Differential characterization of human coronary collateral blood flow velocity

Christophe Tron, Thomas J. Donohue, Richard G. Bach, Thomas Wolford, Eugene A. Caracciolo, Frank V. Aguirre, Alexander Khoury, Morton J. Kern

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22 Scopus citations

Abstract

The functional importance and protective nature of the coronary collateral circulation has been well established. There are few data, however, regarding the phasic nature and absolute velocities of collateral flow in patients. The aim of this study was to characterize and quantify ipsilateral coronary collateral blood flow velocity in patients during coronary angioplasty. Coronary collateral flow velocity was measured in 49 patients during coronary angioplasty. Angiographic collateral filling was categorized by the Rentrop grading scale (0 to 3) and by anatomic pathway (epicardial, intramyocardial, or unknown [acutely recruited]). Collateral blood flow velocity was measured with a Doppler-tipped guide wire placed distal to the balloon occlusion in the collateralized vessel. Collateral flow velocity was characterized as predominantly systolic or diastolic, and phasic flow patterns were defined as biphasic (both systolic and diastolic), monophasic (only systolic or diastolic), or bidirectional (antegrade and retrograde velocity). Twenty-three (47%) patients had biphasic flow; 17 (35%) patients had monophasic flow; and 9 (18%) patients had bidirectional flow. Thirty-six (73%) of 49 patients had predominantly systolic flow signals. Epicardial collateral pathways had the highest total flow velocity integral, at 15.0 ± 7.0 (vs intramyocardial [8.4 ± 5.7] and acutely recruitable [5.4 ± 2.1]; p < 0.05). There were no differences in flow velocity integrals among the Rentrop angiographic grades of collateral filling. These data establish three patterns of coronary collateral blood flow and demonstrate that the majority of collateral flow in the ipsilateral receiving vessel occurs during systole. The measurement of coronary collateral flow velocity provides a unique means to study the effects of pharmacologic or mechanical interventions on human collateral blood flow.

Original languageEnglish
Pages (from-to)508-515
Number of pages8
JournalAmerican heart journal
Volume132
Issue number3
DOIs
StatePublished - Jan 1 1996
Externally publishedYes

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    Tron, C., Donohue, T. J., Bach, R. G., Wolford, T., Caracciolo, E. A., Aguirre, F. V., Khoury, A., & Kern, M. J. (1996). Differential characterization of human coronary collateral blood flow velocity. American heart journal, 132(3), 508-515. https://doi.org/10.1016/S0002-8703(96)90232-X