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Results for “Coronary collateral circulation”

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At least 19 recordsLinked to original sources
PubMed2025

Distinct immune-metabolic phenotypes underlie poor coronary collateral circulation.

BACKGROUND: Coronary collateral circulation (CCC) significantly impacts myocardial perfusion and clinical outcomes in coronary artery disease patients, yet the underlying molecular heterogeneity remains inadequately characterized. OBJECTIVE: To identify distinct molecular phenotypes in patients with poor CCC, validate these phenotypes using clinical parameters, and evaluate their prognostic implications. METHODS: This study enrolled 149 patients (80 with good CCC and 69 with poor CCC) for high-throughput proteomic profiling. Unsupervised consensus clustering identified molecular subtypes within poor CCC patients, followed by differential expression analysis and KEGG pathway enrichment. Boruta feature selection was implemented, and multiple machine learning algorithms were tested on clinical data, with XGBoost optimization (accuracy 80.0%, F1-score 80.31%) and SHAP value interpretation. External validation was performed using the MIMIC database. Kaplan-Meier analysis and Cox regression models assessed major adverse cardiovascular events (MACE). RESULTS: Two distinct phenotypes emerged among poor CCC patients: Cluster 1 (n&#x2009;=&#x2009;39, Complement-Driven Vascular Remodeling [CDVR]) and Cluster 2 (n&#x2009;=&#x2009;30, Immuno-Thrombotic Myocardial Dysfunction [ITMD]). An XGBoost model incorporating fasting glucose, eosinophil percentage, and HbA1c achieved excellent discrimination (AUC&#x2009;>&#x2009;0.91). External validation confirmed the phenotype-specific clinical patterns. Notably, Cluster 2 demonstrated significantly higher MACE incidence compared to Cluster 1 (Log-rank p&#x2009;<&#x2009;0.05), with KEGG analysis revealing significant upregulation of platelet activation, diabetic cardiomyopathy, and metabolic pathways in the ITMD phenotype. CONCLUSION: Poor CCC encompasses distinct immune-metabolic phenotypes that can be accurately classified using integrated proteomic-clinical modeling. This classification enables more precise risk stratification and may guide personalized therapeutic strategies for coronary artery disease patients with inadequate collateralization.

Humans↗
PubMed1979

Coronary collateral circulation as an important factor to modify the ischemic injury of the myocardium in coronary ligated dogs.

Effect of coronary ligation on epicardial and intramyocardial ST-segment voltage was investigated in 121 dogs. After ligation of the anterior descending coronary artery, marked ST-elevation, more than 2 mV, was detected in 102 dogs (Group-I) in epicardial lead of the area which was nourished by the ligated coronary artery. In 7 dogs (Group-II), coronary ligation produced negligible changes in ST-segment voltage in epicardial lead, while significant ST-elevation was observed in the leads of middle and inner layers of the myocardium. Systemic hemo-dynamic parameters showed no statistically significant difference between the 2 groups. Coronary collateral indices, however, revealed the significant difference between them. Systolic peripheral coronary pressure was 29.3 +/- 3.1 mmHg in Group-I and 59.2 +/- 10.6 mmHg in Group-II (P less than 0.05). Retrograde flow was also greater in Group-II (14.8 +/- 4.4 ml/min) than in Group-I (1.3 +/- 0.5 ml/min) (p less than 0.01). Diversion of retrograde flow produced a marked ST-elevation in Group-II. Restoration of retrograde flow to the myocardium immediately decreased the ST-segment voltage. These results suggest that spontaneously developed collaterals have an important function for the prevention of the occurrence of ischemic injury after coronary ligation in dogs.

Animals↗
PubMed1978

Pharmacological alterations of coronary collateral circulation; implication to the steal-phenomenon.

Measurements of resistances were performed on different parts of coronary vessels, including spontaneous collaterals in anesthetized dogs, following ligation and embolization of the descending branch of the left coronary artery. The normal situation was compared with the state of maximal pharmacological dilatation. The pharmacological dilatation decreased the collateral resistance by 24% in spite of the fact that the collaterals supplied an infarcted area in this case; the precollateral resistance, which chiefly consists of large vessels was also diminished. The collateral perfusion pressure is not only dependent on the aortic pressure, but also on the flow rate in the corresponding large coronary vessel and thereby on the ratio of precollateral to postcollateal resistance. A decrease of the collateral perfusion pressure causes an insufficient perfusion of the area supplied by the collaterals only when the pressure fall is not compensated for by an adequate decrease in the collateral resistance and when the ratio of the collateral to the nutritive resistance increases. Thus, both, the extent of the pressure fall across the precollateral resistance and the dilating capacity of the collaterals determine whether is not a pharmacological dilatation of the coronary vascular bed results in an insufficient supply of an infarcted area, i.e. in a so called "Steal-phenomenon". The results show further, that the given physical model of the microcirculation satisfactorily approximates the observed behaviour of the vascular system.

