um mistério a ser resolvido?Absence of arteriosclerosis in intramyocardial coronary arteries: a mystery to be solved? Work AbstractSeveral studies show that portions of intramyocardial coronary arteries are spared of arteriosclerosis, involving morphological, embryological, biochemical and pathophysiological aspects. Endothelial function is significantly affected in the segment of transition, as estimated by the vasoactive response to Ach. These findings suggest that myocardial bridge can provide protection against arteriosclerosis by counteracting the negative effects of endothelial dysfunction. The intramyocardial portion's protection phenomenon deserves further scientific research on all research fronts. Improved morphological, biomechanical and especially physiological and embryological knowledge may be the key to a future window of opportunity for chronic arterial disease therapy and prevention. In addition, this review discusses possible therapeutic approaches for symptomatic coronary ischemia caused by myocardial bridges.Descriptors: Myocardial bridging. Coronary circulation. Endothelium. ResumoDiversos estudos demonstram que as porções intramiocárdicas das artérias coronárias são poupadas da arteriosclerose, envolvendo aspectos morfológicos, embriológicos, biomecânicos e aspectos fisiopatológicos. A função endotelial é significativamente afetada no segmento de transição, tal como estimado pela resposta vasoativa para acetilcolina (Ach). Esses achados sugerem que ponte miocárdica pode fornecer proteção contra a arteriosclerose, por contrariar os efeitos negativos da disfunção endotelial. O fenômeno dessa proteção da porção intramiocárdica merece maior investigação científica em todas as frentes de pesquisa. Maiores conhecimentos sobre os aspectos morfológicos, biomecânicos e, principalmente, fisiológicos e embriológicos podem ser a chave para uma futura janela de oportunidades de terapia e prevenção da doença arterial crônica. Nessa revisão, discutemse, também, possíveis abordagens terapêuticas para fenômenos coronarianos isquêmicos causados por pontes miocárdicas.Descritores: Ponte miocárdica. Circulação coronária. Endotélio. RBCCV 44205-1301

Human cytomegalovirus infection and coronary heart disease: a systematic review

“…Coronary atherosclerotic heart disease, also known as coronary heart disease (CHD), involves the coronary and other circulations [ 1 – 3 ]. Atherosclerosis (AS) causes vascular stenosis and/or obstruction, resulting in myocardial ischemia [ 4 , 5 ] and hypoxia [ 6 ] and ultimately CHD with loss to society [ 7 , 8 ] and even death [ 9 ]. AS is prevalent in the elderly: in Western society it is the primary cause of death, and in China, the incidence is ~ 80% in those over the age of 60 years [ 10 – 12 ].…”

A Morphological Study of Myocardial Bridges in the Fetal Heart

“…Demonstration of Ki-67 activity coupled with decreased muscle and macrophage lowers the atherosclerosis threshold of the bridged segment when compared to other parts of the artery. In addition, the endothelial dysfunction evidenced by the vasoactive response to acetylcholine in the transition segment showed the counteracting effect of the myocardial bridge (38,39). Reports also claimed the technical difficulty posed by MBs in coronary bypass surgery, especially during exposure of the intramuscular segment (4, 23).…”

Speculative Considerations about Some Cardiology Enigmas

“…This protective phenomenon deserves further scientific research. Improved morphological, biomechanical and especially a deeper embryological knowledge may be the key to a future window of opportunity for chronic arterial disease therapy and prevention [5]. …”