Morphologic changes in the coronary arteries in experimental coarctation of the aorta and following its correction

In 33 puppies 2-4 months of age the model of a congenital heart disease was made as coarctation of the aorta. In 6-12 months 18 animals were taken to study, and in 15 animals the coarctation was removed. The latter animals were observed for other 6-12 months. The hearts of both groups were separately weighed, and the vessels of the coronary system were studied by means of a complex of histological and morphometric methods. Simultaneously, the number of smooth muscle cells, as well as the area and volume of their nuclei in media of small coronary arteries were estimated. At the experimental coarctation of the aorta certain hypertrophic-hyperplastic changes in coronary arteries at all branching levels take place. They are of a compensatory-adaptive character and reflect certain reactions of the vascular wall to an increased coronary hemodynamics under conditions of hyperfunction and hypertrophy of the cardiac muscle. Surgical removal of the coarctation is accompanied with a reduce of the hemodynamic loading of the heart, diminished degree of hypertrophy of the organ and a marked decrease of the hypertrophic-hyperplastic changes in its vessels. At the same time, the cardiac vascular system is adapting to the new conditions of circulation: rearrangement of some coronary arteries and arterioles according to the closed type and reduction of circulation in the vascular branches which have lost their importance in feeding the myocardium.     

Adaptive structures of the arteries of the heart participating in the regulation of coronary circulation

By means of a complex of anatomical, histological and histochemical methods cardiac vessels have been studied in 20 control dogs and in 84 dogs with experimentally produced circulatory disturbances peculiar for congenital heart diseases presented as an open arterial duct, coarctation of the aorta and the pulmonary trunk stenosis. The experimental animals have been observed for 6-12 months. In the animals with experimentally produced disturbances of the general and coronary hemodynamics hyperplasy in the coronary branches of the arteries appears, it is more pronounced in functionally loaded cardiac parts, as well as thickening of their walls at the expense of new formations and hyperthrophy of smooth muscle cells. In both control and experimental dogs in the coronary vessels at various branching levels certain formations are revealed; they are of compensatory-adaptive value: intimal and adventitial musculature, polypoid pulvinars, muscular-elastic constrictors, muscular cuffs and precapillary sphincters. They differ in structure, sources of their origin and in their functional value. Degree of their manifestation increases significantly after reproduction of the hemodynamic disturbances in the heart vascular system. The active role of these formations in regulation of the coronary circulation is demonstrated owing to a high content of ribonucleinic acid and glycogene in their smooth muscle cells and also an elevated succinate dehydrogenase, cytochromoxydase, acid and alcaline phosphatase activities.     

Coronary chemoreceptors in rabbits

Position and structure of the coronary ++chemoreceptor (CH) have been studied in 40 Chinchilla rabbits by means of neurohistological and histochemical methods. The CH is situated in the adventitia of the left coronary artery. The CH together with chromaffin cells includes blood vessels, small nervous fasciculi and connective tissue. According to luminescent intensity 2 groups of cells are distinguished. Two types of CH cells are revealed morphometrically, they differ in their size. Metachromasia at staining with toluidine++ blue demonstrates presence of serotonin in the CH. A possible role of the CH in pathogenesis of a sudden death is considered.     

Vessels of the heart and lung in some experimental defects]

Under study were changes of intraorganic blood vessels of the heart and lungs in some experimental defects (open arterial defect, coarctation of the aorta, simultaneous existence of these two defects, stenosis of the pulmonary trunk, defect of the interatrial septum, triad of Fallot, syndrom of Lutembachet). Morphological data correlated with blood pressure in the pulmonary circulation and cardiac chambers. The complex of compensatory-adaptational mechanisms consisting of comparatively active and passive zones is formed in the heart and lungs. In most cases the changes develop in the vessels already existing. In hypertrophy of the myocardium when there is hypertension and hypervolemia in coronary vessels, sinusoids perform the function of blood reservoir, to a certain degree balancing the blood pressure, and luminar ducts relieve the muscle from excessive blood. The changes in the vascular system of the lung are directly dependent upon the pressure in the pulmonary circulation and the duration of observation. The closing arteries are the most active link in the chain of compensatory-adaptational mechanisms.     

Arterial and venous vasculature of the heart of the beluga whale (Delphinapterus leucas)

The arteries and veins of the heart of the beluga whale (Delphinapterus leucas) are described from the dissection of nine specimens. The arterial distribution is composed of the basic mammalian pattern of two major vessels, the left and right coronary arteries, which supply the cardiac tissue. The venous drainage is provided by three major systems which are the great, middle, and small cardiac veins. The vascular characteristics of the heart of the beluga whale are the marked sinuosity of both coronary arteries and their main branches, the numerous large interarterial anastomoses between major vessels, and the duplication of vessels in parallel branches. These characteristics are discussed in functional terms and correlated with the diving ability of the species.     