Animals↗
PubMed1976

Reappraisal of the functional significance of the coronary collateral circulation.

A review of data in 465 patients with complete obstruction of either the left anterior descending or right coronary artery was undertaken to evaluate the functional role of the collateral circulation. Complete obstruction of a dominant right coronary artery was observed in 288 patients, 83 percent with distal filling and visualization of the posterior descending artery by way of collateral vessels. Complete obstruction of the left anterior descending artery was noted in 177 patients, 71 percent with filling and visualization distal to the obstruction by way of collateral vessels. Among patients with obstruction of the left anterior descending artery, there was a significantly greater frequency of congestive heart failure and cardiomegaly in those without collateral vessels than in those with collateral vessels. The former also had a significantly greater frequency of both electrocardiographic evidence of an anterior wall myocardial infarction and angiographic findings of anterior wall asynergy. The frequency of inferior myocardial infarction and inferior wall asynergy was not influenced by the presence of collateral vessels. These observations indicate that the collateral circulation plays a significant protective role in the presence of obstruction of the left anterior descending artery, which is not apparent with obstruction of the right coronary artery.

Adult↗
PubMed1978

The behavior of collateral circulation after coronary artery bypass surgery.

The changes in coronary collateral circulation after bypass surgery were analyzed in 50 patients with coronary disease. The demonstration of collateral circulation was found to be dependent upon the severity of the coronary heart disease and the patency of the bypass. When the graft was patent, it was usually not possible to visualize the collateral circulation demonstrated preoperatively. When the bypass was occluded, the same collateral circulation as before surgery was frequently found.

Collateral Circulation↗
PubMedDate not supplied

[Mechanism of action of vasodilator agents on the collateral blood flow into an area of acute myocardial ischemia].

In acute experiments staged on dogs subject to investigation was collateral coronary circulation studied by registering the retrograde blood flow and the pressure in the ligated coronary artery. It is shown that atropinization (0.05 mg/kg) does not change the positive action of papaverine and diethyphen (2 mg/kg) on the inflow of blood into the area of myocardial ischemia and enhances the beneficial effect on euphylline (4 mg/kg). Preliminary introduction of octadine (5 mg/kg) had no material influence on the nature of the diethyphen action, but greatly weakened that of euphylline and reduced the effect of papaverine. The vasodilating agents attenuated for a short while a pituitrin-induced (0.5 U/kg) spasm of the collaterals and vessels in the ischemic area of the myocardium.

Acute Disease↗
PubMedDate not supplied

[Characteristics of the cardiotropic effect of gutimine].

Experiments proved gutimine capable of intensify the collateral coronary circulation, intraventricular pressure and the rate of its accretion (dp/dt), the excitability and permeability of the heart, as well as to raise the cardiac contractility in dogs during an acute period of myocardial ischemia. In rats with pituitrin-isadrine induced cardiopathy the drug drastically depressed the permeability of the histohematogenous barriers of the myocardium and lengthened somewhat the life span of the animals. Parallel with is rising doses gutimine depressed the excitability threshold of the frog's heart "in situ" in a test with a liminal current producing extrasystole.

Amidines↗
PubMed1978

Effect of exercise on collateral development in dogs with normal coronary arteries.

To determine the effects of chronic exercise on the coronary collateral circulation of dogs with normal coronary arteries, 1-yr-old purebred beagles were divided into sedentary control and exercising groups. The latter were trained to run on a treadmill. A lower maximal heart rate during a standardized exercise test protocol after a 10- to 12-week training period and a higher gastrocnemius cytochrome oxidase activity in the runners attested to the presence of cardiovascular and skeletal muscle training effects. However, left ventricular weights, left ventricle/body weight ratios, myocardial myofibrillar and myosin ATPases, and hemodynamics were similar in sedentary and exercising dogs except for a significantly higher resting cardiac output in the runners. After occlusion of the left anterior descending coronary artery, both collateral conductance (retrograde flow/aortic pressure) and collateral flow measured with microspheres tended to be lower in the trained dogs, but differences were not significant. The endocardial/epicardial flow ratio in the ischemic area after coronary occlusion did not distinguish between exercisers and controls. Thus treadmill running in the dog with normal coronary arteries produced a training effect, but had no effect on coronary collateral vessels.

Adenosine Triphosphatases↗