Related Experiment Videos
Relation between collateral channel filling and flow grade in recipient coronary arteries in patients with stable
N Yoshida1, M Fujita, K Yamanishi
1Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.
Insights
Coronary artery narrowing in chronic effort angina patients stimulates collateral circulation development. The extent of blood flow (Thrombolysis in Myocardial Infarction [TIMI] grade) directly correlates with the degree of collateral vessel visualization.
Area of Science:
- Cardiology
- Vascular Biology
- Medical Imaging
Background:
- Assessing coronary stenosis severity is challenging with standard angiography.
- Flow grade in coronary arteries offers insights into atherosclerotic disease progression and collateral development.
Purpose of the Study:
- To determine the relationship between coronary artery perfusion extent and collateral circulation visualization in ischemic areas.
- To investigate the impact of coronary artery narrowing on collateral development.
Main Methods:
- Analysis of coronary arteriograms from 54 patients with chronic effort angina.
- Classification of patients into four groups based on Thrombolysis in Myocardial Infarction (TIMI) perfusion grades (0-3).
- Assessment of collateral circulation using a four-grade collateral index.
Main Results:
- Significant inverse correlation observed between TIMI perfusion grade and collateral index.
- Mean collateral index for TIMI grades 0, 1, 2, and 3 were 2.7, 2.2, 1.2, and 0.4 respectively.
- Lower perfusion grades (TIMI 0 and 1) showed significantly higher collateralization compared to higher grades (p < 0.01 and p < 0.05).
Conclusions:
- Patients with chronic effort angina demonstrate collateral vessel development in response to coronary artery narrowing.
- The functional status of collateral vessels is likely influenced by the pressure gradient across the collateral network.
Objectives:
The purpose of the present study was to elucidate the relation between the extent of perfusion of the ischemia-related coronary artery and the degree of visualization of the collateral circulation to the ischemic area.
Background:
Because it is difficult to accurately assess coronary stenosis severity with standard angiographic techniques, the inclusion of flow grade in recipient coronary arteries would provide an additional perspective concerning the effect of the progression of atherosclerotic obstructive disease on the development of collateral circulation.
Methods:
The coronary arteriograms of 54 consecutive patients with chronic effort angina without prior myocardial infarction were examined. Patients were classified into four groups according to the extent of perfusion of the ischemia-related coronary artery (Thrombolysis in Myocardial Infarction [TIMI] grade 0 to 3). The degree of angiographically demonstrable collateral circulation was also classified into four grades (collateral index 0 to 3).
Results:
Eighteen patients had TIMI grade 0, 6 had grade 1, 13 had grade 2 and 17 had grade 3 perfusion. The collateral indexes of TIMI 0, 1, 2 and 3 groups were 2.7 +/- 0.7 (mean +/- SEM), 2.2 +/- 0.6, 1.2 +/- 1.1 and 0.4 +/- 0.9, respectively (p < 0.01 vs. TIMI 0, p < 0.05 vs. TIMI 1).
Conclusions:
These findings indicate that all patients with chronic effort angina have the potential for collateral development as a result of coronary artery narrowing, and the functional state of well developed collateral vessels may be primarily determined by the pressure gradient across the collateral network.