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Coronary artery dominance dependent collateral development in the human heart
Affiliations- Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
- Specialist Cardio-Thoracic Surgeon, St. Augustine’s Hospital, Chelmsford Medical Centre, KwaZulu Natal, Durban, South Africa, South Africa
open access
Abstract
Background: In obstructive coronary artery disease, coronary collateral arteries serve as alternative conduits for blood flow to the myocardial tissue supplied by the obstructed vessel(s). Therefore, they are a “natural coronary arterial bypass” to the region supplied by the obstructed vessels. This study aims to determine the influence of demographic and morphologic coronary arterial factors on coronary collateral development in coronary arterial obstruction.
Materials and methods: The study group was selected from the coronary angiographic records of 2029 consecutive patients (mean age: 59 ± 12 years). Coronary collaterals were graded from 0 to 3 based on the collateral connection between the donor and recipient arteries. The angiograms of the patients (n = 286) with total obstruction of the coronary arteries were selected for analysis.
Results: There were no significant association between patients’ age and sex and the formation of excellent collaterals. However, the location of atherosclerotic lesion affected collateral development in the right coronary artery. In addition, the right coronary arterial dominant pattern significantly influenced the formation of excellent coronary collaterals.
Conclusions: Coronary collateral arteries are better developed in right dominant pattern. It may be concluded that coronary arterial morphological pattern influences coronary collateral artery development.
Abstract
Background: In obstructive coronary artery disease, coronary collateral arteries serve as alternative conduits for blood flow to the myocardial tissue supplied by the obstructed vessel(s). Therefore, they are a “natural coronary arterial bypass” to the region supplied by the obstructed vessels. This study aims to determine the influence of demographic and morphologic coronary arterial factors on coronary collateral development in coronary arterial obstruction.
Materials and methods: The study group was selected from the coronary angiographic records of 2029 consecutive patients (mean age: 59 ± 12 years). Coronary collaterals were graded from 0 to 3 based on the collateral connection between the donor and recipient arteries. The angiograms of the patients (n = 286) with total obstruction of the coronary arteries were selected for analysis.
Results: There were no significant association between patients’ age and sex and the formation of excellent collaterals. However, the location of atherosclerotic lesion affected collateral development in the right coronary artery. In addition, the right coronary arterial dominant pattern significantly influenced the formation of excellent coronary collaterals.
Conclusions: Coronary collateral arteries are better developed in right dominant pattern. It may be concluded that coronary arterial morphological pattern influences coronary collateral artery development.
Keywords
coronary artery obstruction, coronary collateral artery, coronary arterial dominance
About this articleTitle
Coronary artery dominance dependent collateral development in the human heart
Journal
Issue
Article type
Original article
Pages
191-196
Published online
2016-08-29
Page views
1499
Article views/downloads
1306
DOI
10.5603/FM.a2016.0051
Pubmed
Bibliographic record
Folia Morphol 2017;76(2):191-196.
Keywords
coronary artery obstruction
coronary collateral artery
coronary arterial dominance
Authors
N. O. Ajayi
E. A. Vanker
K. S. Satyapal
References (25)- Abaci A, Oğuzhan A, Kahraman S, et al. Effect of diabetes mellitus on formation of coronary collateral vessels. Circulation. 1999; 99(17): 2239–2242.
- Berry C, Balachandran KP, L'Allier PL, et al. Importance of collateral circulation in coronary heart disease. Eur Heart J. 2007; 28(3): 278–291.
- Cohen M, Sherman W, Rentrop KP, et al. Determinants of collateral filling observed during sudden controlled coronary artery occlusion in human subjects. J Am Coll Cardiol. 1989; 13(2): 297–303.
- Fujita M, Nakae I, Kihara Y, et al. Determinants of collateral development in patients with acute myocardial infarction. Clin Cardiol. 1999; 22(9): 595–599.
- Ilia R, Carmel S, Cafri C, et al. Coronary collaterals in patients with normal and impaired left ventricular systolic function. Int J Cardiol. 1998; 63(2): 151–153.
- Koerselman J, van der Graaf Y, de Jaegere PP, et al. Coronary collaterals: an important and underexposed aspect of coronary artery disease. Circulation. 2003; 107(19): 2507–2511.
- Koerselman J, de Jaegere PP, van der Graaf Y, et al. SMART Study Group. High blood pressure is inversely related with the presence and extent of coronary collaterals. J Hum Hypertens. 2005; 19(10): 809–817.
- Ladwiniec A, Hoye A. Coronary collaterals: a little give and take, and a few unanswered questions. J Clin Exp Cardiol. 2013; 4(4).
- Levin DC. Pathways and functional significance of the coronary collateral circulation. Circulation. 1974; 50(4): 831–837.
- Loukas M, Bilinsky S, Bilinsky E, et al. The clinical anatomy of the coronary collateral circulation. Clin Anat. 2009; 22(1): 146–160.
- Meier P, Indermuehle A, Pitt B, et al. Coronary collaterals and risk for restenosis after percutaneous coronary interventions: a meta-analysis. BMC Med. 2012; 10: 62.
- Meier P, Schirmer SH, Lansky AJ, et al. The collateral circulation of the heart. BMC Med. 2013; 11: 143.
- Myers JG, Moore JA, Ojha M, et al. Factors influencing blood flow patterns in the human right coronary artery. Ann Biomed Eng. 2001; 29(2): 109–120.
- Nakae I, Fujita M, Miwa K, et al. Age-dependent impairment of coronary collateral development in humans. Heart Vessels. 2000; 15(4): 176–180.
- Piek JJ, van Liebergen RA, Koch KT, et al. Clinical, angiographic and hemodynamic predictors of recruitable collateral flow assessed during balloon angioplasty coronary occlusion. J Am Coll Cardiol. 1997; 29(2): 275–282.
- Schaper W. Collateral circulation: past and present. Basic Res Cardiol. 2009; 104(1): 5–21.
- Seiler C. The human coronary collateral circulation. Heart. 2003; 89(11): 1352–1357.
- Senti S, Fleisch M, Billinger M, et al. Long-term physical exercise and quantitatively assessed human coronary collateral circulation. J Am Coll Cardiol. 1998; 32(1): 49–56.
- Sun Z, Shen Y, Lu L, et al. Clinical and angiographic features associated with coronary collateralization in stable angina patients with chronic total occlusion. J Zhejiang Univ Sci B. 2013; 14(8): 705–712.
- Tatli E, Altun A, Büyüklü M, et al. Coronary collateral vessel development after acute myocardial infarction. Exp Clin Cardiol. 2007; 12(2): 97–99.
- Turgut O, Yilmaz MB, Yalta K, et al. Prognostic relevance of coronary collateral circulation: clinical and epidemiological implications. Int J Cardiol. 2009; 137(3): 300–301.
- van der Hoeven NW, Teunissen PF, Werner GS, et al. Clinical parameters associated with collateral development in patients with chronic total coronary occlusion. Heart. 2013; 99(15): 1100–1105.
- Werner GS, Ferrari M, Heinke S, et al. Angiographic assessment of collateral connections in comparison with invasively determined collateral function in chronic coronary occlusions. Circulation. 2003; 107(15): 1972–1977.
- Werner G. The role of coronary collaterals in chronic total occlusions. Curr Cardiol Rev. 2014; 10(1): 57–64.
- Zbinden R, Zbinden S, Billinger M, et al. Influence of diabetes mellitus on coronary collateral flow: an answer to an old controversy. Heart. 2005; 91(10): 1289–1293.
