Abstract
BackgroundEndothelial dysfunction is thought to be a potential mechanism for the decreased presence of coronary collaterals. The aim of the study was to investigate the association between systemic endothelial function and the extent of coronary collaterals.MethodsWe investigated the association between endothelial function assessed via flow mediated dilation (FMD) of the brachial artery following reactive hyperemia and the extent of coronary collaterals graded from 0 to 3 according to Rentrop classification in a cohort of 171 consecutive patients who had high grade coronary stenosis or occlusion on their angiograms.ResultsMean age was 61 years and 75% were males. Of the 171 patients 88 (51%) had well developed collaterals (grades of 2 or 3) whereas 83 (49%) had impaired collateral development (grades of 0 or 1). Patients with poor collaterals were significantly more likely to have diabetes (p = 0.001), but less likely to have used statins (p = 0.083). FMD measurements were not significantly different among good and poor collateral groups (11.5 ± 5.6 vs. 10.4 ± 6.2% respectively, p = 0.214). Nitroglycerin mediated dilation was also similar (13.4 ± 5.9 vs. 12.8 ± 6.5%, p = 0.521).ConclusionNo significant association was found between the extent of angiographically visible coronary collaterals and systemic endothelial function assessed by FMD of the brachial artery.
Highlights
Endothelial dysfunction is thought to be a potential mechanism for the decreased presence of coronary collaterals
Cardiovascular Ultrasound 2009, 7:25 http://www.cardiovascularultrasound.com/content/7/1/25 protein, and the number and function of endothelial progenitor cells were all suggested as potential determinants of collateral development, it is still unknown why some patients are capable of developing sufficient collateral circulation while others are not [5,6,7,8]
Eighty-six were excluded for the following reasons: (1) acute coronary syndrome within the previous 15 days (n = 53); (2) failing to give informed consent (n = 15); (3) inadequate angiograms for collateral evaluation (n = 12); (4) presence of occluded coronary artery that is supplied by the patent bypass graft (n = 6)
Summary
Endothelial dysfunction is thought to be a potential mechanism for the decreased presence of coronary collaterals. Cardiovascular Ultrasound 2009, 7:25 http://www.cardiovascularultrasound.com/content/7/1/25 protein, and the number and function of endothelial progenitor cells were all suggested as potential determinants of collateral development, it is still unknown why some patients are capable of developing sufficient collateral circulation while others are not [5,6,7,8]. Recent studies have demonstrated that, nitric oxide (NO) bioavailability is critically important in collateral formation [9,10,11]. This led to a common perception that endothelial dysfunction is one of the potential mechanisms for the decreased presence of coronary collaterals. Endothelial function can be assessed noninvasively via flow-mediated dilation (FMD) of the brachial artery using high resolution ultrasound [12,13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
