The Vieussens’ arterial ring (VAR) is a rare coronary anomaly that may be associated with a pulmonary fistula, and has been linked to ischemia, myocardial infarction, heart failure, arrhythmias, and sudden death. We ...The Vieussens’ arterial ring (VAR) is a rare coronary anomaly that may be associated with a pulmonary fistula, and has been linked to ischemia, myocardial infarction, heart failure, arrhythmias, and sudden death. We present the case of a 54-year-old man who was admitted to the emergency room with angina and dyspnea on moderate exertion, in the context of atrial fibrillation and decompensated heart failure with left ventricular systolic dysfunction. In the study of its etiology, coronary computed tomography angiography (CCTA) identified an anomalous conal artery outflow (type C) as part of the VAR and a fistula to the pulmonary artery trunk (variant 1b), with an arterial flow linking the conal artery and the middle third of the left anterior descending artery (LAD), which then fistulized to the pulmonary artery trunk. The hemodynamic and clinical repercussions presented with signs of ischemia in the LAD territory and acute heart failure. In this case, CCTA identified the coronary anomaly and its trajectory with great precision through volume rendering reconstruction, as well as the dynamics of coronary flow in the presence of the pulmonary fistula. This anatomical variant is rarely described, and CCTA is of great utility in the therapeutic decision for fistula closure.展开更多
Background L-type calcium channel participates in the regulation of a variety of physical and pathological process. In vasculature, it mainly mediated agonist-induced vascular smooth muscle contraction. However, it is...Background L-type calcium channel participates in the regulation of a variety of physical and pathological process. In vasculature, it mainly mediated agonist-induced vascular smooth muscle contraction. However, it is not clear whether there are differences in L-type calcium channel mediated vessel responses to certain vasoconstrictors among different species. Methods The coronary arteries were dissected from the heart of rats and mice respectively. The coronary arterial ring contraction was measured by Multi Myograph System. Results Endothelin-1, U46619 and 5-HT could produce concentration-dependent vasoconstriction of coronary arterial rings from rats and mice. Compared with rats, the vessel rings of mice were more sensitive to ET-1 and U46619, and less sensitive to 5-HT. The L-type Ca2~ channel blocker nifedipine could significantly inhibit the coronary artery contractions induced by ET-1, U46619 and 5-HT. The inhibitory effect of i ixM nifedipine on ET-1 and 5-HT-induced coronary artery contractions were stronger in mice than in rats, but its effect on U46619 induced-vessel contractions was much weaker in mice than in rats. Conclusions L-type Ca2＋ channel plays an important role in the coronary arterial contraction, but the responses to vasoconstrictor and L-type Ca2＋ channel blocker are different between rats and mice, thus suggesting that the coronary arteries of rats and mice have different biological characteristics.展开更多
文摘The Vieussens’ arterial ring (VAR) is a rare coronary anomaly that may be associated with a pulmonary fistula, and has been linked to ischemia, myocardial infarction, heart failure, arrhythmias, and sudden death. We present the case of a 54-year-old man who was admitted to the emergency room with angina and dyspnea on moderate exertion, in the context of atrial fibrillation and decompensated heart failure with left ventricular systolic dysfunction. In the study of its etiology, coronary computed tomography angiography (CCTA) identified an anomalous conal artery outflow (type C) as part of the VAR and a fistula to the pulmonary artery trunk (variant 1b), with an arterial flow linking the conal artery and the middle third of the left anterior descending artery (LAD), which then fistulized to the pulmonary artery trunk. The hemodynamic and clinical repercussions presented with signs of ischemia in the LAD territory and acute heart failure. In this case, CCTA identified the coronary anomaly and its trajectory with great precision through volume rendering reconstruction, as well as the dynamics of coronary flow in the presence of the pulmonary fistula. This anatomical variant is rarely described, and CCTA is of great utility in the therapeutic decision for fistula closure.
基金supported by the National Natural Science Foundation of China(No81273516,No 81070102,No 81302779)by Guangdong Provincial TCM Science Foundation(20122180)by Guangdong Provincial Medical Science Foundation(NoA2012006)
文摘Background L-type calcium channel participates in the regulation of a variety of physical and pathological process. In vasculature, it mainly mediated agonist-induced vascular smooth muscle contraction. However, it is not clear whether there are differences in L-type calcium channel mediated vessel responses to certain vasoconstrictors among different species. Methods The coronary arteries were dissected from the heart of rats and mice respectively. The coronary arterial ring contraction was measured by Multi Myograph System. Results Endothelin-1, U46619 and 5-HT could produce concentration-dependent vasoconstriction of coronary arterial rings from rats and mice. Compared with rats, the vessel rings of mice were more sensitive to ET-1 and U46619, and less sensitive to 5-HT. The L-type Ca2~ channel blocker nifedipine could significantly inhibit the coronary artery contractions induced by ET-1, U46619 and 5-HT. The inhibitory effect of i ixM nifedipine on ET-1 and 5-HT-induced coronary artery contractions were stronger in mice than in rats, but its effect on U46619 induced-vessel contractions was much weaker in mice than in rats. Conclusions L-type Ca2＋ channel plays an important role in the coronary arterial contraction, but the responses to vasoconstrictor and L-type Ca2＋ channel blocker are different between rats and mice, thus suggesting that the coronary arteries of rats and mice have different biological characteristics.
