The Effect of Collateral Circulation on Segmental Left Ventricular Contraction

Abstract

The anatomy of the coronary circulation was correlated with left ventricular segmental contractile motion in 162 patients: 43 with normal coronary arteriograms, 119 with significant (> 75%) obstruction of the right coronary artery and/or left anterior descending coronary artery. Collateral vessels were identified in 69% of the patients with coronary artery disease (82/119). The cases with collaterals were graded poor, fair, or good according to the number of vessels and the quality of opacification. Segmental contractile motion was determined angiographically by the percent shortening of each of the six chords of the left ventricle in the right anterior oblique projection. The range of normal shortening (mean ± one standard deviation) for each chord was established in the 43 normal patients as follows: [See Equation in PDF File] Patients were grouped according to the site of coronary artery obstruction and quality of collateral circulation to the area supplied by the obstructed coronary artery. The percent shortening and number of abnormal segments were determined for each patient; there was no consistent difference in segmental contraction between patients with and without collaterals. The quality of collateral vessels did not correlate with either the number of abnormal segments or the percent of chord shortening. In summary, the development of collateral vessels is not associated with the restoration of normal segmental wall motion in patients with coronary artery disease.