Title of article :
Frequency distribution of collateral flow and factors influencing collateral channel development : Functional collateral channel measurement in 450 patients with coronary artery disease
Author/Authors :
Tilmann Pohl، نويسنده , , Christian Seiler، نويسنده , , Michael Billinger، نويسنده , , Evigna Herren، نويسنده , , Kerstin Wustmann، نويسنده , , Haresh Mehta، نويسنده , , Stephan Windecker*، نويسنده , , Franz R. Eberli، نويسنده , , Bernhard Meier، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2001
Pages :
7
From page :
1872
To page :
1878
Abstract :
OBJECTIVES We sought to determine the pathogenetic predictors of collateral channels in a large cohort of patients with coronary artery disease (CAD). BACKGROUND The frequency distribution of collateral flow in patients with CAD is unknown. Only small qualitative studies have investigated which factors influence the development of collateral channels. METHODS In 450 patients with one- to three-vessel CAD undergoing percutaneous transluminal coronary angioplasty (PTCA), collateral flow was measured. A collateral flow index (CFI; no unit) expressing collateral flow relative to normal anterograde flow was determined using coronary wedge pressure or Doppler measurements through sensor-tipped PTCA guide wires. Frequency distribution analysis of CFI and univariate and multivariate analyses of 32 factors, including gender, age, patient history, cardiovascular risk factors, medication and coronary angiographic data, were performed. RESULTS Two-thirds of the patients had a CFI <0.25 and not, vert, similar40% of patients had a CFI <0.15, but only not, vert, similar10% of the patients had a recruitable CFI ≥0.4. By univariate analysis, the following were predictors of CFI ≥0.25: high levels of high-density lipoprotein cholesterol, the absence of previous non–Q-wave myocardial infarction, angina pectoris during an exercise test, angiographic indicators of severe CAD and the left circumflex or right coronary artery as the collateral-receiving vessel. Percent diameter stenosis of the lesion undergoing PTCA was the only independent predictor of a high CFI. CONCLUSIONS This large clinical study of patients with CAD in whom collateral flow was quantitatively assessed reveals that two-thirds of the patients do not have enough collateral flow to prevent myocardial ischemia during coronary occlusion, and that coronary lesion severity is the only independent pathogenetic variable related to collateral flow.
Keywords :
occlusive pressure (coronary wedge pressure) , Poccl , coronary artery disease , percutaneous transluminal coronary angioplasty , aortic pressure , collateral flow index , Right coronary artery , CAD , PTCA , central venous pressure , CVP , LCx , left circumflex coronary artery , left ventricular end-diastolic pressure , Pao , CFI , RCA , LAD , left anterior descending coronary artery , LVEDP
Journal title :
JACC (Journal of the American College of Cardiology)
Serial Year :
2001
Journal title :
JACC (Journal of the American College of Cardiology)
Record number :
596966
Link To Document :
بازگشت