Author + information
- Received July 7, 1992
- Revision received January 14, 1993
- Accepted January 20, 1993
- Published online August 1, 1993.
- Naohiro Yoshida, MD,
- Masatoshi Fujita, MD∗,
- Kazuto Yamanishi, MD and
- Kunihisa Miwa, MD
- ↵∗Address for correspondece: Masatoshi Fujita, MD, The Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University 2630 Sugitani, Toyama 930-01, Japan.
Objectives. The purpose of the present study was to elucidate the relation between the extent of perfusion of the ischemia-related coronary artery and the degree of visualization of the collateral circulation to the ischemic area.
Background. Because it is difficult to accurately assess coronary stenosis severity with standard angiographic techniques, the inclusion of flow grade in recipient coronary arteries would provide an additional perspective concerning the effect of the progression of atherosclerotic obstructive disease on the development of collateral circulation.
Methods. The coronary arteriograms of 54 consecutive patients with chronic effort angina without prior myocardial infarction were examined. Patients were classified into four groups according to the extent of perfusion of the ischemia-related coronary artery (Thrombolysis in Myocardial Infarction [TIMI]grade 0 to 3). The degree of angiographically demonstrable collateral circulation was also classified into four grades (collateral index 0 to 3).
Results. Eighteen patients had TIMI grade 0, 6 had grade 1, 13 had grade 2 and 17 had grade 3 perfusion. The collateral indexes of TIMI 0, 1, 2 and 3 groups were 2.7 ± 0.7 (mean ± SEM), 2.2 ± 0.6∗, 1.2 ± 1.1∗ and 0.4 ± 0.9∗†, respectively (∗p < 0.01 vs. TIMI 0, †p < 0.05 vs. TIMI 1).
Conclusions. These findings indicate that all patients with chronic effort angina have the potential for collateral development as a result of coronary artery narrowing, and the functional state of well developed collateral vessels may be primarily determined by the pressure gradient across the collaterall network.
☆ This study was supported by Grant-in-Aid for Scientific Research No. (C) 04670523 from the Ministry of Education, Science and Culture, Tokyo, Japan.
- Received July 7, 1992.
- Revision received January 14, 1993.
- Accepted January 20, 1993.