Functional Importance of the Human Coronary Collateral Circulation

Abstract

Abstract To determine the effect of intercoronary collateral vessels on the clinical features of coronary-artery disease, 61 patients with collateral vessels were compared with 58 patients without arteriographically demonstrable collateral vessels. No significant differences existed between the two groups in level of physical activity, duration of angina, frequency of prior myocardial infarction or prevalence of electrocardiographic, hemodynamic and ventriculographic abnormalities. Myocardial ischemia was more prevalent in patients with than in those without collateral vessels as evidenced by a significantly greater frequency of abnormal post-exercise electrocardiograms and myocardial lactate production. The incidence of acute myocardial infarction during the follow-up period was nearly identical in the two groups. Death was less frequent in patients with than in those without collateral vessels, but this observation did not achieve statistical significance. Thus, although collateral vessels do not necess...