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Published on: January 28, 2020
[Formation and function of coronary collateral circulation and their influencing factors]
Chuan-chang Li1, Tian-lun Yang, Xiao-qun Pu
1Department of Cardiology, Xiangya Hospital, Central South University, Changsha 410008, China.
Insights
Coronary collateral circulation (CCC) formation increases with severe coronary stenosis. While not affecting formation, HDL and LDL cholesterol levels influence CCC function in coronary artery disease patients.
Area of Science:
- Cardiology
- Vascular Biology
- Medical Imaging
Background:
- Coronary artery disease (CAD) involves severe coronary stenosis.
- Coronary collateral circulation (CCC) plays a vital role in mitigating ischemic damage.
- Understanding CCC formation and function is crucial for managing CAD.
Purpose of the Study:
- To investigate the formation and function of CCC in CAD patients with severe coronary stenosis.
- To identify factors influencing CCC formation and function.
- To correlate CCC characteristics with patient demographics and serum lipid profiles.
Main Methods:
- Coronary angiography was performed on 266 CAD patients with severe coronary stenosis.
- CCC formation was assessed using the Rentrop rating.
- CCC function was evaluated using the Werner collateral collection (CC) rating.
Main Results:
- CCC formation rates significantly increased with stenosis severity (42.6% for 90-94%, 56.9% for 95-99%, 93.0% for 100% stenosis).
- No significant differences in age, gender, MI, hypertension, diabetes, smoking, HDL-C, or LDL-C were found between CCC forming and non-forming groups.
- Higher HDL-C and lower LDL-C levels correlated with better CCC function (CC Grade 2), while lower HDL-C and higher LDL-C correlated with poorer function (CC Grade 0).
Conclusions:
- The severity of coronary stenosis is the primary determinant of CCC formation.
- CCC formation rate escalates with increasing coronary stenosis.
- Serum HDL-C and LDL-C levels are linked to CCC function, not formation, with higher HDL-C and lower LDL-C indicating better function.
Objective:
To clarify the formation and function of coronary collateral circulation (CCC) in coronary artery disease (CAD) patients with severe coronary artery stenosis and their influencing factors.
Methods:
Coronary angiography was performed on 266 CAD patients with severe coronary stenosis. CCC formation was evaluated by Rentrop rating on those 266 patients and 401 severe stenosis arteries; while in CCC formed patients, CCC function was evaluated by Werner collateral collection (CC) rating. The formation, function of CCC and their influencing factors were analyzed and compared.
Results:
CCC formation in those severe stenosis coronary arteries was related to the severity of coronary stenosis: the forming rate of CCC was 42.6% in vessels with 90%-94% stenosis (Group A), 56.9% with 95%-99% stenosis (Group B) and 93.0% with 100% stenosis (Group C) (p <0 .01). Between CCC forming and non-forming groups, there was no significant difference in age, gender, incidence of MI, hypertension and diabetes, history of smoking and serum levels of HDL-C and LDL-C (P > 0.05). In the CCC formation group, serum HDL-C level was the highest in the CC Grade 2 group (according to Werner function rating) and the lowest in the CC Grade 0 group (P < 0.05). Whereas, LDL-C level was the lowest in the CC Grade 2 group and the highest in the CC Grade 0 group (P < 0.05).
Conclusion:
Severity of coronary stenosis was the major influencing factor in CCC formation and function, and the rate of CCC formation increased with the exacerbation of coronary stenosis. Serum HDL-C and LDL-C level had no relationship with CCC formation, but related to CCC function. Better CCC function was found in patients with high level of HDL-C whereas the patients with high level of LDL-C had spoiled CCC function.
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