Kinetics of the red cell washout from coronary vessels of isolated feline hearts.

Twenty seven isolated feline hearts were perfused with cell-free oxygenated Ringer-Locke solutions. The concentration of red blood cells in samples of venous outflow collected from the coronary sinuses was determined by means of a Celloscope counter. Cellular concentrations decreased gradually as the perfusion time increased, and from 10(9) to 10(5) cells per millilitre after 300 ml perfusion. When the ventricular lumens were filled with residual blood (group I, 15 cats), several red cell peaks were superimposed on the smooth exponential decay curve of red cell washout. It is suggested that the peaks were caused by ejection of red cells from the ventricular lumens into communicating branches between the ventricular lumens and coronary capillaries. In cases of blood-emptied hearts (group II, 12 cats) these peaks did not occur, and mathematical analysis showed that summing three exponential functions could approximate the whole washout curve of red cells. This suggests that the coronary circulation may be described by three red cell compartments. The functional implication of this analysis for the microcirculation in the coronary vessels was discussed.     

Histological and immunocytochemical investigation of human coronary vessel development with anti-CD34 antibodies

Information about embryonic development of coronary endothelium is the main clue for the creation of new methods in tissue engineering for treatment of ischemic heart diseases. The purpose of the research was to describe human coronary vessels development on early stages of the prenatal ontogenesis. The first step in human coronary vessels development is the formation of endothelium de novo by transformation of some epicardial and, possibly, endocardial cells. The next step is the ingrowth of sinus venosus endothelium in subepicardium over ventricles and atria, which gives rise to the coronary vessels. Only after 7 days does the primitive coronary plexus of the heart communicate with aorta (third step). During this period, some subepicardial vessels invade myocardium and some intramyocardial vessels contact with the heart cavity. Such intercommunications could help in regulation of blood circulation in primitive coronary plexus before establishment of effective contacts between arterial and venous vessels—excess of blood could be discharged directly into the heart cavity. Additional population of CD34+ cells were revealed inside condensed mesenchyme of the conotruncus; it participates in the formation of vasa vasorum in the aorta. Epicardium and sinus venosus generate endothelium of coronary vessels by neovasculo- and angiogenesis, respectively. During a week after ingrowth of vessels from SV and before their ingrowth to the aorta, ventriculo-coronary communications could be found in the heart.     

Functional and morphological characteristics of coronary vessels in varying degree of coronary perfusion]

Limitation of coronary perfusion of different degree induces inhomogeneous changes in resistance of vessels in the hypoperfusing zone: an adequate dilatory regulatory reaction may be followed by an increase in resistance of the coronary vessels. An active component of diastolic coronary resistance used to analyze vascular reactions, rate and character of changes in resistance under conditions of coronary perfusion as well as histological and electron-microscopic estimation of the vascular wall state testify to reversibility and active character of the observed changes in coronary resistance including its increase. This increase is pathogenetically significant as it may induce further development of the coronary perfusion disorder.     

Arterialization of the venous system of the brain

The possibility of reverse perfusion of the brain (in which arterial blood flows to brain tissues through venous vessels, and venous blood is drained by the arteries) was studied in acute and chronic experiments on dogs. Blood pressure in cerebral veins could reach 90--120 mm Hg, in Willisii arteries it was 5--35 mm Hg. Liquor pressure reached 20--35 mmHg. After temporary arterialization of the brain venous system (10, 30 and 60 min) the animals survived without impairment of the brain function and behaviour. In the future reverse perfusion of the brain (in which blood pressure in the arteries falls to the level of venous pressure) could be used as a means of urgent surgical intervention in cases of threatened or beginning intracranial arterial hemorrhage.     

Comparative characterization of reactions of skeletal muscle arterial and venous vessels to combined adrenergic effects

In experiments with the constant blood flow perfusion of the cat calf muscle and combined actions of adrenalin and noradrenaline were tested as to the blood flow resistance changes of the arterial and venous blood vessels. Separately applied the catecholamines evoked vascular resistance changes practically similar in value; combined effects of catecholamines realized in greater increase of arterial than venous resistance. In contrast to arterial vessels supramaximal stimuli resulted in much lesser constrictive effect as compared with reaction of intramural veins to separately applied catecholamines. Greater doses of catecholamines being combined, stability of effector system of skeletal muscle veins is decreased as compared to arteries.     

