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Dynamic change in collateral flow associated with myocardial ischemia in humans

Y Sakata1, M Kitakaze, F Ishikura

  • 1Cardiovascular Division, Osaka Police Hospital, Osaka, Japan. sakatah@medone.med.osaka-u.ac.jp

International Journal of Cardiology
|October 2, 2001
PubMed

Insights

Collateral blood flow, assessed by myocardial contrast echocardiography (MCE), closely correlates with cardiac function. Changes in collateral flow during pacing, not resting flow, determine myocardial ischemia in patients with coronary collaterals.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Myocardial Perfusion

Background:

  • Assessing collateral circulation is crucial for managing myocardial ischemia.
  • Understanding the dynamic changes in collateral flow is key to evaluating cardiac function.
  • Coronary artery disease often involves complex collateral networks.

Purpose of the Study:

  • To investigate the relationship between collateral blood flow and regional cardiac function.
  • To determine how collateral flow changes during induced myocardial ischemia.
  • To identify predictors of myocardial ischemia in patients with coronary collaterals.

Main Methods:

  • Myocardial contrast echocardiography (MCE) was used to quantify collateral blood flow.
  • Rapid atrial pacing was employed to induce controlled myocardial ischemia.
  • Lactate production was measured to assess the severity of ischemia.

Main Results:

  • Collateral flow, measured by MCE, significantly correlated with regional wall motion.
  • Pacing-induced reduction in collateral flow was more pronounced in patients with lactate production.
  • Resting collateral flow did not differ significantly between groups with and without ischemia.

Conclusions:

  • Myocardial contrast echocardiography effectively assesses collateral flow and its association with cardiac function.
  • The dynamic change in collateral flow during stress, rather than baseline flow, is critical in determining myocardial ischemia.
  • These findings have implications for risk stratification and treatment strategies in patients with coronary collaterals.
Abstract

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