The collateral circulation of the heart in coronary total arterial occlusions in man: Systematic review of assessment and pathophysiology

Khand, Aleem; Fisher, Michael; Jones, Julia; Patel, Bilal; Perry, Raphael A.; Mitsudo, Kazuaki

doi:10.1016/j.ahj.2013.09.010

Cited by 21 publications

(16 citation statements)

References 83 publications

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“…The biopolymer provided both stimuli and structural support to angiogenesis, guiding this process also from the spatial and topographical point of view. This finding could achieve an important significance when considering the clinical incidence of situations in which small coronaries caliber or scarcity of collateral flow in myocardial zones involved by ischemic injury impede to perform coronary artery bypass (CABG) [ 63 ]. In situ-guided angiogenesis through the use of tissue-engineered drug-releasing scaffolds might be an attractive alternative to create a “neoangiogenetic bypass” in myocardial regions which cannot be revascularized, as an adjunct to routinely used autologous grafts.…”

Section: Discussionmentioning

confidence: 99%

Implantation of a Poly-l-Lactide GCSF-Functionalized Scaffold in a Model of Chronic Myocardial Infarction

Spadaccio

Nappi

Marco³

et al. 2017

J. of Cardiovasc. Trans. Res.

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A previously developed poly-l-lactide scaffold releasing granulocyte colony-stimulating factor (PLLA/GCSF) was tested in a rabbit chronic model of myocardial infarction (MI) as a ventricular patch. Control groups were constituted by healthy, chronic MI and nonfunctionalized PLLA scaffold. PLLA-based electrospun scaffold efficiently integrated into a chronic infarcted myocardium. Functionalization of the biopolymer with GCSF led to increased fibroblast-like vimentin-positive cellular colonization and reduced inflammatory cell infiltration within the micrometric fiber mesh in comparison to nonfunctionalized scaffold; PLLA/GCSF polymer induced an angiogenetic process with a statistically significant increase in the number of neovessels compared to the nonfunctionalized scaffold; PLLA/GCSF implanted at the infarcted zone induced a reorganization of the ECM architecture leading to connective tissue deposition and scar remodeling. These findings were coupled with a reduction in end-systolic and end-diastolic volumes, indicating a preventive effect of the scaffold on ventricular dilation, and an improvement in cardiac performance.

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Section: Discussionmentioning

confidence: 99%

Implantation of a Poly-l-Lactide GCSF-Functionalized Scaffold in a Model of Chronic Myocardial Infarction

Spadaccio

Nappi

Marco³

et al. 2017

J. of Cardiovasc. Trans. Res.

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show abstract

“…An alternative, less frequent mechanism is the growth of new capillaries by hypoxia-induced sprouting from existing vessels (angiogenesis) [ 48 , 52 ]. Although collateral circulation can supply only part of the metabolic needs of the ischemic myocardium, a high degree of collateralization has been shown to improve survival in patients with stable or acute CAD [ 53 , 54 ].…”

Section: Coronary Microvascular Circulationmentioning

confidence: 99%

Coronary Microvascular Dysfunction

Vancheri¹,

Longo²,

Vancheri

et al. 2020

JCM

209

153

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Many patients with chest pain undergoing coronary angiography do not show significant obstructive coronary lesions. A substantial proportion of these patients have abnormalities in the function and structure of coronary microcirculation due to endothelial and smooth muscle cell dysfunction. The coronary microcirculation has a fundamental role in the regulation of coronary blood flow in response to cardiac oxygen requirements. Impairment of this mechanism, defined as coronary microvascular dysfunction (CMD), carries an increased risk of adverse cardiovascular clinical outcomes. Coronary endothelial dysfunction accounts for approximately two-thirds of clinical conditions presenting with symptoms and signs of myocardial ischemia without obstructive coronary disease, termed “ischemia with non-obstructive coronary artery disease” (INOCA) and for a small proportion of “myocardial infarction with non-obstructive coronary artery disease” (MINOCA). More frequently, the clinical presentation of INOCA is microvascular angina due to CMD, while some patients present vasospastic angina due to epicardial spasm, and mixed epicardial and microvascular forms. CMD may be associated with focal and diffuse epicardial coronary atherosclerosis, which may reinforce each other. Both INOCA and MINOCA are more common in females. Clinical classification of CMD includes the association with conditions in which atherosclerosis has limited relevance, with non-obstructive atherosclerosis, and with obstructive atherosclerosis. Several studies already exist which support the evidence that CMD is part of systemic microvascular disease involving multiple organs, such as brain and kidney. Moreover, CMD is strongly associated with the development of heart failure with preserved ejection fraction (HFpEF), diabetes, hypertensive heart disease, and also chronic inflammatory and autoimmune diseases. Since coronary microcirculation is not visible on invasive angiography or computed tomographic coronary angiography (CTCA), the diagnosis of CMD is usually based on functional assessment of microcirculation, which can be performed by both invasive and non-invasive methods, including the assessment of delayed flow of contrast during angiography, measurement of coronary flow reserve (CFR) and index of microvascular resistance (IMR), evaluation of angina induced by intracoronary acetylcholine infusion, and assessment of myocardial perfusion by positron emission tomography (PET) and magnetic resonance (CMR).

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“…20,21 The CCBF can satisfy resting metabolic cardiac requirements but not under stress in spite of the degree of CCBF evaluated by arteriography and physiologic assessment. 22 A 2015 review found that successful retrograde passage of a wire through collateral channels in appropriate patients could result in revascularization of complex CTO with a low risk of major complications. 23 The importance of CCBF would appear key in planning PCI and in anticipated benefit.…”

Section: Chronic Total Occlusion Of Coronary Arteriesmentioning

confidence: 99%

Prognostic Implications of Coronary Collaterals in Transmural Infarct-Related Percutaneous Coronary Interventions

2018

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The collateral circulation of the heart in coronary total arterial occlusions in man: Systematic review of assessment and pathophysiology

Cited by 21 publications

References 83 publications

Implantation of a Poly-l-Lactide GCSF-Functionalized Scaffold in a Model of Chronic Myocardial Infarction

Implantation of a Poly-l-Lactide GCSF-Functionalized Scaffold in a Model of Chronic Myocardial Infarction

Coronary Microvascular Dysfunction

Prognostic Implications of Coronary Collaterals in Transmural Infarct-Related Percutaneous Coronary Interventions

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