Abstract
Background and Objectives:Coronary collateral circulation is known to have beneficial effects in patients with angina pectoris and myocardial infarction. The purpose of this study is to determine the predictors of collateral vessels development, the pathways of collateral circulation and the changes in collateral flow after coronary intervention and its functional significance in patients with total occlusion. Materials and Methods: One hundred thirty five patients who underwent coronary angiogram between Jan ’97 and Dec ’97 in Chonnam University Hospital (out of 3,264 cases) had total occlusion of one coronary artery were classified into two groups;angina pectoris (Group I:50 M, 19 F, 62.4±11.0 years) and acute myocardial infarction (Group II:47 M, 19 F, 62.0±9.5 years). Results:Among 135 patients, 123 patients had collateral circulation. Collaterals were more frequently observed and better developed (grade 2 or 3) in Group I than Group II. Proximal and ostial lesions were associated with well developed collaterals. Collateral circulation was more frequently observed and well developed in proportion to the duration of angina in Group I. In 123 patients with collateral circulation, 247 collateral circulations were observed. Right coronary artery (RCA) and Left circumflex coronary artery (LCX) were more frequent recipient arteries than left anterior descending coronary artery (LAD)(RCA:2.20±1.02, LCX:1.88±0.94, LAD:1.29±0.8 respectively, RCA vs. LAD:p<0.001, LCX vs. LAD:p=0.014). Coronary interventions were performed in 50 out of 135 patients, collateral flow of Group II decreased much more than Group I after intervention (Group I:5/14, Group II: 24/36, p=0.046). The wall motion score was lower in patients with well developed than poorly developed collaterals (20.7±4.91 vs. 23.7±6.22, p=0.015). Conclusion:Proximal or ostial lesion and duration of 논문접수일:1999년 8월 24일 심사완료일:2000년 2월 17일 교신저자:정명호, 501-757 광주광역시 동구 학1동 8번지 전남대학교병원 심장센터 전화:(062) 220-6243·전송:(062) 228-7174 E-mail:myungho@chollian.net
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