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Published on: February 16, 2016
Contradictory Effect of Coronary Collateral Circulation on Regional Myocardial Perfusion That Assessed by
Semra Ozdemir1, Ahmet Barutcu2, Ercan Aksit2
1Department of Nuclear Medicine, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale 17110, Turkey.
Insights
Well-developed coronary collateral circulation (CCC) may improve heart function, but gated myocardial perfusion scintigraphy (gated MPS) showed no statistically significant benefit in this study. Larger patient cohorts are needed to confirm these findings.
Area of Science:
- Cardiology
- Nuclear Medicine
- Medical Imaging
Background:
- Conflicting data exists on the role of coronary collateral circulation (CCC) in myocardial perfusion and function.
- Gated myocardial perfusion scintigraphy (gated MPS) is a key imaging technique for assessing cardiac health.
- Understanding CCC's impact is crucial for managing ischemic heart disease.
Purpose of the Study:
- To investigate the effect of well-developed coronary collateral circulation (CCC) on myocardial perfusion and function.
- To address contradictory findings from previous studies using gated myocardial perfusion scintigraphy (gated MPS).
- To evaluate the utility of gated MPS in assessing CCC's contribution.
Main Methods:
- Retrospective analysis of 96 patients who underwent both gated MPS and coronary angiography.
- Patients were divided into two groups based on collateral artery development (Rentrop grade 0-1 vs. 2-3).
- Gated MPS was used to assess myocardial perfusion, function, and left ventricular synchronization (phase analysis).
Main Results:
- No statistically significant differences in perfusion or functional parameters were observed between groups with varying CCC development.
- Phase analysis parameters, evaluating left ventricular synchronization, also showed no significant differences.
- Left ventricular mass index was elevated in the well-developed CCC group, approaching statistical significance (P=0.059).
Conclusions:
- Gated MPS suggests that while well-developed CCC may positively influence myocardial perfusion and function, the effect was not statistically significant in this cohort.
- The study highlights the need for larger sample sizes to definitively establish the impact of CCC.
- Further research is warranted to validate these findings in diverse patient populations.
Background:
Previous studies showed conflicting results about the contribution of coronary collateral circulation (CCC) to myocardial perfusion and function. The aim of this study was to investigate these contradictory problems by gated myocardial perfusion scintigraphy (gated MPS) for the first time.
Methods:
The current cohort was retrospectively selected among patients who underwent gated MPS and coronary angiography within 2 months. Two different groups including 96 patients were assessed by gated MPS to detect the understanding of the miscellaneous effect of CCC on myocardial perfusion. Group 1 consisted of those who had collateral arteries that were not-well-developed (Rentrop grade 0 - 1) (n = 58), while group 2 consisted of those who had collateral arteries that were well-developed (Rentrop grade 2 - 3) (n = 38).
Results:
There was no statistically significant difference between groups 1 and 2 in terms of perfusion and functional parameters obtained from gated MPS. Furthermore, no statistically significant difference was found in the phase analysis parameters which is a novel technique to evaluate left ventricular synchronization. On the other hand the left ventricular mass index values were high and quite close to the statistically significant value (P = 0.059) in group 2.
Conclusions:
The current results that obtained by using the gated MPS technique for the first time in the evaluation of CCC showed that the well-developed collateral circulation has a positive effect on myocardial perfusion and function, but this effect was not statistically significant. Results need to be supported by large scale of patients' size.
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