Determinants of Preformed Collateral Vessels in the Human Heart without Coronary Artery Disease

Abstract

Background: Coronary collaterals protect myocardium jeopardized by coronary artery disease (CAD). Promotion of collateral circulation is desirable before myocardial damage occurs. Therefore, determinants of collateral preformation in patients without CAD should be elucidated. Methods: In 106 patients undergoing coronary angiography who were free of coronary stenoses, a total of 39 clinical test variables were collected. The coronary collateral flow index (CFI) was measured. Stepwise multiple linear regression analysis was performed after choosing a restricted number of candidates emerging from univariate testing. Separate multiple regression analyses were performed in patients with and without beta-blocker therapy. Results: Nine parameters were found to be possible determinants of CFI by univariate analysis: arterial hypertension (aHT), dyslipidemia, statins, diuretics, age, height, heart rate (HR), pulse pressure amplitude, and left ventricular end-diastolic pressure (LVEDP). After multiple regression analysis, a low HR, absence of aHT, and elevated LVEDP were significantly related to CFI (F = 5.31, p = 0.002, adjusted r² = 0.12). In patients without beta-blockers, a low HR and absence of aHT were independent predictors of CFI (F = 8.03, p < 0.001, n = 50, adjusted r² = 0.30). Conclusions: A low HR and absence of aHT are both related to collateral preformation in humans. We suppose that bradycardia favors fluid shear stress in coronary arteries, thus triggering collateral growth.

Exercise Training for Refractory Angina: Improving the Coronary Collateral Circulation

“…A recent study showed that external counterpulsation which simulates physical exercise can induce collateral growth by increasing the shear force on the endothelium [9]. A lower heart rate may increase shear force on the endothelium due to the larger stroke volume and pulse pressure [10]. Individuals with a lower resting heart rate have a better developed collateral network [10], and regular physical exercise leads to a lower resting heart rate.…”

“…A lower heart rate may increase shear force on the endothelium due to the larger stroke volume and pulse pressure [10]. Individuals with a lower resting heart rate have a better developed collateral network [10], and regular physical exercise leads to a lower resting heart rate.…”

The Relationship Between Coronary Collateral Circulation and In-hospital Mortality in Patients with First Acute Anterior STEMI

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ABSTRACT

Aim: The aim of the present study is to investigate the prognostic value of Coronary Collateral Circulation (CCC) in patients with the first acute anterior wall ST Elevation Myocardial Infarction (STEMI) undergoing primary percutaneous coronary intervention w (p-PCI).

Material and Method: A total of 220 Patients with first acute 08, 95 %CI 1,07 to 1,26, p=0,03), Semptomların başlangıcın-dan p-PKG yapılıncaya kadar geçen süre ([OR] 1,6, 95 %CI 1,06 to 2,59, p=0,04),3, 95 %CI 1,04 to 10,9, p=0,04)

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The coronary collateral circulation-clinical predictors

“…A previous large study of 450 patients with coronary artery disease that considered patient history, cardiovascular risk factors, medication use and angiographic data showed that the only independent determinant of adequate collateral circulation was the degree of coronary artery stenosis (8). In patients without coronary artery disease, the baseline heart rate has been described as the main predictor of collateralization (9). There is also evidence that genetic factors play a role (10).…”