Background: Many processes contributing to the functional and structural regulation of the coronary circulation have been identified. A proper understanding of the complex interplay of these processes requires a quantitative systems approach that includes the complexity of the coronary network. The purpose of this study was to provide a detailed quantification of the branching characteristics and local hemodynamics of the human coronary circulation.
Methods: The coronary arteries of a human heart were filled post-mortem with fluorescent replica material. The frozen heart was alternately cut and block-face imaged using a high-resolution imaging cryomicrotome. From the resulting 3D reconstruction of the left coronary circulation, topological (node and loop characteristics), topographic (diameters and length of segments), and geometric (position) properties were analyzed, along with predictions of local hemodynamics (pressure and flow).
Results: The reconstructed left coronary tree consisted of 202,184 segments with diameters ranging from 30 μm to 4 mm. Most segments were between 100 μm and 1 mm long. The median segment length was similar for diameters ranging between 75 and 200 μm. 91% of the nodes were bifurcations. These bifurcations were more symmetric and less variable in smaller vessels. Most of the pressure drop occurred in vessels between 200 μm and 1 mm in diameter. Downstream conductance variability affected neither local pressure nor median local flow and added limited extra variation of local flow. The left coronary circulation perfused 358 cm of myocardium. Median perfused volume at a truncation level of 100 to 200 μm was 20 mm with a median perfusion of 5.6 ml/min/g and a high local heterogeneity.
Conclusion: This study provides the branching characteristics and hemodynamic analysis of the left coronary arterial circulation of a human heart. The resulting model can be deployed for further hemodynamic studies at the whole organ and local level.
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http://dx.doi.org/10.3389/fphys.2019.01611 | DOI Listing |
Herz
January 2025
Faculty of Medicine, Department of Cardiology, Bilecik Şeyh Edebali University, Pelitözü Mahallesi Fatih Sultan Mehmet Blv. No. 27 Merkez, Bilecik, Turkey.
Background: The aim of this study was to compare the efficacy outcomes of the traditional Judkins left and right catheters with those of the recently introduced Tiger catheter in female participants aged 65 years and older who underwent transradial coronary angiography.
Methods: A cohort of 160 female patients aged 65 and older who were scheduled for coronary angiography (CAG) were divided into two groups according to the use of Tiger (n = 80) or Judkins (n = 80) catheters for radial angiography at a ratio of 1:1, respectively. We analyzed the effectiveness of the Tiger and Judkins catheters, the incidence of catheter failure, contrast volume, CAG time, fluoroscopy time, dose-area product (in mGy/cm), and the occurrence of radial spasm.
Eur J Intern Med
January 2025
Cardiology Department, Hospital Clínico Universitario, Universitat de València, INCLIVA, Valencia, Spain; CIBER Cardiovascular, Madrid, Spain.
Aims: Hypoalbuminemia is frequently found in patients with heart failure (HF), associated with higher morbimortality in acute HF (AHF). Moreover, Carbohydrate Antigen 125 (CA125) is elevated in most of the AHF patients. In this cohort of patients admitted for AHF, our objective was to evaluate the association between hypoalbuminemia and long-term outcomes, including mortality and HF readmissions, stratified by CA125 concentration.
View Article and Find Full Text PDFJ Mol Cell Cardiol
December 2024
A.I.Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland; Heart Centre and Gene Therapy Unit, Kuopio University Hospital, Kuopio, Finland. Electronic address:
Background: Coronary stenting operations have become the main option for the treatment of coronary heart disease. Vessel recovery after stenting has emerged as a critical factor in reducing possible complications. In this study, we evaluated the feasibility, safety and efficacy of locally administered intraluminal gene therapy delivered using a specialized infusion balloon catheter.
View Article and Find Full Text PDFArch Cardiovasc Dis
December 2024
Service de cardiologie, hôpital Henri-Mondor, 94000 Créteil, France. Electronic address:
Background: Catheter ablation for atrial fibrillation in patients with heart failure with reduced ejection fraction is associated with a significant reduction in morbimortality. The convergent procedure is a valid ablation option for the treatment of long-standing persistent atrial fibrillation.
Aim: To describe the outcomes of patients with heart failure with reduced ejection fraction and long-standing persistent atrial fibrillation who underwent the convergent procedure.
BMJ Case Rep
January 2025
Pediatrics, The University of Tennessee Health Science Center, Memphis, Tennessee, USA.
A term, healthy infant presented with respiratory distress and severe pulmonary hypertension (PH). With an unclear aetiology and the intent to decrease right ventricular afterload, pulmonary vasodilators were initiated. Follow-up imaging revealed a supravalvular mitral ring as the cause of the PH which resolved after surgical resection of the membrane.
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