Is there functional collateral flow during vascular occlusion in angiographically normal coronary arteries?

Wustmann, Kerstin; Zbinden, Stephan; Windecker, Stephan; Meier, Bernhard; Seiler, Christian (2003). Is there functional collateral flow during vascular occlusion in angiographically normal coronary arteries? Circulation, 107(17), pp. 2213-2220. American Heart Association 10.1161/01.CIR.0000066321.03474.DA

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BACKGROUND

Thus far, it is unknown whether there is functional collateral flow through preexisting anastomoses in patients with angiographically normal coronary arteries. Such preformed coronary collateral vessels could form the basis for subsequently developing protective natural bypasses in the presence of coronary artery disease.

METHODS AND RESULTS

Among 100 patients, the collateral flow index (CFI) was measured in coronary arteries without stenotic lesions. The CFI was determined by simultaneous measurement of mean aortic pressure, central venous pressure, and coronary wedge pressure via a sensor-tipped guidewire at the end of a 1-minute balloon occlusion. Patients were divided in 2 groups according to complete angiographic absence (51 patients) or partial presence (49 patients) of stenotic lesions in coronary arteries other than that undergoing collateral measurement. CFI in all patients (61+/-10 years; men/women, 69/31) amounted to 0.18+/-0.08 (range, 0.04 to 0.36). It showed a normal Gaussian frequency distribution; 22 individuals had a CFI > or =0.25, a value that was empirically found to represent well-developed collaterals protective against myocardial ischemia during coronary occlusion. Accordingly, 17 patients did not reveal signs of myocardial ischemia during coronary balloon occlusion, as assessed from an intracoronary ECG, and 26 patients did not experience angina pectoris during occlusion.

CONCLUSIONS

In humans with angiographically normal coronary arteries, there are functional collateral vessels to the extent that one fifth to one quarter of them do not show signs of myocardial ischemia during brief vascular occlusions.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Wustmann, Kerstin Brigitte; Zbinden, Stephan; Windecker, Stephan; Meier, Bernhard and Seiler, Christian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1524-4539

Publisher:

American Heart Association

Language:

English

Submitter:

Kerstin Brigitte Wustmann

Date Deposited:

29 Jun 2021 16:18

Last Modified:

29 Jun 2021 16:18

Publisher DOI:

10.1161/01.CIR.0000066321.03474.DA

PubMed ID:

12707241

BORIS DOI:

10.48350/157178

URI:

https://boris.unibe.ch/id/eprint/157178

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