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Coronary collateral circulation and diastolic function

T Nii1, Y Tsuchiya, H Tahara

  • 1Second Department of Internal Medicine, Fukuoka University School of Medicine, Japan.

International Journal of Cardiology
|March 15, 1994
PubMed
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Coronary collaterals in patients with effort-induced angina are linked to impaired left ventricular diastolic function. Visible collaterals may indicate more severe coronary stenosis and poorer diastolic function.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology

Background:

  • Coronary artery disease (CAD) is associated with impaired left ventricular (LV) filling.
  • Coronary collaterals may influence diastolic function in patients with CAD.

Purpose of the Study:

  • To evaluate the impact of coronary collaterals on diastolic function in patients experiencing effort-induced angina.
  • To determine if visible coronary collaterals serve as a marker for the severity of coronary stenosis and LV diastolic dysfunction.

Main Methods:

  • Resting radionuclide ventriculography was performed in 14 patients with severe isolated left anterior descending coronary artery stenosis and 7 normal subjects.
  • Patients were categorized based on the presence and grade (Rentrop classification) of collateral vessels.
  • Systolic and diastolic functional indices were compared between groups with and without collateral vessels.

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Main Results:

  • Global peak filling rate was significantly reduced in patients with collateral vessels (P < 0.01).
  • Septal, apical, and lateral peak filling rates were also reduced, with lateral peak filling rate showing statistical significance (P < 0.05).
  • Exercise tolerance, measured by rate-pressure product, was significantly lower in patients with collaterals (P < 0.01).

Conclusions:

  • Angiographically visible coronary collaterals are associated with impaired left ventricular diastolic function in patients with effort-induced angina.
  • The presence of collaterals may signify more severe coronary stenosis and a greater degree of diastolic dysfunction.