Retrograde coronary venous perfusion at low pressure

The effectiveness of localized retrograde coronary venous perfusion (RCVP) in preventing or reversing myocardial ischemia after acute ligation of a coronary artery is described. Ten domestic pigs (Group I) underwent aorto left anterior coronary vein grafting with RCVP at systemic pressure. In another set of ten pigs (Group II), the coronary vein was similarly grafted, but the proximal end of the graft was perfused with oxygenated blood by means of an external pump at reduced pressure and flow. In both groups, RCVP successfully reversed the mechanical or electrical effects produced by 2 to 5 minutes of acute arterial ligation. After several hours, Group I animals showed evidence of acute ischemia and developing infarction. Group II animals, however, were maintained for 7 hours or more with regional RCVP and no evidence of ischemia. Retrograde coronary venous perfusion at reduced pressure may be more effective than perfusion at systemic pressure in providing myocardial blood flow.     

Evolution of blood vessels of the heart wall

In progressive development of the organisms, the cardio-vascular system perfects, its construction is adequate to the level and character of the animal's metabolism. The hypobranchial arteries, forming in the subbranchial area in fishes, make the immediate source for the branching off the coronary arteries. Comparison of the data concerning the places where the cranial coronary arteries take their origin in amphibia, reptiles, birds and mammalia demonstrates that the evolutional process is directed towards transference of the places of their branching off on the ventral aorta, and then on the nearest distance to the heart. Certain data are obtained on evolution of the blood circulation pathways in the myocardium and, particularly, on presence of blood vessels in the spongy myocardium in Elasmobranchii, Chondrosteoideii, as well as in the alligator. The most important of the myocardial blood vessels at all stages of evolution is their connection with the cardiac chambers. At definite stages of phylogenesis, simultaneously with compactization of the myocardium and formation of veins from the intertrabecular spaces, the subepicardial and intramural veins unite into a single venous system, bringing blood to the cardiac cavity. In birds, mammalia and human being, the coronary vessels have reached a high degree of development, having penetrated by their branches into all layers of the cardiac wall, and thus they exclude the dependence of the myocardial blood supply from the blood that is present in the cardiac cavity.     

Capacity and exchange functions of the kidney blood vessels at various leveles of venous outflow

In perfusion of the cat hemodynamically isolated kidney with a constant blood flow volume, responses of venous vessels to noradrenaline did not depend on the venous outflow pressure level and only involved a diminishing of the blood filling which distinguishes kidneys from other organs. The renal veins' capacity decreased in response to noradrenaline practically completely disappears in high values of the venous outflow pressure. The renal capillary filtration coefficient was shown to equal 0.21 +/- 0.11, whereas the effect of changes in renal vein's pressure on implementation of the microvessels' exchange function in determined by the shifts of capillary hydrostatic pressure.     

Heat production as a criterion of adrenergic regulation of metabolic processes of the myocardium

Bolus injection of adrenaline in coronary perfusion blood flow caused different-directed changes in coronary venous blood temperature. Directivity and myocardium heat production changes are determined by peculiarities of interactions between adrenergic and cholinergic mechanisms of cardiodynamics and myocardial metabolism regulation. Cholinergic blockade by atropine++ increases heat production and limits negative ino- and chronotropic components of cardiac adrenergic reactions. That increase is completely eliminated by subsequent obsidan blockade of beta-adrenoreceptors.     

Effects of exercise training on coronary transport capacity

Coronary transport capacity was estimated in eight sedentary control and eight exercise-trained anesthetized dogs by determining the differences between base line and the highest coronary blood flow and permeability-surface area product (PS) obtained during maximal adenosine vasodilation with coronary perfusion pressure constant. The anterior descending branch of the left coronary artery was cannulated and pump-perfused under constant-pressure conditions (approximately equal to 100 Torr) while aortic, central venous, and coronary perfusion pressures, heart rate, electrocardiogram, and coronary flow were monitored. Myocardial extraction and PS of 51Cr-labeled ethylenediaminetetraacetic acid were determined with the single-injection indicator-diffusion method. The efficacy of the 16 +/- 1 wk exercise training program was shown by significant increases in the succinate dehydrogenase activities of the gastrocnemius, gluteus medialis, and long head of triceps brachii muscles. There were no differences between control and trained dogs for either resting coronary blood flow or PS. During maximal vasodilation with adenosine, the trained dogs had significantly lower perfusion pressures with constant flow and, with constant-pressure vasodilation, greater coronary blood flow and PS. It is concluded that exercise training in dogs induces an increased coronary transport capacity that includes increases in coronary blood flow capacity (26% of control) and capillary diffusion capacity (82% of control).     

