Korean Circ J.  1997 Jan;27(1):65-77. 10.4070/kcj.1997.27.1.65.

The Influence of Morphological Characteristics of lesions on the Development of Collateral Circulation in Angina Pectoris

• Chung WY
• Kim YJ
• Kim HS
• Park DG
• Kim CH
• Sohn DW
• Oh BH
• Lee MM
• Park YB
• Choi YS
• Seo JD
• Lee YW

• KMID: 2229040
• DOI: http://doi.org/10.4070/kcj.1997.27.1.65

Abstract

BACKGROUND
It is well known that collateral circulation has important roles in ischemic heart disease. It reduce ventricular remodelingand infarct size to improve ventricular function and survival. Extents and duration of ischemia are critical stimulants of the development of coronary collaterla circulation. We hypothesize that collateral circulation is poor in patients with lisions at branching points because atherosclerosis progress more rapidly not to allow the collateral circulation to develop. METHOD: We studied total 330 coronary angiography, which have more than 50% stenosis in any coronary artery, normal letf ventriculography and no history of myocardial infarction. In each coronary angiography, severity, site, proximity, length of lesions were analyzed, classified, and collaterale circulation was graded. We also observed whether the lesions involve branching point or not.
RESULTS
While coronary collateral circulation developed well when stenosis was more than 90% in the severity, it was poor when the lesions involve branching points. Collateral circulation tended to be poor in case of eccentric lesion, but it was statistically insignificant. The above findings support our hypothesis of the accelerated atherosclerosis at branching points.
CONCLUSIONS
The facts that the development of coronary collaterals is poor with lesions involving branching points suggest that atherosclerosis is accelerated at these lesions that is characterized by blood stasis, turbulence and lower arterial wall tension.

Keyword

Coronary collateral circulation; Atherosclerosis; Branching point

MeSH Terms

Angina Pectoris*
Atherosclerosis
Collateral Circulation*
Constriction, Pathologic
Coronary Angiography
Coronary Vessels
Humans
Ischemia
Myocardial Infarction
Myocardial Ischemia
Ventricular Function