Cardiac Vasculature: Development and Pathology

Coronary vessels are of particular clinical interest to the general public and adult cardiologists because of their propensity in populations of developed countries to get clogged leading to chest pain (angina) and heart attacks (myocardial infarctions; MIs). Coronary artery disease (CAD) is the leading type of heart disease and the leading cause of deaths in the USA in both men and women (representing 51% of all cardiovascular diseases in 2006; American Heart Association Heart Disease and Stroke Statistics 2010 Update-at-a-glance; http://www.americanheart.org/downloadable/heart/1265665152970DS3241%20HeartStrokeUpdate_2010.pdf; http://www.nlm.nih.gov/medlineplus/coronaryartery disease.html). While the developmental biology of cardiac vessels seems removed from this concern for the adult population, findings from this field may be beneficial and relevant for all age groups. Interest in the development of coronary vessels has increased due to findings that suggest the embryonic epicardium provides components of the coronary vessels and factors that positively influence the myocardium. The possibility has been raised that the epicardium might be sufficiently activated to repair cardiac tissue in the adult in part by promoting coronary vascularization. The aim of this Chapter is to call attention to questions regarding coronary vessels that still require answers and to introduce hypotheses that may lead to answers and strategies for cardiotherapy.