Physiologically assessed coronary collateral flow and adverse cardiac ischemic events: a follow-up study in 403 patients with coronary artery disease

Billinger, Michael; Kloos, Patrik; Eberli, Franz R.; Windecker, Stephan; Meier, Bernhard; Seiler, Christian

doi:10.1016/s0735-1097(02)02378-1

Cited by 128 publications

(72 citation statements)

References 17 publications

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“…This observation paves way for collateral assessments with ECV. Since the benefit impact of welldeveloped collateral vessels on the occurrence of future major cardiac ischemic events has been clearly reported [32], our findings also indicates that segmental ECV value distal to a CTO vessel may emerge as a promising bimarker for patients' outcome. Our study had several limitations.…”

Section: Discussionsupporting

confidence: 60%

Extracellular volume fraction in coronary chronic total occlusion patients

Chen

Zhang

Yang

et al. 2015

Int J Cardiovasc Imaging

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(1) To assess extracellular volume fraction (ECV) and regional systolic function in patients presenting with coronary chronic total occlusion (CTO) in areas without significant late gadolinium enhancement (LGE), and (2) to investigate the correlation between angiography collateral flow and ECV in territories supplied by CTO vessels. A total of 50 angiographically documented CTO patients and 15 age- and sex-matched normal controls were recruited to the study. Myocardial ECV, was calculated in infarcted, global non-infarcted and the entire myocardium respectively. Segmental ECV was calculated from myocardial segments within the perfusion territory of a CTO vessel. The global and regional systolic function was evaluated using ejection fraction and percent systolic thickening. ECVs in global myocardium and global non-infarcted myocardium were significantly elevated in comparison with that in controls (29.1 ± 4.2% and 26.6 ± 2.6% vs. 23.3 ± 2.0%, all P < 0.005). Global ECV significantly correlated with LV ejection fraction (r = -0.56, P < 0.001) and ECV inversely correlated with systolic thickening in global non-infarcted myocardium (r = -0.31, P < 0.05). The lower segmental ECV was associated with the presence of well-developed collaterals (P = 0.004), and multivariate binary logistic analysis demonstrated that mean segmental ECV and course of disease were the independent discriminator of collateral flow with overall diagnostic accuracy of 74.4%. In patients with CTO, ECV is found to be increased beyond that observed with LGE, and correlates with LV regional wall motion abnormality, which appears to reflect diffuse myocardial fibrosis. Mean segmental ECV value, combined with course of disease, may serve as good predictors of collateral flow.

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Section: Discussionsupporting

confidence: 60%

Extracellular volume fraction in coronary chronic total occlusion patients

Chen

Zhang

Yang

et al. 2015

Int J Cardiovasc Imaging

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“…Consequently, a sufficiently developed intracranial collateral blood supply theoretically reduces cerebral injury by protecting watershed areas that are most susceptible to infarction, and by limiting the size of an ischaemic area following embolic vessel occlusion. In parallel with the results obtained in cardiac studies [5,13], the presence of intracranial collateral circulation in patients with severe carotid artery stenosis has been associated with a better clinical outcome: these patients have a lower risk of stroke or transient ischaemic attacks, and generally a better functional recovery following an ischaemic event [23]. It is therefore conceivable that the presence of cerebral collaterals will also positively influence neurocognitive outcome following cardiac surgery.…”

Section: Reasonmentioning

confidence: 79%

“…Previous studies on coronary collaterals have either looked at possible determinants of their presence or focused on their effect on cardiac outcomes [5,[10][11][12][13]. The forming rate of coronary collaterals has been demonstrated to increase with the severity of stenotic disease of the coronary arteries [14].…”

Section: Discussionmentioning

confidence: 99%

“…a One patient who was unsuitable for neuropsychological testing at baseline had died at 5-year follow-up. and recent studies have shown that coronary collateral circulation favours long-term cardiac outcome in patients undergoing percutaneous cardiac interventions and off-pump cardiac surgery [5,13]. However, the association between coronary collaterals and cognitive outcome has never been studied before.…”

Section: Reasonmentioning

confidence: 99%

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Presence of coronary collaterals is associated with a decreased incidence of cognitive decline after coronary artery bypass surgery☆

Dieleman

Sauër

Klijn

et al. 2009

European Journal of Cardio-Thoracic Surgery

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“…After they enlarge sufficiently, they become visible on invasive coronary angiography (ICA). The presence and extent of coronary collateralization often determines the necessity for revascularization of occluded vessels as well as the method of revascularization (i.e., PCI vs. CABG) [5][6][7]. ICA is currently considered the standard of reference for direct visualization of coronary collaterals [8].…”

Section: Introductionmentioning

confidence: 99%

Assessment of the presence and extent of coronary collateralization by coronary computed tomographic angiography in patients with total occlusions

Rieber

Sheth

Mooyaart

et al. 2008

Int J Cardiovasc Imaging

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Coronary computed tomography angiography (CTA) may be helpful to manage patients with chronic coronary occlusions. The aim of this study was to determine the sensitivity and specificity of CTA to detect the presence and extent of coronary collaterals as compared to invasive coronary angiography (ICA). We retrospectively evaluated 26 patients who underwent both coronary CTA and ICA within 3 weeks and demonstrated a total coronary occlusion (TIMI grade 0) in one of the major coronary arteries. CTA was performed using a 64-slice multidetector CT. The presence, and extent of collateralization was assessed by two blinded observers using the Rentrop classification for ICA. CTA accurately identified the presence and location of all 26 total occlusions. The presence of any collaterals was accurately detected in 21/23 patients [sensitivity 91% (CI: 71-98%)] and the absence in three patients [specificity 100% (CI: 29%-100%)]. The sensitivity of coronary CTA to identify patients with collateralization increased from 91 to 94% (CI: 71-99%) and 100% (CI: 59-100%) for collaterals Rentrop grade 2 and 3 in ICA, respectively. Coronary CTA accurately detects the presence of any coronary collateralization in patients with total occlusions. Although CT technology is currently limited in the assessment of individual collaterals and smaller vessels, it may be helpful in the management of patients with total occlusions.

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Physiologically assessed coronary collateral flow and adverse cardiac ischemic events: a follow-up study in 403 patients with coronary artery disease

Abstract: In this relatively large population with chronic stable coronary artery disease undergoing quantitative collateral measurement, the beneficial impact of well developed collateral vessels on the occurrence of future major cardiac ischemic events is clearly demonstrated.

Cited by 128 publications

References 17 publications

Extracellular volume fraction in coronary chronic total occlusion patients

Extracellular volume fraction in coronary chronic total occlusion patients

Presence of coronary collaterals is associated with a decreased incidence of cognitive decline after coronary artery bypass surgery☆

Assessment of the presence and extent of coronary collateralization by coronary computed tomographic angiography in patients with total occlusions

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