Coronary collateral vessels in patients with previous myocardial infarction.
To assess the degree of collateral vessels after myocardial infarction, coronary angiograms, left ventriculograms, and exercise thallium-201 myocardial scintigrams of 36 patients with previous myocardial infarction were reviewed. All 36 patients had total occlusion of infarct-related coronary artery and no more than 70% stenosis in other coronary arteries. In 19 of 36 patients with transient reduction of thallium-201 uptake in the infarcted area during exercise (Group A), good collaterals were observed in 10 patients, intermediate collaterals in 7 patients, and poor collaterals in 2 patients. In 17 of 36 patients without transient reduction of thallium-201 uptake in the infarcted area during exercise (Group B), good collaterals were seen in 2 patients, intermediate collaterals in 7 patients, and poor collaterals in 8 patients (p less than 0.025). Left ventricular contractions in the infarcted area were normal or hypokinetic in 10 patients and akinetic or dyskinetic in 9 patients in Group A. In Group B, 1 patient had hypokinetic contraction and 16 patients had akinetic or dyskinetic contraction (p less than 0.005). Thus, patients with transient reduction of thallium-201 uptake in the infarcted area during exercise had well developed collaterals and preserved left ventricular contraction, compared to those in patients without transient reduction of thallium-201 uptake in the infarcted area during exercise. These results suggest that the presence of viable myocardium in the infarcted area might be related to the degree of collateral vessels.
Department of Internal Medicine, Yamaguchi University School of Medicine, Japan.
M
M
Nakatsuka
Y
Y
Matsuda
M
M
Ozaki
H
H
Ogawa
K
K
Moritani
M
M
Khono
T
T
Miura
T
T
Shimizu
Y
Y
Furutani
R
R
Kusukawa
D000368:Aged; D001794:Blood Pressure; D006328:Cardiac Catheterization; D003097:Collateral Circulation; D003327:Coronary Disease / Q000503:physiopathology; D003331:Coronary Vessels / Q000502:physiology*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000503:physiopathology*; D005082:Physical Exertion; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes