This study assesses the relation between qualitative and quantitative findings of myocytes and interstitial connective tissue in the ischemic heart disease. Qualitative and quantitative changes of myocytes and interstitial connective tissue were studied on the serial cross myocardial sections from 20 autopsied hearts with ischemic lesions, stained by immunohistochemistry using a monoclonal antibody (von Willebrand factor) and with hematoxylin-eosin method. Myocardial sections included proximal and distal part of occlusion and area of occlusion of coronary vessels. The volume densities (V V) of the cardiac myocytes and interstitial fibrosis in the group with coronary occlusion were examined stereologically and compared with control group. The findings showed a significant reduction in the volume density of myocytes and an increase in the volume density of interstitial fibrosis in patients with coronary occlusion compared with control group. Significant reduction in the volume density of myocytes and an increase in volume density of interstitial fibrosis were greater in the distal part of occlusion and area of occlusion, than in the proximal part of the occlusion. Our stereological results give useful quantitative information's of changes in myocardium parts during coronary occlusion as well as in normal conditions, and represent objective proof of significant changes in ischemic myocardium described by qualitative analyses.

Proficiency in the anatomy of coronary arteries and their variations is significant for proper interpretation of the coronary angiographies, assessment of the complexity and result of the coronary insufficiency as well as surgical myocardium revascularization. The objective of this study is anatomy-radiology research of the methods of branching the main trunk of left coronary artery and to prove importance of the diagonal branch (ramus diagonalis) existence in the conditions of coronary insufficiency. In this study we have analyzed 100 coronary angiographies done at the Clinic for Heart Diseases and Rheumatism of the Clinic Center of University of Sarajevo and dissected 20 human hearts from the Institute of Anatomy. In our study we have come upon two methods of branching of main trunk of left coronary artery (bifurcation and trifurcation). By the method of the angiography we have found the bifurcation in 71% of cases while 65% of cases were proved by the dissection method. Trifurcation has been discovered in 29% of cases of analyzed angiographies i.e. 35% of cases of dissected hearts. We believe that third terminal branch of the left coronary artery should be marked as ramus diagonalis. This branch, including its anastomoses, presents important pattern of the collateral blood flow, which has special meaning, under conditions of coronary insufficiency.

Variations of the human coronary arteries have always attracted the attention of many researchers. A review of the literature shows that variations can cause ischemic heart disease or sudden cardiac death. The aim of the investigations was to examine the existence and clinical significance of variations of the human coronary arteries. Special attention has been focused on myocardial bridging of the coronary arteries and coronary arteriovenous fistula. Our investigations were carried out on the human hearts at the Department of Anatomy and on patients at the Cardiology Department of University Clinical Centre in Sarajevo. Using the method of dissection and coronary angiography we established the existence of variations of the coronary arteries (variations of origin, distribution) on the human hearts without macroscopic visible changes as well as on patients with ischemic changes (angina pectoris, myocardial infarction, congenital cardiovascular malformation etc.). We established the higher incidence of ischemic changes on patients with variations of coronary arteries.

We have investigated the intramural blood vessels of the A-V segment in the conductive system of 20 human hearts using the method of light microscopy. The results of our study have shown that the A-V segment of the conductive heart muscles in human hearts has an abundant vascularisation. We have found the greatest density of the intramural net in the dorsal part of the A-V node; this density of blood vessels decreased toward the Hiss' bundle. After comparing these results with the earlier findings in the study of the intramural net in the S-A system we have found that A-V segment of the conductive heart system has a poorer blood supply in regard to S-A system. We have also found that the intramural net of blood vessels is weaker in the adjacent ventricular parts and in the interventricular septum. It cannot be said that there exists any surface vascular zone subepicardial, middle and deep sub-endocardiac--in the A-V segment of the conductive system of human heart.