Determinants of collateral development in a canine model with repeated coronary occlusion

It is now accepted that repetitive 2-min coronary occlusion can develop collateral vessels to the area perfused by the occluded coronary artery. However, which factors influence collateral development has yet to be fully elucidated. The goal of the present study was to identify the determinants of the rate of coronary collateral development in dogs undergoing repeated coronary occlusion. The study was conducted in 19 conscious dogs instrumented for measurements of a subendocardial segment length in the area perfused by the left circumflex coronary artery (LCCA), LCCA flow, and left ventricular pressure. An externally inflatable pneumatic occluder was placed around the LCCA. After the recovery from surgery, 2-min LCCA occlusions were conducted eight times daily. Following 141 +/- 61 (SD) LCCA occlusions (20 +/- 7 days), an LCCA occlusion produced no reduction in segment shortening and negligible reactive hyperemia. The total number of LCCA occlusions needed for adequate collateral development (the rate of collateralization) correlated well with the severity of myocardial ischemia during the first occlusion, which was determined mainly by the extent of postsurgical initial collateral circulation. On the other hand, the response to the ischemic stimulus in the later stage of collateral development was independent of the extent of development of the initial postsurgical collaterals. It is concluded that the overall rate of collateral development is slower in dogs with initially poorer collaterals; however, the response of each dog to the ischemic stimulus in the later stage of collateral development was similar among dogs regardless of the extent of the initial collaterals.