Document Detail


Angiographic assessment of collateral connections in comparison with invasively determined collateral function in chronic coronary occlusions.
MedLine Citation:
PMID:  12665484     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The evaluation of new therapeutic modalities to induce collateral growth in coronary artery disease require improved methods of angiographic characterization of collaterals, which should be validated by quantitative assessment of collateral function. METHODS AND RESULTS: In 100 patients with total chronic occlusion of a major coronary artery (duration >2 weeks) collaterals were assessed angiographically by the Rentrop grading, by their anatomic location, and by a new grading of collateral connections (CC grade 0: no continuous connection, CC1: threadlike continuous connection, CC2: side branch-like connection). The interobserver variability was 10%. Collateral function was assessed by Doppler flow (average peak velocity) and pressure recordings distal to the occlusion before recanalization. A collateral resistance index (RColl) was calculated. Recruitable collateral flow was measured during a final balloon inflation >30 minutes after the baseline measurement. The comparison of the anatomic location, the Rentrop, and the collateral connection grade showed only for the latter an independent and significant relation with RColl. CC2 collaterals preserved regional left ventricular function better than did CC1 collaterals and provided a higher collateral flow reserve during adenosine infusion. CC0 collaterals were predominantly observed in recent occlusions of 2 to 4 weeks' duration, with the highest RColl. During balloon reocclusion, recruitable collateral function was best preserved with CC2 and least with CC0. CONCLUSIONS: The angiographic grading of collateral connections in total chronic occlusions could differentiate collaterals according to their functional capacity to preserve regional left ventricular function and was closely associated with invasively determined parameters of collateral hemodynamics.
Authors:
Gerald S Werner; Markus Ferrari; Stephan Heinke; Friedhelm Kuethe; Ralf Surber; Barbara M Richartz; Hans R Figulla
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2003-03-24
Journal Detail:
Title:  Circulation     Volume:  107     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-22     Completed Date:  2003-04-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1972-7     Citation Subset:  AIM; IM    
Affiliation:
Clinic for Internal Medicine III, Friedrich-Schiller-University Jena, Jena, Germany. gerald.werner@med.uni-jena.de
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MeSH Terms
Descriptor/Qualifier:
Adenosine / pharmacology
Analysis of Variance
Angioplasty, Transluminal, Percutaneous Coronary
Blood Flow Velocity
Blood Pressure
Chronic Disease
Collateral Circulation*
Coronary Angiography
Coronary Circulation*
Coronary Disease / diagnosis,  physiopathology*,  therapy
Female
Humans
Male
Middle Aged
Observer Variation
Ultrasonics
Ultrasonography, Interventional
Vascular Patency
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
58-61-7/Adenosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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