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Numerous investigations have shown that well-developed coronary collaterals exert protective effect on left ventricular functions. But, relationship between collateral grade and left ventricular end diastolic pressure has not been studied in chronic total occlusion patients. Also, there are conflicting data regarding to effect of collaterals on NT-proBNP levels, which has important diagnostic and prognostic utility in coronary heart disease and left ventricular dysfunction. The aim of our study is to evaluate the relationship between coronary collateral circulation and left ventricular end diastolic pressure and NT-proBNP levels.
Study group was retrospectively selected from patients who had coronary angiography at our center between June 2011 and March 2013. Clinical, biochemical, angiographic and haemodynamic data of 199 stable patients having at least one totally occluded main coronary artery were evaluated. Coronary collateral circulation was graded according to Rentrop classification. While Rentrop grade 3 was defined as good, all remaining collateral grades regarded as poor collaterals. We used Chi-square, Student t and Mann-Whitney U tests for statistical analysis.
Overall 87 patients were found to have good collaterals and 112 patients had poor collaterals. There were no significant difference between patients having good or poor coronary collaterals regarding to left ventricular end diastolic pressure (16,96 ± 5,59mmHg vs 15,61 ± 6,06mmHg, p=0,379) and NT-proBNP levels (765,84 ±1417,31 pg/ml vs 994,79 ± 1787,90 pg/ml, p=0,486).
Even well-developed coronary collaterals may be incapable of protecting the rise of left ventricular end diastolic pressure and NT-proBNP levels which are reliable markers of the left ventricular dysfunction.