Effect of the alpha-adrenoblocker pyrroxan on systemic hemodynamics in puppies and dogs with vasorenal hypertension]

Vasorenal hypertension was induced in 2--3-month-old puppies and adult dogs by stricture of both renal arteries. 1.5 mg/kg of pyrroxan was injected intravenously 3 and 14 days later. A reduction of increased arterial pressure was noted both in adult dogs and in puppies, to the subnormal level in the latter. Hypotensive effect of the preparation was connected in adult animals with diminution of the general peripheral vascular resistance and in puppies, besides, with reduction of cardiac output. Pyrroxan injection was accompanied in all the animals with tachycardia, reduction of the phase of isometric contraction and activation of myocardial contractility.     

The arterial circulation of the heart

Blood flows into the aorta and its branches during left ventricular systole. Most of the arterial walls in the body stretch during systole in accordance with their elastic properties (Roston, 1962a, b). During diastole, the rebound of the distended walls supplies an additional propulsive force pushing the blood forward. Since the metabolic exchange between most of the tissues in the body and their blood vessels is ordinarily the same throughout the cardiac cycle, it makes little difference whether or not the blood flow occurs during systole or diastole. The circulation in the coronary arteries behaves in a quite different way. Because the muscle fibers of the heart contract during systole and relax during diastole, different conditions for blood flow and metabolic exchange exist during the phases of the cardiac cycle. As a result, specification of whether blood flows in the coronary arteries during systole or diastole may be important. Such specification complicates the study of the coronary artery circulation. For example, because of the arterial elasticity, some of the blood which enters the coronary arteries during diastole comes in contact with the muscle fibers during systole. The present work contains a theoretical study of the coronary artery circulation.     

Role of the vagus in control of the major conduit coronary artery in the dog.

Using El Badawi and Schenk's modification of Karnovski's method for the demonstration of acetylcholinesterase, the authors found cholinergic fibres both in the perivascular connective tissue and directly in the wall (in the adventitia) of the major coronary arteries; the fibres were distributed regularly around the circumference of the arteries. In the case of the smaller intramyocardial arteries, the cholinergic fibres were concentrated at two poles of the blood vessel; none were present in the wall of the veins. The shape and topography of the coronary cholinergic arterial plexus resemble the shape and topography of the coronary sympathetic adrenergic system. In apparent contradiction of this finding, stimulation of the cervical vagus did not affect the diameter of the large coronary arteries. Since acetylcholine (6--10 micrograms/kg i.v.) produced a mean 7.4% increase in the diameter of the ramus interventricularis ventralis, we concluded that there are no postgangliar cholinergic fibres of vasomotor significance for the large coronary arteries in the cervical vagus. The specific acetylcholinesterase activity found in the wall of these vessels belongs either to cholinergic terminals whose ganglion cells are not located in the vagal ganglion, or to cholinergic axones terminating outside the wall of the large coronary arteries.     

Scanning electron microscopy substantiates histology in showing the inadequacy of the existing theories on the development of the proximal coronary arteries and their connections with the arterial trunks

Development of proximal coronary arterial segments and coronary arterial orifices was studied by scanning electron microscopy in 20 rat embryos and by light microscopy in serial sections of 20 human and another 18 rat embryos. Neither by scanning electron microscopy nor by light microscopy did we observe more than two coronary arterial orifices. These coronary orifices were always situated in the sinuses of the aorta that faced the pulmonary artery. In the human embryos the coronary orifices emerged between 37-39 days of gestation (16-19 mm crown-rump length, Streeter horizon XVIII-XIX) and were invariably present beyond 39 days (19 mm crown-rump length, Streeter horizon XIX). In rat embryos, the coronary orifices emerged in both scanning electron microscopy and light microscopy at 15-17 days of gestation (13-17 mm crown-rump length) and were invariably present beyond 17 days (17 mm crown-rump length). In both human and rat embryos, either by scanning electron microscopy and light microscopy, the left coronary orifice was observed significantly earlier. In all the investigated embryos, human as well as rat, septation at arterial orifice level was complete, including the earliest stages studied. Light microscopy showed that at the emerging stages of the coronary orifices, the proximal epicardial segments of the left and right coronary arteries could already be identified in a peritruncal ring of epicardial vasculature, before the coronary orifice was observed. This was the case in human as well as in rat embryos. Thus, a coronary orifice was never seen in the absence of a proximal coronary artery. The present theories on development of the proximal coronary arteries and coronary orifices do not offer an adequate explanation for either these data or the known possible congenital abnormalities of the coronary arteries. Our study supports dual proximal coronary arterial development. These two proximal coronary arteries develop out of a peritruncal ring of vascular structures on to the aorta. The process by which the coronary orifices actually develop remains to be explained.     

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.     

