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This is how natural bypasses save you from a heart attack
Atherosclerosis (or atherosclerosis) is a very common pathological change in the arteries, which occurs primarily in industrialized countries. It can have dramatic consequences for the cardiovascular system and, among other things, lead to a heart attack. Researchers are now explaining how natural bypasses save you from a heart attack.
Atherosclerosis (colloquially: hardening of the arteries) can be life-threatening. But the human body helps itself with vasoconstriction by creating natural vascular bypasses. Scientists have now clarified how the mechanism of so-called arteriogenesis works at the molecular and cellular level and published their results in the journal “Blood” of the American Society for Hematology.
Underserved tissue is saved
As the Justus Liebig University Gießen (JLU) wrote in a statement, teams of Prof. Dr. Klaus T. Preissner, Institute of Biochemistry at the Medical Faculty of the JLU, and PD Dr. Elisabeth Deindl, Walter Brendel Center for Experimental Medicine at the Ludwig Maximilians University (LMU) Munich, together with other national and international cooperation partners.
In arteriogenesis (the formation of a natural bypass after vascular occlusion), the body enlarges the existing network of tiny blood vessels, the arterioles. According to the experts, a multi-stage process of growth of bypass circuits - so-called collateral arteries - can compensate for the occlusion of a larger artery and the undersupplied tissue can be saved.
However, this process takes days to weeks, so that in most cases, the narrowed vessel is closed by thrombosis faster than the natural bypass can be formed. It is therefore of great interest to better understand the process of arteriogenesis and, if necessary, to accelerate it in patients.
Many patients do not know that they were saved from a heart attack
The researchers found that arterial occlusion resulted in physical changes and additional shear forces in the blood flow in the preformed arterial bypasses. According to the information, this leads to the release of "alarm molecules" from the vessel walls, in particular of extracellular ribonucleic acids (RNA).
These nucleic acid alarms then release growth factors via a signal cascade, which enlarge the inside of natural bypasses up to 20 times. The collateral vessels return sufficient blood and thus oxygen and nutrients to the tissue that is under-supplied due to the narrowing of the vessels. "Many patients who have had an imperceptible vascular occlusion behind them do not even know that these natural bypasses saved them from an acute heart attack," explains Dr. Deindl.
"If the extracellular RNA that triggers this process is missing or certain parts of the signaling cascade are blocked, bypass circuits are not formed and the tissue is unable to regenerate itself," said Prof. Preissner. In order to use this physiologically efficient form of blood vessel regeneration for the development of new forms of therapy for vascular occlusion, the team of scientists now wants to find ways to stimulate partial reactions of arteriogenesis.
Around four million people affected in Germany
According to health experts, around four million people in Germany suffer from hardening of the arteries, but only every third person is diagnosed with the disease. "Large studies have shown that certain risk factors are involved in the development and progression of arteriosclerosis," writes the German Vascular League on its website. “Above all, fat metabolism disorders seem to play a crucial role in the development of the disease. But a whole series of other factors also favor atherosclerosis, such as age, male gender or an inherited burden, ”said the experts. (ad)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Justus Liebig University Gießen: How natural bypasses can save you from a heart attack, (accessed: September 18, 2019), Justus Liebig University Gießen
- Blood: Extracellular RNA released due to shear stress controls natural bypass growth by mediating mechanotransduction, (accessed: 18.09.2019), Blood
- German Vascular League: Arteriosclerosis, (accessed: September 18, 2019), German Vascular League