Angiographically demonstrated coronary collaterals predict residual viable myocardium in patients with chronic myocardial infarction: a regional metabolic study.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8804703 Publication Model: Print Cited Medium: Print ISSN: 0914-5087 (Print) Linking ISSN: 09145087 NLM ISO Abbreviation: J Cardiol Subsets: MEDLINE
    • Publication Information:
      Publication: Amsterdam : Elsevier
      Original Publication: Tokyo : Japanese College Of Cardiology
    • Subject Terms:
      Collateral Circulation* ; Coronary Circulation*; Myocardial Infarction/*metabolism; Adult ; Aged ; Coronary Angiography ; Female ; Humans ; Lactic Acid/metabolism ; Male ; Middle Aged ; Myocardial Infarction/diagnostic imaging ; Myocardial Infarction/physiopathology ; Radionuclide Imaging
    • Abstract:
      Angiographical demonstration of coronary collateral circulation may suggest the presence of residual viable myocardium. The development of coronary collaterals was judged according to Rentrop's classification in 37 patients with old anteroseptal myocardial infarction and 13 control patients with chest pain syndrome. The subjects with myocardial infarction were divided into 2 groups: 17 patients with the main branch of the left coronary artery clearly identified by collateral blood flow from the contralateral coronary artery [Coll(+)group, male/female 10/7, mean age 56.6 years]and 20 patients with obscure coronary trunk [Coll(-)group, male/female 16/4, mean age 54.9 years]. Thallium-201 myocardial scintigraphy and examination of local myocardial metabolism were carried out by measuring the flux of lactic acid under dipyridamole infusion load. Coronary stenosis of 99% or total occlusion was found in only 5 of 20 patients (25%)in the Coll(-)group but in 16 of 17 patients(94%)in the Coll(+)group(p < 0.001). Redistribution of myocardial scintigraphy was found in 11 of 15 patients(73%)in the Coll(+)group, but only 3 of 18 patients (17%)in the Coll(-)group(p < 0.01). The myocardial lactic acid extraction rate was--13.2 +/- 17.0% in the Coll(+)group, but 9.1 +/- 13.2% in the Coll(-)group(p < 0.001). These results suggest that coronary collateral may contribute to minimizing the infarct area and to prediction of the presence of viable myocardium.
    • Accession Number:
      33X04XA5AT (Lactic Acid)
    • Publication Date:
      Date Created: 20000314 Date Completed: 20000505 Latest Revision: 20161124
    • Publication Date:
      20231215
    • Accession Number:
      10713931