Coronary collateral quantitation in patients with coronary artery disease using intravascular flow velocity or pressure measurements

Seiler, Christian; Fleisch, Martin; Garachemani, Ali; Meier, Bernhard

doi:10.1016/s0735-1097(98)00384-2

Cited by 232 publications

(175 citation statements)

References 32 publications

Supporting

Mentioning

172

Contrasting

Unclassified

Order By: Relevance

“…Coronary angiography, although the most frequently used diagnostic technique for the assessment of collateral vessels, can only identify vessels 4100 mm in diameter, whereas most collateral vessels are smaller. 19 Furthermore, even though the overlap between quantitative measures and qualitative angiographic degrees of collateral flow has been demonstrated to be quite large, 20 quantitative indices of collateral circulation may be better markers of the functional significance of collateral vessels, in particular in recruitable (Rentrop-grade 1) collaterals. 14,21,22 A recent study, 23 nonetheless, reported High blood pressure reduces collaterals J Koerselman et al good correlation between a novel angiographic method of assessment and function.…”

Section: Discussionmentioning

confidence: 99%

High blood pressure is inversely related with the presence and extent of coronary collaterals

et al. 2005

View full text Add to dashboard Cite

Patients with hypertension have an increased case fatality during acute myocardial infarction (MI). Coronary collateral (CC) circulation has been proposed to reduce the risk of death during acute ischaemia. We determined whether and to which degree high blood pressure (BP) affects the presence and extent of CC circulation. A cross-sectional study in 237 patients (84% males), admitted for elective coronary angioplasty between January 1998 and July 2002, was conducted. Collaterals were graded with Rentrop's classification (grade 0-3). CC presence was defined as Rentrop-grade X1. BP was measured twice with an inflatable cuff manometer in seated position. Pulse pressure was calculated by systolic blood pressure (SBP)Àdiastolic blood pressure (DBP). Mean arterial pressure was calculated by DBP þ 1/3 Â (SBPÀDBP). Systolic hypertension was defined by a reading X140 mmHg. We used logistic regression with adjustment for putative confounders. SBP (odds ratio (OR) 0.86 per 10 mmHg; 95% confidence interval (CI) 0.73-1.00), DBP (OR 0.67 per 10 mmHg; 95% CI 0.49-0.93), mean arterial pressure (OR 0.73 per 10 mmHg; 95% CI 0.56-0.94), systolic hypertension (OR 0.49; 95% CI 0.26-0.94), and antihypertensive treatment (OR 0.53; 95% CI 0.27-1.02), each were inversely associated with the presence of CCs. Also, among patients with CCs, there was a graded, significant inverse relation between levels of SBP, levels of pulse pressure, and collateral extent. There is an inverse relationship between BP and the presence and extent of CC circulation in patients with ischaemic heart disease.

show abstract

Section: Discussionmentioning

confidence: 99%

High blood pressure is inversely related with the presence and extent of coronary collaterals

et al. 2005

View full text Add to dashboard Cite

show abstract

“…A Doppler-derived collateral flow index (CFI) was calculated as the ratio of APV Occl /APV Ante . 18 The antegrade APV Ante was recorded at the same position where the collateral flow signal had been recorded at the end of the recanalization procedure. A pressure-derived collateral pressure index (CPI) was calculated as (P D ϪCVP)/(P Ao ϪCVP), where CVP is the central venous pressure.…”

Section: Baseline Studymentioning

confidence: 99%

“…CVP was measured invasively in 41 patients (10Ϯ3 mm Hg) and substituted for by 10 mm Hg in the remaining patients. 18 A collateral resistance index was calculated as R Coll ϭ(P Ao ϪP D )/APV Occl , and a peripheral resistance index was calculated as R P ϭP D /APV Occl . 17,19 In 80 patients, the immediately recruitable collateral flow velocity and distal coronary pressure were recorded at the end of the procedure (31Ϯ19 minutes after the baseline recording) during a final balloon inflation of 3 minutes.…”

Section: Baseline Studymentioning

confidence: 99%

“…In the case of an acute occlusion, collateral recovery would take too long to prevent ischemia in most patients, as only 18% of patients had a CPI Ն0.3 at follow-up. 18 The mechanisms involved in collateral regression and recovery probably are flow-dependent changes of the collateral vascular tone. 13 This is documented in our study by the increase of R Coll .…”

Section: Collateral Regression and Recovery After Recanalization Of Amentioning

confidence: 99%

“…[12][13][14] The applicability of these data to human pathophysiology is not yet proven, but the advent of direct measurement of collateral function in humans with miniaturized sensors of coronary flow and pressure provides a means to test the experimental data in humans. [15][16][17][18][19] Applying these invasive methods in CTOs, we had recently shown a loss of collateral function within 30 minutes after recanalization. 19, 20 The present study should assess whether collaterals regress or remain preserved several months after recanalization.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Regression of Collateral Function After Recanalization of Chronic Total Coronary Occlusions

et al. 2003

View full text Add to dashboard Cite

Background-Collaterals can maintain myocardial function or preserve viability in chronic total coronary occlusions (CTOs). It is unknown whether and to what extent collaterals regress after successful recanalization of a CTO. Methods and Results-In 103 patients with successful recanalization of a CTO collateral function was assessed by intracoronary Doppler and pressure recordings before and after recanalization, and again after 5.0Ϯ1.3 months. Doppler (CFI) and pressure-derived collateral function indexes (CPI) and collateral (R Coll ) and peripheral resistance indexes (R P ) were calculated. In 10 patients with reocclusion, all without myocardial infarction during follow-up, collateral function had reached a similar level as before the first recanalization. In the other 93 patients with or without restenosis, collateral function was attenuated during follow-up. CPI had decreased by 23% immediately after recanalization (PϽ0.001) and decreased further by another 23% at follow-up (PϽ0.001). The R Coll increased immediately after recanalization by 82% (PϽ0.001) and by a further 273% at follow-up (PϽ0.001). In contrast, R P increased only by 22% after recanalization (PϽ0.001) and by an additional 12% at follow-up (PϽ0.05). The initial size of the collaterals but not the incidence of a restenosis influenced the collateral regression. Only 18% of patients at follow-up had collaterals with a CPI Ͼ0.30, presumably sufficient to prevent ischemia during acute occlusion. Conclusions-Collateral function regresses during long-term follow-up, especially in collaterals with a small diameter. In the majority of patients, collaterals are not readily recruitable in the case of acute occlusion. However, collaterals have the potential to recover in the case of chronic reocclusion.

show abstract

Impact of Female Sex on Death and Bleeding After Fibrinolytic Treatment of Myocardial Infarction in GUSTO V

Reynolds¹

2007

Arch Intern Med

View full text Add to dashboard Cite

Coronary collateral quantitation in patients with coronary artery disease using intravascular flow velocity or pressure measurements

Abstract: Intracoronary flow velocity or pressure measurements during routine PTCA represent an accurate and, at last, quantitative method for assessing the coronary collateral circulation in humans.

Cited by 232 publications

References 32 publications

High blood pressure is inversely related with the presence and extent of coronary collaterals

High blood pressure is inversely related with the presence and extent of coronary collaterals

Regression of Collateral Function After Recanalization of Chronic Total Coronary Occlusions

Impact of Female Sex on Death and Bleeding After Fibrinolytic Treatment of Myocardial Infarction in GUSTO V

Contact Info

Product

Resources

About