Morphology of the Myocardial Microcirculation
The small arteries of the heart wall can be placed in two main categories (1) the direct, anatomical vessels which supply the heart muscle and (2) the anastomotic channels which connect them. The anatomical blood supply is perfect in its architecture and the product of millions of years of evolutionary design. As a result it is not only highly efficient but has a reserve capacity to meet the requirements of exertional stress — upon which survival of the species has depended. By contrast, coronary arterial anastomoses are of importance only in disease. Having no evident normal physiological function, they can surely have had no evolutionary influence. Even when enlarged in disease they have little or no reserve capacity to meet the extra needs of stress.
KeywordsLeft Ventricular Wall Reserve Capacity Coronary Collateral Heart Wall Arterial Anastomosis
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