Studies on the coronary circulation. III. Collateral circulation of beating human and dog hearts with coronary occlusion

Prinzmetal, Myron; Bergman, Harry; Krüger, H; Schwartz, Lois L.; Simkin, Benjamin; Sobin, Sidney S.

doi:10.1016/0002-8703(48)90447-5

Cited by 86 publications

(7 citation statements)

References 23 publications

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“…Finally, as Wiggers 26 has asserted, the marginal areas of the territory supplied by a particular coronary artery must receive a dual blood supply. Convincing evidence for this is afforded by the fluorescein dye experiments of Prinzmetal and his collaborators, 27 by the polarographic studies of Sayen and his coworkers, 28 and by the results of fibrinolytic therapy reported by Nydick and his colleagues. 29 The higher Rb 8e clearances in the apical portions of the ischemic region in the present study are probably attributable to the fact that the larger terminal branches of the anterior descending and circumflex arteries tend to converge as the apex is approached ( fig.…”

mentioning

confidence: 97%

Collateral Blood Flow to the Myocardium as Determined by the Clearance of Rubidium ⁸⁶ Chloride

Levy

Imperial

Zieske

1961

Circulation Research

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The left circumflex coronary artery was li gated in anesthetized dogs, and the blood flow to the normal and ischemic regions was esti mated by means of the Rb 86 clearance tech nique. Time occlusion of this coronary artery resulted in an appreciable reduction in the Rb 86 clearance, principally in the posterior region of the left ventricle bounded by the circumflex artery, the posterior descending branch, the ramus marginis obtusi, and the apex. The diminution of clearance of this iso tope was most marked in the basal region, and imp roved progressively toward the apex. Clearances were also decreased in the basal regions just anterior and posterior to this zone. The weight of the ischemic zone, as defined by the Rb clearance technique, was approxi matelv half of that outlined in other studies by injection of dye into the distal end of the occl.uded circumflex artery. Th.is implies that the marginal zone of the territory supplied by the left circumflex coronary artery must receive a dual blood supply. Also, the Rb 86 clearance in the ischemic zone exceeds the es timates of collateral flow l)rovided by simul taneously measured ietrogracle flows. This was true despite the facts that (a) actual blood flows must exceed the measured R clear ances, since extraction is never complete, and (b) retrograde flows overestimate the true value for interarterial collateral flow. When the interarterial collateral flow is drained away by leaving the low resistance cannula system uriclamped during the isotope inf u sion, the Rb 86 clearance is not appreciably af fected in the marginal zone and is reduced by 50 to 60 per cent in the central and basal Portions of the ischemic region. rphese find ings signify that an appreciable circulation must be provided by vessels which communi cate with the capillary beds within the ische inic zone anc1, therefore, would contribute to the measured retrograde flow to only a neg ligible extent.

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mentioning

confidence: 97%

Collateral Blood Flow to the Myocardium as Determined by the Clearance of Rubidium ⁸⁶ Chloride

Levy

Imperial

Zieske

1961

Circulation Research

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“…The high incidence of survival of the subepicardial layers in the group with coronary insufficiency may be explained in part by the greater collateral circulation in this region of the myo¬ cardium, as demonstrated by Prinzmetal and associates. 12 The difference in character of the infarction in the two groups seems to explain the high incidence of pericarditis and cardiac rupture following acute coronary occlusion and infarction and the low incidence of these complications in the patients with coronary insuffi¬ ciency. The observations on this series support the current opinion that previous infarction with scarring plays a role in preventing cardiac rupture in that part of the heart, with a subsequent acute myocardial infarct in that area.13 In 61% of all our cases gross scarring was noted.…”

Section: Incidence Oj Acute Coronary Occlusion As Compared With That mentioning

confidence: 99%

Myocardial Infarction With and Without Acute Coronary Occlusion

Miller¹

1951

AMA Arch Intern Med

111

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“…В эпикарде человека, кошек и собак были обнаружены типичные артериоло-венулярные анастомозы [1]. Однако они не соответствуют описанию тех непосредственных соустий между артериями и венами, расположенных под эпикардом которые были выявлены ранее [2,3]. Описавшие их авторы, используя инъекционные методы, допускали возможность перехода взвеси туши из субэпикардиальных артерий в субэпикардиальные вены.…”

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The epicardium as a biological filter of the heart

2020

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In the epicardium of many mammals, animals, including humans, were found to have typical arteriovenular anastomoses. However, they do not correspond to the description of those direct anastomoses between arteries and veins located under the epicardium, which were previously identified. The authors who described them, using injection methods, showed the passage of carcass suspension from sub-epicardial arteries to sub-epicardial veins. But they could not accurately identify the type of vessels carrying out these connections. It is possible that these are arteriovenular anastomoses, since their diameter not exceeds the diameter of the blood capillaries. At the same time, it was shown that the vascular structures of the epicardium carry out the separation of the blood in the coronary artery system. As a result, blood with high hematocrit and freed from most various analytes and neutrophilic granulocytes enters the microvascular bed of the myocardium. The ultrafiltrate of the blood plasma in the sub-epicardial loose connective tissue undergoes biodegradation and is utilized in the lymphatic micro vessels. The aim of the work is the morphological and functional substantiation of the concept about of the epicardium as a biological filter of the heart. The vascular bed of the epicardium of hearts of mature dogs was studied (n=5), revealed by various routine histological and original intra- and extravascular methods. It is proved that the microvascular bloodstream of the sub-epicardial connective tissue has pronounced organ specificity. It is determined by the presence of arteriovenular anastomoses and permanent plasma capillaries, as well as the high permeability of all vascular components. The microvascular bed of the epicardium causes an ascending dilatation of the coronary arteries and contributes to ultrafiltration of a significant amount of blood plasma into the sub-epicardial interstitial space. Thus, the process of the separation of the blood is carried out, as a result of which blood with high hematocrit and free of neutrophilic granulocytes enters the myocardium. In the epicardial connective tissue, analytes accumulate that cannot be resorbed by venous micro vessels. This «biological debris» undergoes destruction in the sub-epicardial connective tissue, which proves the role of the epicardium as a biological filter of the heart.

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Studies on the coronary circulation. III. Collateral circulation of beating human and dog hearts with coronary occlusion

Cited by 86 publications

References 23 publications

Collateral Blood Flow to the Myocardium as Determined by the Clearance of Rubidium ⁸⁶ Chloride

Collateral Blood Flow to the Myocardium as Determined by the Clearance of Rubidium ⁸⁶ Chloride

Myocardial Infarction With and Without Acute Coronary Occlusion

The epicardium as a biological filter of the heart

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Studies on the coronary circulation. III. Collateral circulation of beating human and dog hearts with coronary occlusion

Cited by 86 publications

References 23 publications

Collateral Blood Flow to the Myocardium as Determined by the Clearance of Rubidium 86 Chloride

Collateral Blood Flow to the Myocardium as Determined by the Clearance of Rubidium 86 Chloride

Myocardial Infarction With and Without Acute Coronary Occlusion

The epicardium as a biological filter of the heart

Contact Info

Product

Resources

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Collateral Blood Flow to the Myocardium as Determined by the Clearance of Rubidium ⁸⁶ Chloride

Collateral Blood Flow to the Myocardium as Determined by the Clearance of Rubidium ⁸⁶ Chloride