Downstream Influence of Coronary Stenoses on Microcirculatory Remodeling: A Histopathology Study

Guus A. de Waard, Maurits R. Hollander, Danique Ruiter, Thomas ten Bokkel Huinink, Romain Meer, Nina W. van der Hoeven, Elisa Meinster, Jeroen A. M. Beliën, Hans W. Niessen, Niels van Royen

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Abstract

OBJECTIVE: Inducible myocardial ischemia is influenced by contributions of both the epicardial artery and the coronary microcirculation. Experimental studies have found adverse microcirculatory remodeling to occur downstream of severe coronary stenoses. Coronary physiology studies in patients contradict the experimental findings, as the minimal microvascular resistance is not modified by stenoses. The objective was to determine whether microcirculatory remodeling occurs downstream of coronary stenoses in the human coronary circulation. Approach and Results: Myocardium corresponding to 115 coronary arteries of 55 deceased patients was investigated. Histopathologic staining of the microcirculation was performed using antibodies against SMA-α (smooth muscle actin-α) and CD31, to stain arterioles and capillaries, respectively. The following parameters were analyzed: ratio between lumen and vesel area, ratio between lumen and vessel diameter (both ratios for arterioles of <40, 40-100, and 100-200 µm diameter), arteriolar density, and capillary density. From the 55 patients, 32 pairs of an unobstructed coronary artery and a coronary artery with a stenosis were formed. No statistically significant differences between any of the microcirculatory parameters were found. A confirmatory unpaired analysis compared 3 groups: (1) coronary arteries in patients without coronary artery disease (n=53), (2) unobstructed coronary arteries in patients with a stenosis in one of the other coronary arteries (n=23), and (3) coronary stenoses (n=39). No statistically significant differences were observed between the groups. CONCLUSIONS: The microcirculation distal to noncritical stenoses does not undergo structural remodeling in the human coronary circulation.
Original languageEnglish
Pages (from-to)230-238
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume40
Issue number1
DOIs
Publication statusPublished - 2020

Cite this

@article{b8400bb54550463696c64a1342615d80,
title = "Downstream Influence of Coronary Stenoses on Microcirculatory Remodeling: A Histopathology Study",
abstract = "OBJECTIVE: Inducible myocardial ischemia is influenced by contributions of both the epicardial artery and the coronary microcirculation. Experimental studies have found adverse microcirculatory remodeling to occur downstream of severe coronary stenoses. Coronary physiology studies in patients contradict the experimental findings, as the minimal microvascular resistance is not modified by stenoses. The objective was to determine whether microcirculatory remodeling occurs downstream of coronary stenoses in the human coronary circulation. Approach and Results: Myocardium corresponding to 115 coronary arteries of 55 deceased patients was investigated. Histopathologic staining of the microcirculation was performed using antibodies against SMA-α (smooth muscle actin-α) and CD31, to stain arterioles and capillaries, respectively. The following parameters were analyzed: ratio between lumen and vesel area, ratio between lumen and vessel diameter (both ratios for arterioles of <40, 40-100, and 100-200 µm diameter), arteriolar density, and capillary density. From the 55 patients, 32 pairs of an unobstructed coronary artery and a coronary artery with a stenosis were formed. No statistically significant differences between any of the microcirculatory parameters were found. A confirmatory unpaired analysis compared 3 groups: (1) coronary arteries in patients without coronary artery disease (n=53), (2) unobstructed coronary arteries in patients with a stenosis in one of the other coronary arteries (n=23), and (3) coronary stenoses (n=39). No statistically significant differences were observed between the groups. CONCLUSIONS: The microcirculation distal to noncritical stenoses does not undergo structural remodeling in the human coronary circulation.",
author = "{de Waard}, {Guus A.} and Hollander, {Maurits R.} and Danique Ruiter and {ten Bokkel Huinink}, Thomas and Romain Meer and {van der Hoeven}, {Nina W.} and Elisa Meinster and Beli{\"e}n, {Jeroen A. M.} and Niessen, {Hans W.} and {van Royen}, Niels",
year = "2020",
doi = "10.1161/ATVBAHA.119.313462",
language = "English",
volume = "40",
pages = "230--238",
journal = "Arteriosclerosis, Thrombosis, and Vascular Biology",
issn = "1079-5642",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

Downstream Influence of Coronary Stenoses on Microcirculatory Remodeling: A Histopathology Study. / de Waard, Guus A.; Hollander, Maurits R.; Ruiter, Danique; ten Bokkel Huinink, Thomas; Meer, Romain; van der Hoeven, Nina W.; Meinster, Elisa; Beliën, Jeroen A. M.; Niessen, Hans W.; van Royen, Niels.

