Radiologically detected collaterals and regional myocardial flow responses to ischaemia in ischaemic heart disease.
By employing 133 Xenon injections and a gamma camera recording of the initial uptake and subsequent disappearance of the tracer, regional myocardial perfusion rates were determined in 38 patients with ischaemic heart disease. Areas supplied by collaterals and areas devoid of them were analyzed separately. In addition to determining basal flow rates, the regional perfusion was studied by repeated 133Xenon scintigrams during pacing-induced ischaemia. The data were grouped and analyzed according to the visual assessment of collateral response as observed in the angiograms performed under the same circumstances. Eleven patients who did not have collaterals on their angiograms were excluded, as were three patients in whom the collaterals were supplying segments distal to only subtotal obstructions leaving 24 patients to the study proper. Angiographic appraisal disclosed two different responses to ischaemia: ten patients exhibited an increase in the collateral pattern (responders) and 14 patients showed no change or reduction in the collaterals (nonresponders). The prepacing grading of the collaterals was similar in the subgroups. Under basal conditions the regional myocardial flow rates in areas supplied by collaterals or devoid of them were roughly similar. Upon ischaemia the greatest regional flow increment occurred in the responders. The data demonstrate a reasonable agreement between the visual assessment of collateral response to ischaemia and a change in the regional perfusion. The data further indicate that similar collateral patterns observed by routine coronary angiography are not functionally equipotent.
D000328:Adult; D000790:Angiocardiography; D003097:Collateral Circulation; D003326:Coronary Circulation; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D014980:Xenon Radioisotopes
D014980:Xenon Radioisotopes