Quantification of collateral flow in humans: a comparison of angiographic, electrocardiographic and hemodynamic variables
| Autor: | Jan J. Piek, Kong I. Lie, Robbert J. de Winter, Karel T. Koch, Rob A.M van Liebergen, Carl E. Schotborgh |
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| Přispěvatelé: | Other departments |
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male Cardiac Catheterization medicine.medical_specialty Myocardial Ischemia Ischemia Collateral Circulation Hemodynamics Blood Pressure Coronary Angiography Electrocardiography Predictive Value of Tests Coronary Circulation Internal medicine medicine Humans Prospective Studies Aged medicine.diagnostic_test business.industry Reproducibility of Results Ultrasonography Doppler Middle Aged Collateral circulation medicine.disease medicine.anatomical_structure Coronary occlusion Angiography cardiovascular system Cardiology Aortic pressure Female Cardiology and Cardiovascular Medicine business Blood Flow Velocity Follow-Up Studies Artery |
| Zdroj: | Journal of the American College of Cardiology, 33(3), 670-677. Elsevier USA |
| ISSN: | 0735-1097 |
| Popis: | OBJECTIVES Evaluation of collateral vascular circulation according to hemodynamic variables and its relation to myocardial ischemia. BACKGROUND There is limited information regarding the hemodynamic quantification of recruitable collateral vessels. METHODS Angiography of the donor coronary artery was performed before and during balloon coronary occlusion in 63 patients with one vessel disease. Patients were divided into groups of those with an absence of collateral vessels (group 1, n = 10), those with recruitable collateral vessels (group 2, n = 23) and those with spontaneously visible collateral vessels (group 3, n = 30). During balloon inflation the coronary wedge/aortic pressure ratio (Pw/Pao) was determined as were collateral blood flow velocity variables, using a 0.014″ Doppler guide wire. Myocardial ischemia was defined as ≥0.1 mV ST-shift on a 12 lead electrocardiogram at 1 min coronary occlusion. RESULTS Myocardial ischemia was present in all patients of group 1, in 14 patients of group 2 and in 3 patients of group 3. Recruitable collateral flow without ischemia showed similar hemodynamic values as in group 3 while these values were similar to group 1 in regard to the presence of recruitable collateral vessels showing ischemia. Logistic regression analysis revealed both Pw/Pao and Vicolas independent predictors for the function of collateral vessels. CONCLUSIONS Hemodynamic variables of collateral vascular circulation are better markers of the functional significance of collateral vessels than is coronary angiography. The total collateral blood flow velocity integral and coronary wedge/aortic pressure ratio are good and independent predictors of the function of collateral vessels producing complementary information. |
| Databáze: | OpenAIRE |
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