In: Arteriosclerosis, Thrombosis, and Vascular Biology, Vol. 40, No. 1, 2020, p. 230-238.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Downstream Influence of Coronary Stenoses on Microcirculatory Remodeling: A Histopathology Study

AU - de Waard, Guus A.

AU - Hollander, Maurits R.

AU - Ruiter, Danique

AU - ten Bokkel Huinink, Thomas

AU - Meer, Romain

AU - van der Hoeven, Nina W.

AU - Meinster, Elisa

AU - Beliën, Jeroen A. M.

AU - Niessen, Hans W.

AU - van Royen, Niels

PY - 2020

Y1 - 2020

N2 - OBJECTIVE: Inducible myocardial ischemia is influenced by contributions of both the epicardial artery and the coronary microcirculation. Experimental studies have found adverse microcirculatory remodeling to occur downstream of severe coronary stenoses. Coronary physiology studies in patients contradict the experimental findings, as the minimal microvascular resistance is not modified by stenoses. The objective was to determine whether microcirculatory remodeling occurs downstream of coronary stenoses in the human coronary circulation. Approach and Results: Myocardium corresponding to 115 coronary arteries of 55 deceased patients was investigated. Histopathologic staining of the microcirculation was performed using antibodies against SMA-α (smooth muscle actin-α) and CD31, to stain arterioles and capillaries, respectively. The following parameters were analyzed: ratio between lumen and vesel area, ratio between lumen and vessel diameter (both ratios for arterioles of <40, 40-100, and 100-200 µm diameter), arteriolar density, and capillary density. From the 55 patients, 32 pairs of an unobstructed coronary artery and a coronary artery with a stenosis were formed. No statistically significant differences between any of the microcirculatory parameters were found. A confirmatory unpaired analysis compared 3 groups: (1) coronary arteries in patients without coronary artery disease (n=53), (2) unobstructed coronary arteries in patients with a stenosis in one of the other coronary arteries (n=23), and (3) coronary stenoses (n=39). No statistically significant differences were observed between the groups. CONCLUSIONS: The microcirculation distal to noncritical stenoses does not undergo structural remodeling in the human coronary circulation.

AB - OBJECTIVE: Inducible myocardial ischemia is influenced by contributions of both the epicardial artery and the coronary microcirculation. Experimental studies have found adverse microcirculatory remodeling to occur downstream of severe coronary stenoses. Coronary physiology studies in patients contradict the experimental findings, as the minimal microvascular resistance is not modified by stenoses. The objective was to determine whether microcirculatory remodeling occurs downstream of coronary stenoses in the human coronary circulation. Approach and Results: Myocardium corresponding to 115 coronary arteries of 55 deceased patients was investigated. Histopathologic staining of the microcirculation was performed using antibodies against SMA-α (smooth muscle actin-α) and CD31, to stain arterioles and capillaries, respectively. The following parameters were analyzed: ratio between lumen and vesel area, ratio between lumen and vessel diameter (both ratios for arterioles of <40, 40-100, and 100-200 µm diameter), arteriolar density, and capillary density. From the 55 patients, 32 pairs of an unobstructed coronary artery and a coronary artery with a stenosis were formed. No statistically significant differences between any of the microcirculatory parameters were found. A confirmatory unpaired analysis compared 3 groups: (1) coronary arteries in patients without coronary artery disease (n=53), (2) unobstructed coronary arteries in patients with a stenosis in one of the other coronary arteries (n=23), and (3) coronary stenoses (n=39). No statistically significant differences were observed between the groups. CONCLUSIONS: The microcirculation distal to noncritical stenoses does not undergo structural remodeling in the human coronary circulation.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/31665906

U2 - 10.1161/ATVBAHA.119.313462

DO - 10.1161/ATVBAHA.119.313462

M3 - Article

VL - 40

SP - 230

EP - 238

JO - Arteriosclerosis, Thrombosis, and Vascular Biology

JF - Arteriosclerosis, Thrombosis, and Vascular Biology

SN - 1079-5642

IS - 1

ER -