Ultrastructural localization of arginine vasopressin in coronary vessels of newborn rat

We report on the ultrastructural distribution of arginine-vasopressin (AVP) in the heart of newborn rats using pre-embedding peroxidase-antiperoxidase immunocytochemistry with a polyclonal AVP antibody for electron microscopy. Positive labelling for AVP was localized in endothelial cells of main coronary arteries and cardiac vessels of smaller diameter (microvessels). Examination of the right coronary artery showed that approximately 58% of the endothelial cells were positive for AVP. Immunoreactivity to AVP in the cytoplasm of arterial endothelium predominated in association with the membranes of granular endoplasmic reticulum and in subplasmalemmal areas. The endothelium of small vessels exhibits less endoplasmic reticulum, but still shows AVP immunoprecipitate in the cytoplasm. It is suggested that endothelial AVP may contribute to vasomotor control of the coronary circulation in the early stages of postnatal development. AVP antibody also labelled some fibroblast/fibroblast-like cells associated with the coronary arteries and microvessels; thus, these cells as well as the endothelium appear to be a source of AVP in the newborn rat heart. The functional significance of these findings is discussed.     

Exercise training-induced coronary vascular adaptation.

Aerobic exercise training induces an increase in coronary vascular transport capacity. This increased transport capacity is the result of increases in both blood flow capacity and capillary exchange capacity. These functional changes are the result of two major types of adaptive responses, structural vascular adaptation and altered control of vascular resistance. Structural vascular adaptation occurs in response to exercise training in at least two forms, increases in the cross-sectional area of the proximal coronary arteries and angiogenesis. Angiogenesis has been demonstrated in that training causes moderate cardiac hypertrophy while maintaining or increasing capillary density and increasing arteriolar density. Training-induced changes in coronary vascular control have been shown to include altered coronary responses to vasoactive substances, changes in endothelium-mediated vasoregulation, and alterations in the cellular-molecular control of intracellular free Ca2+ in both endothelial and vascular smooth muscle cells isolated from coronary arteries of exercise-trained animals. The signal or signals for these adaptive responses remain unknown. The hypothesis that the adaptive strategy entails maintenance of normal shear stress in coronary arterial vessels is discussed. We propose that as a result of training-induced structural vascular adaptations and alterations in the control of vascular resistance, shear stress throughout the coronary vasculature is returned to the level present in sedentary animals. The signal for adaptation may be peak shear stress during exercise and/or average shear stress over a 24-h period of time.     

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.     

Urotensin-II and cardiovascular remodeling

Urotensin-II (U-II), a cyclic undecapeptide, and its receptor, UT, have been linked to vascular and cardiac remodeling. In patients with coronary artery disease (CAD), it has been shown that U-II plasma levels are significantly greater than in normal patients and the severity of the disease is increased proportionally to the U-II plasma levels. We showed that U-II protein and mRNA levels were significantly elevated in the arteries of patients with coronary atherosclerosis in comparison to healthy arteries. We observed U-II expression in endothelial cells, foam cells, and myointimal and medial vSMCs of atherosclerotic human coronary arteries. Recent studies have demonstrated that U-II acts in synergy with mildly oxidized LDL inducing vascular smooth muscle cell (vSMC) proliferation. Additionally, U-II has been shown to induce cardiac fibrosis and cardiomyocyte hypertrophy leading to cardiac remodeling. When using a selective U-II antagonist, SB-611812, we demonstrated a decrease in cardiac dysfunction including a reduction in cardiomyocyte hypertrophy and cardiac fibrosis. These findings suggest that U-II is undoubtedly a potential therapeutic target in treating cardiovascular remodeling.     

Evaluation of coronary bed function by positron emission tomography using 13N-ammonium during cold stimulation

The present investigation was to study the time course of changes in myocardial blood flow (MBF) in response to cold stimulation. Thirty-eight patients having risk factors of cardiovascular complications were examined. The time course of MBF changes was estimated by positron emission tomography (PET) using 13N-ammonium at rest and during a cold test (CT). Endothelium-dependent vasodilation of the brachial artery was determined from the results of a reactive hyperemia test, by applying ultrasonic duplex scanning. No significant MBF increase in response to the cold test was an indicator of coronary arterial endothelial dysfunction at cardiac 13N-ammonium PET. Agreement of the results of brachial arterial ultrasonography during reactive hyperemia and cardiac 13N-ammonium PET in the presence of the cold test suggests that endothelial dysfunction is generalized. Cardiovascular risk factors, such as left ventricular hypertrophy, smoking, dyslipidemia, and diabetes mellitus, substantially affect coronary arterial function. Left ventricular hypertrophy is an independent factor that influences the size of the coronary reserve and, in combination with endothelial dysfunction, worsens coronary microcirculation.     

