Abstract
Ischemic heart diseases (IHD) cause millions of deaths around the world annually. While surgical and pharmacological interventions are commonly used to treat patients with IHD, their efficacy varies from patient to patient and is limited by the severity of the disease. One promising, at least theoretically, approach for treating IHD is induction of coronary collateral growth (CCG). Coronary collaterals are arteriole-to-arteriole anastomoses that can undergo expansion and remodeling in the setting of coronary disease when the disease elicits myocardial ischemia and creates a pressure difference across the collateral vessel that creates unidirectional flow. Well-developed collaterals can restore blood flow in the ischemic area of the myocardium and protect the myocardium at risk. Moreover, such collaterals are correlated to reduced mortality and infarct size and better cardiac function during occlusion of coronary arteries. Therefore, understanding the process of CCG is highly important as a potentially viable treatment of IHD. While there are several excellent review articles on this topic, this review will provide a unified overview of the various aspects related to CCG as well as an update of the advancements in the field. We also call for more detailed studies with an interdisciplinary approach to advance our knowledge of CCG. In this review, we will describe growth of coronary collaterals, the various factors that contribute to CCG, animal models used to study CCG, and the cardioprotective effects of coronary collaterals during ischemia. We will also discuss the impairment of CCG in metabolic syndrome and the therapeutic potentials of CCG in IHD.
Highlights
Cardiovascular disease remains the top underlying cause of death worldwide, with 17.3 of 54 million deaths attributed to it in 2013 [3]
It is further estimated that 16.5 million Americans over the age of 20 yr old have coronary heart disease (CHD) and ~790,000 individuals suffer myocardial infarctions (MIs) each year [3]
Stem cells are promising in their ability to induce coronary collateral growth (CCG), this is an area of incomplete study
Summary
Jamaiyar A, Juguilon C, Dong F, Cumpston D, Enrick M, Chilian WM, Yin L. Cardioprotection during ischemia by coronary collateral growth. At least theoretically, approach for treating IHD is induction of coronary collateral growth (CCG). Well-developed collaterals can restore blood flow in the ischemic area of the myocardium and protect the myocardium at risk. Such collaterals are correlated to reduced mortality and infarct size and better cardiac function during occlusion of coronary arteries. We will describe growth of coronary collaterals, the various factors that contribute to CCG, animal models used to study CCG, and the cardioprotective effects of coronary collaterals during ischemia.
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More From: American Journal of Physiology-Heart and Circulatory Physiology
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