What question did this study set out to answer?

To prospectively determine whether coronary collateral circulation limits myocardial ischemia during sudden, controlled coronary artery occlusion in humans.

September 1, 1986CirculationOpen Access

Limitation of myocardial ischemia by collateral circulation during sudden controlled coronary artery occlusion in human subjects: a prospective study.

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Why the study?

Does collateral circulation limit myocardial ischemia during sudden coronary occlusion in patients undergoing elective coronary angioplasty?

Population

23 patients with isolated left anterior descending or right coronary disease and normal left ventriculograms…

Design

Cohort

Follow-up

30 to 40 sec into inflation

Authors

MCMarc CohenInterventional / Structural Cardiology KRK.Peter RentropColumbia University Irving Medical Center

Discussion

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Implication

Collateral grade during angioplasty was associated with less ischemia; hypothesis-generating for collateral-targeted strategies in acute occlusion.

Key Points

To prospectively determine whether coronary collateral circulation limits myocardial ischemia during sudden, controlled coronary artery occlusion in humans.
Assessed 23 patients with isolated left anterior descending (n = 14) or right coronary artery (n = 9) disease and normal baseline left ventriculograms during elective coronary angioplasty.
Evaluated collateral filling grades (0 to 3) via contralateral artery catheterization, left ventricular hypocontractile perimeter via ventriculography, and 12-lead ECG ST-segment elevation at 30–40 seconds of balloon occlusion.
Grade of collateral filling correlated strongly and inversely with the percent of hypocontractile left ventricular perimeter (r = -0.85) and the sum of ST-segment elevation (r = -0.87).
Anginal pain occurred in 100% of patients with grade 0 or 1 collateral filling compared with 36% of patients with grade 2 or 3 collateral filling during balloon occlusion.

Structured PICO

Does collateral circulation limit myocardial ischemia during sudden coronary occlusion in patients undergoing elective coronary angioplasty?

Population

23 patients with isolated left anterior descending (n = 14) or right coronary (n = 9) disease and normal left ventriculograms undergoing elective coronary angioplasty.

Intervention

Assessment of collateral filling during sudden controlled coronary occlusion by balloon inflation.

Outcome

Indexes of myocardial ischemia including percent of the left ventricular perimeter showing new hypocontractility and the sum of ST segment elevation measured on a simultaneous 12-lead electrocardiogram at 30 to 40 sec into inflation.surrogate

Collateral circulation significantly limits myocardial ischemia, as evidenced by reduced ventricular asynergy and ST-segment elevation, during acute coronary occlusion.

Cite This Study

Cohen et al. (1986) studied this question.

synapsesocial.com/papers/69fe7963d8476229fea3585a https://doi.org/10.1161/01.cir.74.3.469

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Implication

Collateral grade during angioplasty was associated with less ischemia; hypothesis-generating for collateral-targeted strategies in acute occlusion.

Limitation of myocardial ischemia by collateral circulation during sudden controlled coronary artery occlusion in human subjects: a prospective study.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Limitation of myocardial ischemia by collateral circulation during sudden controlled coronary artery occlusion in human subjects: a prospective study.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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