Open AccessCoronary Collateral Circulation
Author(s) -
Pellinen T. J.,
Virtanen K. S.,
Toivonen L.,
Heikkilä J.,
Hekali P.,
Frick M. H.
Publication year - 1991
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960140206
Subject(s) - medicine , cardiology , right coronary artery , collateral circulation , artery , myocardial infarction , coronary arteries , occlusion , coronary artery disease , circumflex , coronary circulation , left coronary artery , coronary angiography , blood flow
The occurrence and influence of coronary collateral circulation and obstruction of the supplying coronary arteries on left ventricular contractility, prevalence of myocardial infarction, and bicycle exercise ergometer test were studied in a random sample of 286 patients with angiographically documented coronary artery disease. Collaterals appeared increasingly in all three main coronary arteries with grade of obstruction. The highest prevalence of collaterals occurred in stenosis of the right coronary artery (60%), followed by the left descending artery (45%); they occurred least in the left circumflex artery (21%) (p<0.001). The frequency of intra‐arterial collateral circulation was 42%, 11%, and 12%, respectively (p<0.001). With total occlusion of the left anterior descending coronary artery, 22% of the patients had nor‐mokinetic anterior and apical left ventricular wall when collaterals were present. More often, the inferior wall showed normal contraction with total occlusion of the right coronary artery and collaterals [52%, p<0.001 compared with left anterior descending artery (LAD)]. The prevalence of inferior myocardial infarction was 39%, with collateral circulation to the totally occluded right coronary artery. The respective prevalence of anterior infarction and total occlusion in the left coronary artery was 58% (p<0.02). The presence or absence of collaterals had no obvious influence on ST‐segment response during bicycle ergometer test. In triple‐vessel disease, peak work capacity was better when collaterals to LAD were not jeopardized (427 kpm) than when jeopardized (321 kpm) (p.<0.02).