A crowning achievement for deciphering coronary origins

摘要

Named for its crownlike appearance (1), the coronary circulation comprises arteries and veins that transport blood to and from the heart's muscle, respectively. When a large coronary artery becomes obstructed, a downstream segment of cardiac muscle dies from oxygen deprivation in a pathologic condition called acute myocardial infarction (2), or heart attack. Over time, the injured heart replaces damaged muscle with scar tissue (3) that maintains cardiac wall integrity but also adversely affects pump function, which often leads to heart failure (4). Therapeutic interventions that stimulate the growth of new cardiac muscle to supplant scar formation would substantially improve heart attack outcomes (5). The success of any such strategy would also rely on concomitant growth of new coronary blood vessels. Therefore, a comprehensive understanding of how this specialized vascular bed develops is a prerequisite for regenerative strategies designed to reduce the morbidity and mortality caused by heart failure after myocardial infarction. On page 90 in this issue, Tian et al. (6) demonstrate that a large fraction of coronary vessels in the mouse heart form during postnatal life through a unique mechanism.