Malaga (Spain) (EFE).- A research group in Spain and France has discovered the cellular mechanism that causes coronary arterioventricular fistulas, a congenital anomaly that in the most serious cases can cause death.
Led by José María Pérez, professor at the Spanish University of Málaga, this team includes researchers from the National Center for Cardiovascular Research in Madrid, the Maternal-Infant Hospital of Málaga, the Center for Applied Medical Research in Pamplona (Spain) and the Necker Hospital and the Pasteur/Imagine Institute in Paris.
The results have been published in the journal “Experimental and molecular medicine”, from the Nature editorial group.
What are coronary fistulas
Coronary fistulas are abnormal connections between different blood vessels of the coronary system, large arteries or veins (aorta, pulmonary or cava) or other parts of the heart, such as its chambers (atria and ventricles).
The most frequent type of coronary fistula is precisely the latter, which involves the connection of a coronary artery with the interior of the heart, which is what they have studied.
It is estimated that between 0.21 and 5.8% of the population have coronary anomalies and that between 0.1 and 0.2% of patients who come for a hospital review of their coronary arteries have a fistula.
A relatively low incidence rate, although it must be taken into account that in many cases the presence of this defect is not diagnosed, details EFE Pérez.
Although fistulas are often small and are not serious or cause problems, allowing those affected to lead a normal life, larger ones can be associated with serious complications such as endocarditis (infection of the tissue that lines the heart internally), hypertrophy or dilation of the ventricular walls and sudden death.
a congenital anomaly
This congenital deformation is generated during embryonic development, although up to now the information available about its origin has been scarce.
Doctor Pérez leads one of the few studies that explain the causes of this defect, which can help improve early diagnosis of this type of anomaly and other associated pathologies.
The results of the investigation suggest that the appearance of discontinuities in the ventricular muscle wall is at the origin of this coronary defect.
The chambers of the heart are lined with three tissues: the endocardium, the innermost; the myocardium, the thick central muscular layer, which allows the contraction of the atria and ventricles and, therefore, blood circulation; and the epicardium, which covers the outer surface.
When the endocardium and epicardium come into contact abnormally early during embryonic development, usually because the myocardium that separates the two layers presents thinner than normal regions or porous areas, a connection is generated between the surface and the interior. of the heart that will mature into a fistula.
To carry out this study, the team has worked with mouse and bird embryos and human samples provided by informed consent.
The results open the door to identify new candidate genes for the early diagnosis of these congenital anomalies and their associated risks.