Bifurcation asymmetry of the porcine coronary vasculature and its implications on coronary flow heterogeneity

The branching pattern of the coronary arteries and veins is asymmetric, i.e., many small vessels branch off of a large trunk such that the two daughter vessels at a bifurcation are of unequal diameters and lengths. One important implication of the geometric vascular asymmetry is the dispersion of blood flow at a bifurcation, which leads to large spatial heterogeneity of myocardial blood flow. To document the asymmetric branching pattern of the coronary vessels, we computed an asymmetry ratio for the diameters and lengths of all vessels, defined as the ratio of the daughter diameters and lengths, respectively. Previous data from silicone elastomer cast of the entire coronary vasculature including arteries, arterioles, venules, and veins were analyzed. Data on smaller vessels were obtained from histological specimens by optical sectioning, whereas data on larger vessels were obtained from vascular casts. Asymmetry ratios for vascular areas, volumes, resistances, and flows of the various daughter vessels were computed from the asymmetry ratios of diameters and lengths for every order of mother vessel. The results show that the largest orders of arterial and venous vessels are most asymmetric and the degree of asymmetry decreases toward the smaller vessels. Furthermore, the diameter asymmetry at a bifurcation is significantly larger for the coronary veins (1.7-6.8 for sinus veins) than the corresponding arteries (1.5-5.8 for left anterior descending coronary artery) for orders 2-10, respectively. The reported diameter asymmetry at a bifurcation leads to significant heterogeneity of blood flow at a bifurcation. Hence, the present data quantify the dispersion of blood flow at a bifurcation and are essential for understanding flow heterogeneity in the coronary circulation.     

Retrograde perfusion and filling of mouse coronary vasculature as preparation for micro computed tomography imaging

Visualization of the vasculature is becoming increasingly important for understanding many different disease states. While several techniques exist for imaging vasculature, few are able to visualize the vascular network as a whole while extending to a resolution that includes the smaller vessels. Additionally, many vascular casting techniques destroy the surrounding tissue, preventing further analysis of the sample. One method which circumvents these issues is micro-Computed Tomography (μCT). μCT imaging can scan at resolutions <10 microns, is capable of producing 3D reconstructions of the vascular network, and leaves the tissue intact for subsequent analysis (e.g., histology and morphometry). However, imaging vessels by ex vivo μCT methods requires that the vessels be filled with a radiopaque compound. As such, the accurate representation of vasculature produced by μCT imaging is contingent upon reliable and complete filling of the vessels. In this protocol, we describe a technique for filling mouse coronary vessels in preparation for μCT imaging. Two predominate techniques exist for filling the coronary vasculature: in vivo via cannulation and retrograde perfusion of the aorta (or a branch off the aortic arch), or ex vivo via a Langendorff perfusion system. Here we describe an in vivo aortic cannulation method which has been specifically designed to ensure filling of all vessels. We use a low viscosity radiopaque compound called Microfil which can perfuse through the smallest vessels to fill all the capillaries, as well as both the arterial and venous sides of the vascular network. Vessels are perfused with buffer using a pressurized perfusion system, and then filled with Microfil. To ensure that Microfil fills the small higher resistance vessels, we ligate the large branches emanating from the aorta, which diverts the Microfil into the coronaries. Once filling is complete, to prevent the elastic nature of cardiac tissue from squeezing Microfil out of some vessels, we ligate accessible major vascular exit points immediately after filling. Therefore, our technique is optimized for complete filling and maximum retention of the filling agent, enabling visualization of the complete coronary vascular network--arteries, capillaries, and veins alike.     

A METHOD OF CORONARY RETROPERFUSION FOR THE TREATMENT OF ACUTE MYOCARDIAL ISCHEMIA

A method of retrograde perfusion of the myocardium has been developed in dogs. It consists of a double lumen balloon-tipped catheter inserted transvenously into the coronary sinus, with one lumen connected to a roller pump, the other to a helium counterpulsing pump. Oxygenated heparinized blood is obtained from the femoral artery and pumped continuously into the coronary sinus at a pressure of 50-75 mm Hg. The balloon is inflated during diastole, sealing the coronary sinus and promoting retrograde flow, and is deflated during systole, allowing blood drainage into the right atrium and preventing venous congestion. Thirteen anesthetized open-chest dogs were subjected to 15 minutes of proximal LAD artery occlusion and 30 minutes of diastolic coronary sinus perfusion (DCSP). The area of ischemia was mapped by means of platinum electrodes capable of simultaneously measuring myocardial tissue oxygen tension M(p)O(2)) and electrograms. Reduction of M(p)O(2) with simultaneous elevation of the ST segment on the corresponding electrogram was considered an indication of ischemia. Diastolic coronary sinus perfusion improved myocardial oxygen tension in the ischemic myocardium, reduced ST segment elevation, and tended to restore arterial blood pressure. Histologically, there was no intramyocardial hemorrhage.     

