Immediate recruitment of dormant coronary collaterals can provide more than half of normal resting perfusion during coronary occlusion in patients with coronary artery disease.
Coronary angiography
collateral flow
coronary physiology
Journal
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
ISSN: 1532-6551
Titre abrégé: J Nucl Cardiol
Pays: United States
ID NLM: 9423534
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
18
11
2022
accepted:
24
03
2023
medline:
28
11
2023
pubmed:
7
6
2023
entrez:
6
6
2023
Statut:
ppublish
Résumé
Dormant coronary collaterals are highly prevalent and clinically beneficial in cases of coronary occlusion. However, the magnitude of myocardial perfusion provided by immediate coronary collateral recruitment during acute occlusion is unknown. We aimed to quantify collateral myocardial perfusion during balloon occlusion in patients with coronary artery disease (CAD). Patients without angiographically visible collaterals undergoing elective percutaneous transluminal coronary angioplasty (PTCA) to a single epicardial vessel underwent two scans with 99mTc-sestamibi myocardial perfusion single-photon emission computed tomography (SPECT). All subjects underwent at least three minutes of angiographically verified complete balloon occlusion, at which time an intravenous injection of the radiotracer was administered, followed by SPECT imaging. A second radiotracer injection followed by SPECT imaging was performed 24 h after PTCA. The study included 22 patients (median [interquartile range] age 68 [54-72] years. The perfusion defect extent was 19 [11-38] % of the LV, and the collateral perfusion at rest was 64 [58-67]% of normal. This is the first study to describe the magnitude of short-term changes in coronary microvascular collateral perfusion in patients with CAD. On average, despite coronary occlusion and an absence of angiographically visible collateral vessels, collaterals provided more than half of the normal perfusion.
Sections du résumé
BACKGROUND
BACKGROUND
Dormant coronary collaterals are highly prevalent and clinically beneficial in cases of coronary occlusion. However, the magnitude of myocardial perfusion provided by immediate coronary collateral recruitment during acute occlusion is unknown. We aimed to quantify collateral myocardial perfusion during balloon occlusion in patients with coronary artery disease (CAD).
METHODS
METHODS
Patients without angiographically visible collaterals undergoing elective percutaneous transluminal coronary angioplasty (PTCA) to a single epicardial vessel underwent two scans with 99mTc-sestamibi myocardial perfusion single-photon emission computed tomography (SPECT). All subjects underwent at least three minutes of angiographically verified complete balloon occlusion, at which time an intravenous injection of the radiotracer was administered, followed by SPECT imaging. A second radiotracer injection followed by SPECT imaging was performed 24 h after PTCA.
RESULTS
RESULTS
The study included 22 patients (median [interquartile range] age 68 [54-72] years. The perfusion defect extent was 19 [11-38] % of the LV, and the collateral perfusion at rest was 64 [58-67]% of normal.
CONCLUSION
CONCLUSIONS
This is the first study to describe the magnitude of short-term changes in coronary microvascular collateral perfusion in patients with CAD. On average, despite coronary occlusion and an absence of angiographically visible collateral vessels, collaterals provided more than half of the normal perfusion.
Identifiants
pubmed: 37280387
doi: 10.1007/s12350-023-03271-x
pii: 10.1007/s12350-023-03271-x
pmc: PMC10682227
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2338-2345Informations de copyright
© 2023. The Author(s).
Références
Eur Heart J. 2018 Sep 14;39(35):3322-3330
pubmed: 29850808
Circulation. 1990 Oct;82(4):1424-37
pubmed: 2401074
J Nucl Cardiol. 2013 Feb;20(1):38-44
pubmed: 23143809
Eur J Nucl Med Mol Imaging. 2012 Jun;39(6):1048-55
pubmed: 22426827
J Nucl Cardiol. 2006 Sep;13(5):642-51
pubmed: 16945744
Molecules. 2022 Feb 10;27(4):
pubmed: 35208982
Am J Pathol. 1975 Oct;81(1):179-98
pubmed: 1180331
Nucl Med Commun. 2002 Mar;23(3):219-28
pubmed: 11891479
Am J Cardiol. 2020 May 15;125(10):1455-1460
pubmed: 32245631
Circulation. 1989 Nov;80(5):1166-75
pubmed: 2509103
J Am Coll Cardiol. 1985 Mar;5(3):587-92
pubmed: 3156171
Catheter Cardiovasc Interv. 2021 May 1;97(6):E771-E777
pubmed: 33118694
J Nucl Cardiol. 2022 Feb;29(1):46-55
pubmed: 32424676
Am J Physiol. 1985 Oct;249(4 Pt 2):H783-91
pubmed: 4051015
Am J Cardiol. 1969 Sep;24(3):393-400
pubmed: 5805200
Circ Res. 1985 May;56(5):651-65
pubmed: 3838923
Eur J Nucl Med Mol Imaging. 2022 Dec;50(1):160-167
pubmed: 36053295
J Am Coll Cardiol. 1993 Oct;22(4):1033-43
pubmed: 8409038
J Am Coll Cardiol. 1995 Aug;26(2):388-93
pubmed: 7608439
JACC Cardiovasc Imaging. 2012 Jun;5(6):596-603
pubmed: 22698528
J Nucl Med. 1995 Jun;36(6):1130-6
pubmed: 7769439
J Thromb Thrombolysis. 2021 May;51(4):1005-1016
pubmed: 32930943
J Cardiovasc Magn Reson. 2009 Sep 23;11:38
pubmed: 19775428
Eur J Nucl Med Mol Imaging. 2021 Sep;48(10):3162-3171
pubmed: 33594472
Am J Cardiol. 1990 Oct 16;66(13):23E-31E
pubmed: 2145742
J Nucl Med. 2010 Jan;51(1):46-51
pubmed: 20008999
Am J Cardiol. 2006 Feb 1;97(3):295-300
pubmed: 16442384
Circulation. 1977 Nov;56(5):786-94
pubmed: 912839
Circulation. 2003 May 6;107(17):2213-20
pubmed: 12707241
Lab Invest. 1979 Jun;40(6):633-44
pubmed: 449273