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Coronary artery anomalies

Part I: Recent insights from molecular embryology

Anomalien der Koronararterien Teil I: Aktuelle Erkenntnisse aus der Embryologie

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Zusammenfassung

Angeborene Anomalien der Koronargefäße finden sich in 0,2–1,2% der Bevölkerung und können mit erheblicher Morbidität und Mortalität assoziiert sein. Diese Arbeit liefert eine Übersicht zum aktuellen Stand aus Sicht der Embryologie (Teil I) und zur klinischen Diagnostik und Therapie (Teil II).

Im vorliegenden ersten Teil der Arbeit bieten wir eine Übersicht zur koronaren Vaskulogenese, Angiogenese und embryonalen Arteriogenese. Hierbei beleuchten wir besonders die Rolle von Vorläuferzellen wie beispielsweise der epikardialen Vorläuferzellen, der kardialen Neuralleistenzellen und Vorläuferzellen des peripheren Reizleitungssystems. Darüber hinaus stellen wir die Rolle verschiedener Wachstumsfaktoren (beispielsweise FGV, HIF 1, PDGF B, TGFβ1, VEGF und VEGFR-2) und Gene (beispielsweise FOG-2, VCAM-1, Bves und RALDH2) bei der Regulation einzelner Schritte der koronaren Gefäßbildung dar.

Dieser Teil der Übersicht möchte die Vielzahl von Möglichkeiten und Mechanismen zur Entstehung koronarer Anomalitäten verdeutlichen. Deshalb verweisen wir besonders auf Ergebnisse aus Experimenten, die eine systematische Beziehung definierter Störungen auf molekularer Ebene mit koronarer Anomalie erkennen lassen. Besonders gehen wir hierbei auf die Rolle der Neuralleiste bei der Entwicklung von Koronaranomalien und deren Assoziation mit Anomalien der Aortenwurzel und Aortenklappe ein.

Summary

Congenital anomalies of the coronary arteries occur in 0.2–1.2% of the general population and may cause substantial cardiovascular morbidity and mortality. We review some of the advances that have been made both, in the understanding of the embryonic development of the coronary arteries (part I) and in the clinical diagnosis and management of their anomalies (part II).

In this first part of our review we elucidate basic mechanisms of coronary vasculogenesis, angiogenesis and embryonic arteriogenesis. Moreover, we review the role of cellular progenitors such as epicardium-derived cells, cardiac neural crest cells and cells of the peripheral conduction system. Then we discuss the role of growths factors (such as FGV, HIF 1, PDGF B, TGFβ1, VEGF, and VEGFR-2) and genes (such as FOG-2, VCAM-1, Bves, and RALDH2) at different states of coronary development. and we discuss the role of the cardiac neural crest in the concurrence of coronary anomalies with aortic root malformations.

This part of the article is designed to review major determinants of coronary vascular development to provide a better understanding of the multiplicity of options and mechanisms that may give rise to coronary anomaly. To this end, we highlight results from experiments that provide insight in mechanisms of coronary malformation

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Authors and Affiliations

  1. Clinic of Internal Medicine III, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany

    Y. von Kodolitsch,  W. D. Ito,  O. Franzen,  G. K. Lund,  D. H. Koschyk &  T. Meinertz

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  1. Y. von Kodolitsch
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  2. W. D. Ito
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Correspondence to Y. von Kodolitsch.

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von Kodolitsch, Y., Ito, W.D., Franzen, O. et al. Coronary artery anomalies. Z Kardiol 93, 929–937 (2004). https://doi.org/10.1007/s00392-004-0152-7

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  • DOI: https://doi.org/10.1007/s00392-004-0152-7

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