Heart vessels
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Heart Vessels: Structure, Function, and Development
Overview of Cardiovascular Disease and Engineered Tissue
Cardiovascular disease remains the leading cause of mortality worldwide, necessitating advancements in therapeutic options. Recent efforts have focused on creating engineered tissues to replace diseased heart tissues, including the myocardium, heart valves, and great vessels. Current research explores various methods, their limitations, and future directions in this field.
Vascular Communications in the Heart
Coronary Arteries and Heart Chambers
Research has identified two types of vascular communications between the coronary arteries and the heart chambers. The first type, known as "arterio-luminal" vessels, are small branches of arteries or arterioles that empty directly into the heart lumen. The second type, "arterio-sinusoidal" vessels, break into sinusoids lying between muscle bundles, playing a crucial role in nourishing the heart muscle.
Thebesian Vessels
The Thebesian vessels provide a direct connection between the coronary arteries and the heart chambers, bypassing the capillaries. These vessels can supply significant blood flow to the heart muscle, especially under conditions where coronary artery orifices are gradually closing, ensuring efficient circulation.
Development and Plasticity of Great Vessels
Pharyngeal Arch Arteries (PAAs)
The PAAs are embryonic blood vessels that give rise to major arteries connecting to the heart. These vessels originate from nkx2.5-expressing mesodermal cells and require the transcription factors tcf21 and nkx2.5 for their specification and survival. Interestingly, if these progenitor cells are ablated, endothelial cells from the dorsal head vasculature can compensate, highlighting the plasticity in great vessel formation.
Coronary Vessel Formation
The formation of coronary vessels is critical for heart development and repair. Recent studies have identified new cellular and molecular mechanisms, such as collateral artery formation and endocardial-to-endothelial differentiation, which are essential for coronary vessel development and regeneration. These findings open new avenues for promoting cardiac repair and treating ischemic heart disease.
Functional Classification of Coronary Arteries
Distributing vs. Delivering Vessels
Coronary arteries can be classified into distributing and delivering vessels. Distributing vessels, such as the right coronary artery and left anterior descending artery, convey blood to the borders of myocardial zones. In contrast, delivering vessels, including diagonal and septal branches, are responsible for the actual delivery of blood into these zones. This classification is crucial for understanding the hemodynamic role of each vessel in coronary heart disease.
Role of VEGF-B in Coronary Vessel Development
VEGF-B and Cardiac Regeneration
Vascular endothelial growth factor B (VEGF-B) plays a significant role in promoting the growth of coronary vessels from the endocardium, supporting myocardial expansion. Overexpression of VEGF-B in animal models has shown to enhance endothelial proliferation and improve cardiac function post-myocardial infarction, suggesting its potential as a therapeutic strategy for cardiac neovascularization.
Small Vessel Disease (SVD) in Heart and Brain
Pathogenic Aspects and Therapeutic Challenges
Small-vessel disease (SVD) affects both the heart and brain, leading to reduced blood flow and ischemia. Despite extensive research into antioxidants and oxidative stress inhibitors, effective therapeutic approaches for SVD remain elusive. Current treatments often rely on traditional anti-ischemic therapies used for coronary artery disease.
Conclusion
Understanding the structure, function, and development of heart vessels is crucial for advancing cardiovascular disease treatment. From the intricate vascular communications within the heart to the developmental plasticity of great vessels and the potential of VEGF-B in cardiac regeneration, ongoing research continues to uncover new insights and therapeutic possibilities. Addressing the challenges of small-vessel disease remains a critical area for future investigation.
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