Metabolic vasodilatation in skeletal muscle and the problem of the direct or indirect action of oxygen on resistant blood vessels.

1. Vasodilatation induced by venous blood infusion and reactive hyperaemia following the reduction of perfusion pressure for different lengths of time (1 to 128 sec) were studied in the haemodynamically isolated and denervated vascular bed of the dog gracilis muscle. The two local regulatory situations differed chiefly in respect to the oxygen concentration in the precapillary part of the blood bed (51.4% and 97.6% respectively) and in the size of the blood flow (100% and 48.5% of the resting value). 2. The interval between the time when venous blood entered the resistant precapillary vessels and the onset of the local regulatory response was 25.1 +/- 1.9 seconds. In prolongation of the duration of reduced perfusion pressure, the continuous increase in the maximum reactive hyperaemia value was interrupted, on reducing it for 16-32 seconds, by a significant (P less than 0.001) abrupt increase in this value. 3. We conclude from the good agreement of these two time values that: 1. reduction of the blood oxygen concentration to 51.4% does not directly affect the smooth muscle cells in the wall of resistant vessels; 2. an interval of 25.1 +/- 1.9 sec (16-32 seconds) is needed for interference with the metabolism of skeletal muscle to attain a critical value and for the relevant chemical signal to produce a dilatation response in the arterioles.     

Tissue-growth-based synthetic tree generation and perfusion simulation

Biological tissues receive oxygen and nutrients from blood vessels by developing an indispensable supply and demand relationship with the blood vessels. We implemented a synthetic tree generation algorithm by considering the interactions between the tissues and blood vessels. We first segment major arteries using medical image data and synthetic trees are generated originating from these segmented arteries. They grow into extensive networks of small vessels to fill the supplied tissues and satisfy the metabolic demand of them. Further, the algorithm is optimized to be executed in parallel without affecting the generated tree volumes. The generated vascular trees are used to simulate blood perfusion in the tissues by performing multiscale blood flow simulations. One-dimensional blood flow equations were used to solve for blood flow and pressure in the generated vascular trees and Darcy flow equations were solved for blood perfusion in the tissues using a porous model assumption. Both equations are coupled at terminal segments explicitly. The proposed methods were applied to idealized models with different tree resolutions and metabolic demands for validation. The methods demonstrated that realistic synthetic trees were generated with significantly less computational expense compared to that of a constrained constructive optimization method. The methods were then applied to cerebrovascular arteries supplying a human brain and coronary arteries supplying the left and right ventricles to demonstrate the capabilities of the proposed methods. The proposed methods can be utilized to quantify tissue perfusion and predict areas prone to ischemia in patient-specific geometries.

     

Cardiac vessels of human fetuses and newborn infants

The anatomy of the cardiac arteries has been studied in 78 and that of the veins--in 74 total preparations of human fetal hearts 3--10-lunar month-old and in newborns. The cardiac vessels are injected with contrast masses, erythrocytes are stained with benzidine, histotopograms are made. In the fetuses all branches of the 1st-3d order of the coronary arteries and cardiac veins have been formed. Topography and main dimentions of large cardiac vessels are defined. During the prenatal period ramification zones of the coronary arteries do not change. In different age groups of the fetuses and newborns right coronary type of the cardiac blood supply predominates considerably (58-60%), in 27-32%--equal, and in 8-13%--left coronary type is observed. A great variability of the venous cardiac bed, vast intervenous anastomoses and a special importance of the cardiac middle vein in blood outflow are noted.     

