Coronary heart disease (CHD) is the leading cause of death in the U.S. The coronary arteries supply blood to the myocardium (heart muscle), and the reduced blood flow (ischemia) caused by CHD can lead to death of myocardial tissue (heart attack); most frequently affected is the area of the left ventricle known as the trabecular myocardium. One way to relieve CHD ischemia would be to regenerate coronary arteries serving the trabecular myocardium via cell-specific strategies—which would require knowing how those arteries are formed during development.

In a paper published online on April 5 in Developmental Cell, Bin Zhou, M.D., Ph.D., and colleagues report that trabecular arteries in the mouse embryonic heart arise from a subset of ventricular endocardial cells via two distinct waves of coronary vascularization in the ventricle wall. The researchers also identified the sequential signaling pathway that regulates this two-step developmental process. If adult ventricular endocardial cells can be reactivated, these findings could lead to the regrowth of trabecular coronary arteries to replace those damaged by CHD.

Dr. Zhou is professor of genetics, of pediatrics, and of medicine at Einstein.