Related Experiment Video

Updated: Dec 27, 2025

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

Published on: February 16, 2016

20.0K

Coronary collaterals and myocardial viability in patients with chronic total occlusions

Stefan P Schumacher1, Henk Everaars, Wijnand J Stuijfzand

  • 1Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|March 4, 2020
PubMed

Insights

Well-developed coronary collaterals in chronic total occlusions are linked to less heart muscle damage. However, viable heart tissue is often found even with poor collaterals, suggesting potential for recovery.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Cardiovascular Research

Background:

  • Chronic coronary total occlusions (CTOs) present a challenge in cardiology.
  • Assessing myocardial viability and scar burden in CTOs is crucial for treatment decisions.
  • The role of coronary collateral circulation in determining myocardial health in CTOs requires further elucidation.

Purpose of the Study:

  • To investigate the association between coronary collateral development and myocardial viability.
  • To quantify myocardial function and scar using cardiac magnetic resonance (CMR) in patients with CTO.
  • To determine if well-developed collaterals correlate with preserved myocardial function in CTO territories.

Main Methods:

  • Utilized quantitative cardiac magnetic resonance (CMR) imaging.
  • Included 218 patients with CTOs diagnosed between 2013 and 2018.
  • Assessed collateral development using collateral connection (CC) score and Rentrop grade.
  • Defined myocardial viability by segmental wall thickening (SWT) and late gadolinium enhancement (LGE).

Main Results:

  • Well-developed collaterals (CC score 2/Rentrop grade 3) were present in 67% of patients.
  • Patients with well-developed collaterals showed greater SWT (3.72 vs. 3.05 mm, p<0.01) and less scar (7.0% vs. 13.1%, p=0.048).
  • Myocardial viability was more prevalent in CTO segments with poorly developed collaterals (44% vs. 30%, p<0.01).

Conclusions:

  • The extent of myocardial infarction in CTOs is generally limited.
  • Well-developed coronary collaterals are associated with reduced myocardial scarring and better preserved function.
  • Significant myocardial viability is frequently observed even in the presence of poorly developed collaterals, indicating potential for recovery.
Abstract

More Related Videos

Author Spotlight: Enhancing Coronary Artery Revascularization05:25

Author Spotlight: Enhancing Coronary Artery Revascularization

Published on: September 15, 2023

1.1K
Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats06:32

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Published on: June 28, 2019

8.4K

Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
154
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
301
Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
250
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
186
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
797
Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
538