Mechanisms of oxygen demand/supply balance in the right ventricle

Few studies have investigated factors responsible for the O2 demand/supply balance in the right ventricle. Resting right coronary blood flow is lower than left coronary blood flow, which is consistent with the lesser work of the right ventricle. Because right and left coronary artery perfusion pressures are identical, right coronary conductance is less than left coronary conductance, but the signal relating this conductance to the lower right ventricular O2 demand has not been defined. At rest, the left ventricle extracts approximately 75% of the O2 delivered by coronary blood flow, whereas right ventricular O2 extraction is only ~50%. As a result, resting right coronary venous PO2 is approximately 30 mm Hg, whereas left coronary venous PO2 is approximately 20 mm Hg. Right coronary conductance does not sufficiently restrict flow to force the right ventricle to extract the same percentage of O2 as the left ventricle. Endogenous nitric oxide impacts the right ventricular O2 demand/supply balance by increasing the right coronary blood flow at rest and during acute pulmonary hypertension, systemic hypoxia, norepinephrine infusion, and coronary hypoperfusion. The substantial right ventricular O2 extraction reserve is used preferentially during exercise-induced increases in right ventricular myocardial O2 consumption. An augmented, sympathetic-mediated vasoconstrictor tone blunts metabolically mediated dilator mechanisms during exercise and forces the right ventricle to mobilize its O2 extraction reserve, but this tone does not limit resting right coronary flow. During exercise, right coronary vasodilation does not occur until right coronary venous PO2 decreases to approximately 20 mm Hg. The mechanism responsible for right coronary vasodilation at low PO2 has not been delineated. In the poorly autoregulating right coronary circulation, reduced coronary pressure unloads the coronary hydraulic skeleton and reduces right ventricular systolic stiffness. Thus, normal right ventricular external work and O2 demand/supply balance can be maintained during moderate coronary hypoperfusion.     

Experimental measurements of the temperature variation along artery-vein pairs from 200 to 1000 microns diameter in rat hind limb

Theoretical studies have indicated that a significant fraction of all blood-tissue heat transfer occurs in artery-vein pairs whose arterial diameter varies between 200 and 1000 microns. In this study, we have developed a new in vivo technique in which it is possible to make the first direct measurements of the countercurrent thermal equilibration that occurs along thermally significant vessels of this size. Fine wire thermocouples were attached by superglue to the femoral arteries and veins and their subsequent branches in rats and the axial temperature variation in each vessel was measured under different physiological conditions. Unlike the blood vessels < 200 microns in diameter, where the blood rapidly equilibrates with the surrounding tissue, we found that the thermal equilibration length of blood vessels between 200 microns and 1000 microns in diameter is longer than or at least equivalent to the vessel length. It is shown that the axial arterial temperature decays from 44% to 76% of the total core-skin temperature difference along blood vessels of this size, and this decay depends strongly on the local blood perfusion rate and the vascular geometry. Our experimental measurements also showed that the SAV venous blood recaptured up to 41% of the total heat released from its countercurrent artery under normal conditions. The contribution of countercurrent heat exchange is significantly reduced in these larger thermally significant vessels for hyperemic conditions as predicted by previous theoretical analyses. Results from this study, when combined with previous analyses of vessel pairs less than 200 microns diameter, enable one estimate the arterial supply temperature and the correction coefficient in the modified perfusion source term developed by the authors.     

Notch signaling is required for arterial-venous differentiation during embryonic vascular development

Recent evidence indicates that acquisition of artery or vein identity during vascular development is governed, in part, by genetic mechanisms. The artery-specific expression of a number of Notch signaling genes in mouse and zebrafish suggests that this pathway may play a role in arterial-venous cell fate determination during vascular development. We show that loss of Notch signaling in zebrafish embryos leads to molecular defects in arterial-venous differentiation, including loss of artery-specific markers and ectopic expression of venous markers within the dorsal aorta. Conversely, we find that ectopic activation of Notch signaling leads to repression of venous cell fate. Finally, embryos lacking Notch function exhibit defects in blood vessel formation similar to those associated with improper arterial-venous specification. Our results suggest that Notch signaling is required for the proper development of arterial and venous blood vessels, and that a major role of Notch signaling in blood vessels is to repress venous differentiation within developing arteries. Movies available on-line     

Hedgehog signaling to distinct cell types differentially regulates coronary artery and vein development

Vascular development begins with formation of a primary capillary plexus that is later remodeled to give rise to the definitive vasculature. Although the mechanism by which arterial and venous fates are acquired is well understood, little is known about when during vascular development arterial and venous vessels emerge and how their growth is regulated. Previously, we have demonstrated that a hedgehog (HH)/vascular endothelial growth factor (VEGF) and angiopoeitin 2 (ANG2) signaling pathway is essential for the development of the coronary vasculature. Here, we use conditional gene targeting to identify the cell types that receive HH signaling and mediate coronary vascular development. We show that HH signaling to the cardiomyoblast is required for the development of coronary veins, while HH signaling to the perivascular cell (PVC) is necessary for coronary arterial growth. Moreover, the cardiomyoblast and PVC appear to be the exclusive cell types that receive HH signals, as ablation of HH signaling in both cell types leads to an arrest in coronary development. Finally, we present evidence suggesting that coronary arteries and veins may be derived from distinct lineages.