The collateral circulation of the heart
Pascal Meier1, Stephan H Schirmer, Alexandra J Lansky
1The Heart Hospital London, University College London Hospitals UCLH, London, UK. pascalmeier74@gmail.com
BMC Medicine
|June 6, 2013
Summary
Coronary collateral arteries offer protective benefits in coronary artery disease by providing alternative blood flow. Therapeutic strategies to enhance these vessels show promising results in recent pilot studies.
Area of Science:
- Cardiovascular Science
- Medical Research
Background:
- Coronary arteries were historically viewed as end arteries.
- Anastomotic vessels, or collateral arteries, interconnect epicardial coronary arteries.
- These collaterals supply the myocardium during occlusive coronary artery disease.
Purpose of the Study:
- To investigate the role and therapeutic potential of coronary collateral arteries.
- To summarize current understanding of collateral circulation assessment and enhancement.
Main Methods:
- Review of existing literature on coronary collateral circulation.
- Discussion of assessment methods, including intracoronary pressure measurements.
- Analysis of therapeutic strategies, including past clinical trials and recent pilot studies.
Main Results:
- Increasing evidence supports a protective role for collateral arteries in coronary artery disease.
- Intracoronary pressure measurements are the gold standard for assessing collateral function.
- Initial therapeutic trials were unsuccessful, but recent pilot studies show promise.
Conclusions:
- Coronary collateral arteries play a significant protective role in coronary artery disease.
- Therapeutic induction of collateral growth remains an area of active research.
- Emerging strategies like external counterpulsation and G-CSF show potential for enhancing collateral circulation.
Related Concept Videos
02:03Anatomy of the Circulatory System
The human circulatory system consists of blood, blood vessels that carry blood away from the heart, around the body, and back to the heart, and the heart itself, which acts as a central pump. The systemic circuit supplies blood to the whole body, the coronary circuit supplies blood to the heart, and the pulmonary circuit supplies blood flow between the heart and lungs.
01:15Overview of Systemic and Pulmonary Circulation
The systemic and pulmonary circuits are crucial components of the circulatory system, working together to transport blood between the heart, lungs, and the rest of the body. The process begins with pulmonary circulation, where deoxygenated blood is pumped from the right ventricle to the lungs via the pulmonary trunk and arteries. Upon reaching the lungs, the blood becomes oxygenated and returns to the heart, specifically to the left atrium, via the pulmonary veins.
The oxygenated blood is sent...
The oxygenated blood is sent...
01:11Overview of Systemic Arteries
The human body is a complex, well-organized machine, and at the heart of its operations lies the circulatory system. This network of blood vessels, which includes systemic arteries, plays a vital role in maintaining life by transporting nutrients, oxygen, and waste products to and from cells throughout the body.
Systemic circulation is the part of the cardiovascular system that carries oxygenated blood away from the heart to the body's tissues and returns deoxygenated blood back to the heart.
Systemic circulation is the part of the cardiovascular system that carries oxygenated blood away from the heart to the body's tissues and returns deoxygenated blood back to the heart.
01:21Coronary Circulation
The heart, an organ critical to survival, gets nourishment not from the blood it pumps but from a separate circulation system known as coronary circulation. This is the shortest circulation in the body and is responsible for supplying the heart with the nutrients it needs to function effectively.
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
01:14Overview of the Cardiovascular System
The cardiovascular system is a vital transportation system in the body. It comprises the heart and blood vessels and facilitates the exchange of gases, nutrients, and waste products.
Heart
The heart is the central pump of the cardiovascular system that circulates blood throughout the body. It comprises two atria receiving the blood and two ventricles pumping blood out of the heart. Their rhythmic contractions, called heartbeats, ensure that blood flow remains continuous.
Blood Vessels
Blood...
Heart
The heart is the central pump of the cardiovascular system that circulates blood throughout the body. It comprises two atria receiving the blood and two ventricles pumping blood out of the heart. Their rhythmic contractions, called heartbeats, ensure that blood flow remains continuous.
Blood Vessels
Blood...
01:19Overview of Pulmonary Circulation
The pulmonary circulation is a vital system in our body that acts as a bridge between the respiratory and cardiovascular systems. It serves as a transport network for deoxygenated blood from the heart to the lungs and then returns oxygen-rich blood back to the heart.
The process begins with the right ventricle of the heart pumping deoxygenated blood into the pulmonary trunk. This large vessel extends about 5 centimeters before splitting into the left and right pulmonary arteries. These arteries...
The process begins with the right ventricle of the heart pumping deoxygenated blood into the pulmonary trunk. This large vessel extends about 5 centimeters before splitting into the left and right pulmonary arteries. These arteries...