Prenatal development of the intrinsic nerves of the muscles of the human foot

Myelogenesis and blood supply of the intraorganic nerves have been studied in 4-6- and 7-9-month-old human fetuses. At first, the intramuscular nerves are presented as very thick fasciculi (the diameter is more than 90), thick (the diameter is from 50 up to 90) and single muddle neural fasciculi (the diameter is from 30 up to 50 mcm). The microcirculatory blood bed is formed at the expense of branches of the blood vessel-satellites and the blood vessels of the surrounding tissues and is carried out, without any interruption, along the whole extent. In 7-9-month-old fetuses the neural apparatus becomes more complex. The number of the middle neural fasciculi appear. On the background of fine neural fibers in the fasciculi a small part of the middle neural fibers appears, and in the musculus flexor digitorum brevis--single thick neural fibers. The intramuscular nerves have their own hemocirculatory bed presented by microvessels that are on the perineurium surface, in its bulck and among neural fibers.     

Evaluation of coronary bed function by positron emission tomography using 13N-ammonium during cold stimulation

The purpose of the present investigation was to study the time course of changes in myocardial blood flow (MBF) in response to cold stimulation. Thirty-eight patients having risk factors of cardiovascular complications were examined. The time course of MBF changes was estimated by positron emission tomography (PET) using 13N-ammonium at rest and during a cold test (CT). Endothelium-dependent vasodilation of the brachial artery was determined from the results of a reactive hyperemia test, by applying ultrasound duplex scanning. No significant MBF increase in response to the cold test was an indicator of coronary arterial endothelial dysfunction at cardiac 13N-ammonium PET. Agreement of the results of brachial arterial ultrasonography during reactive hyperemia and cardiac 13N-ammonium PET in the presence of the cold test suggests that endothelial dysfunction is generalized. Cardiovascular risk factors, such as left ventricular hypertrophy, smoking, dyslipidemia, and diabetes mellitus, substantially affect coronary arterial function. Left ventricular hypertrophy is an independent factor that influences the amount of the coronary reserve and, in combination with endothelial dysfunction, worsens coronary microcirculation.     

Spatial relationship between cardiac mast cells and coronary capillaries in neonatal rats with cardiomegaly.

Density of cardiac mast cells and their localization with respect to coronary capillaries was studied in two experimental situations. First, cardiac hypertrophy produced by aortic constriction in 5-day-old rats was studied. Left ventricular weight increased more than twofold in this experimental situation, while the increases in total capillary length and total number of cardiac mast cells were much smaller, resulting in decreased densities of both tissue components. In the second series of experiments, localization of cardiac mast cells at two distinct portions of coronary capillaries was studied in normal hearts of adult rats. Differential histochemical staining enabled us to distinguish between the portions of capillaries close to arterioles and portions on the venular side. The number of mast cells close to arteriolar portions of coronary capillaries was significantly higher than one would expect in the case of their even distribution along the capillary wall. The relationship between the mast cells and formation of new capillaries is discussed.     

Arterial identity of endothelial cells is controlled by local cues.

The ephrins and their Eph receptors comprise the largest family of receptor tyrosine kinases. Studies on mice have revealed an important function of ephrin-B2 and Eph-B4 for the development of the arterial and venous vasculature, respectively, but the mechanisms regulating their expression have not been studied yet. We have cloned a chick ephrin-B2 cDNA probe. Expression was observed in endothelial cells of extra- and intraembryonic arteries and arterioles in all embryos studied from day 2 (stage 10 HH, before perfusion of the vessels) to day 16. Additionally, expression was found in the somites and neural tube in early stages, and later also in the smooth muscle cells of the aorta, parts of the Müllerian duct, dosal neural tube, and joints of the limbs. We isolated endothelial cells from the internal carotid artery and the vena cava of 14-day-old quail embryos and grafted them separately into day-3 chick embryos. Reincubation was performed until day 6 and the quail endothelial cells were identified with the QH1 antibody. The grafted arterial and venous endothelial cells expressed ephrin-B2 when they integrated into the lining of arteries. Cells that were not integrated into vessels, or into vessels other than arteries, were ephrin-B2-negative. The studies show that the expression of the arterial marker ephrin-B2 is controlled by local cues in arterial vessels of older embryos. Physical forces or the media smooth muscle cells may be involved in this process.     

Changes in systemic hemodynamics following administration of synthetic angiotensin II to dogs of different ages]

Experiments were conducted on dogs aged 18-22 days, 2-3 month-old and adult dogs. Arterial blood pressure, cardiac output, heart rate and total peripheral resistance during the infusion of synthetic angiotensin-II-amide in a dose of 2 mug/kg per minute were studied. An increase of arterial pressure in adult dogs during the action of angiotensin-II was connected with the elevation of the total peripheral resistance. An increase of the total peripheral resistance and also of the cardiac output was seen in the puppies. The differences in the degree of increase of the arterial blood pressure in adult dogs and puppies were not marked.