title: Effects of coronary collateral vessels in left ventricular segmental motions and myocardial viability using color kinesis dobutamine stress echocardiography.
abstract: OBJECTIVE
  To detect the functional importance of coronary collaterals, which develop after acute myocardial infarctions (AMI).
  
  
  METHODS
  Forty patients with acute AMI whose coronary angiography demonstrated a total occlusion of the left anterior descendant (LAD) artery were included in the study, between January 2003 and June 2004. All of the study patients underwent coronary angiography and left ventriculography using standard Judkins techniques (Phillips Integris-3000). Left ventricular (LV) free walls were divided into 5 segments, and all of these segments motions were evaluated then LV free wall motion score index (WMSI) was calculated. The study patients were divided into 2 groups: good (Rentrop 3; group I; n = 14) and poor coronary collateral circulation (Rentrop 0-2; group II; n = 26) according to the Rentrop grading. Then, color kinesis dobutamine stress echocardiography (CK-DSE) was performed to all patients with standard techniques 6 weeks after AMI.
  
  
  RESULTS
  There were no significant differences for age, gender, risk factors for the coronary artery disease and use of the fibrinolytic therapy between the groups. There were no significant statistical differences for angiographic WMSI, left ventricular ejection fraction (LVEF), end-diastolic volume, end-systolic volume and end-diastolic pressures between the 2 groups. No difference was detected between Group I and II for initial EF, WMSI and peak dose WMSI in CK-DSE procedure. Viability was determined in all of the 14 patients in group I (100%) and 12 of 26 patients in group II (46%) (p = 0.03).
  
  
  CONCLUSIONS
  In early periods of an AMI genesis of the coronary collateral circulation does not affect left ventricular global and regional systolic functions, but increase viability quite significantly. According to our findings early revascularization could be carried out in patients with good coronary collateral circulation without doing any test for viability.
authors.affiliation: Department of Cardiology, Trakya University School of Medicine, Edirne, Turkey. ersantatli@hotmail.com
authors.forename: Ersan
authors.initials: E
authors.lastname: Tatli
authors.forename: Huseyin
authors.initials: H
authors.lastname: Surucu
authors.forename: Erkan
authors.initials: E
authors.lastname: Oztekin
authors.forename: Abdullah
authors.initials: A
authors.lastname: Ulucay
authors.forename: Fatih
authors.initials: F
authors.lastname: Ozcelik
authors.forename: Orhan
authors.initials: O
authors.lastname: Ozer
authors.forename: Meryem
authors.initials: M
authors.lastname: Aktoz
mesh_terms: D002316:Cardiotonic Agents; D003097:Collateral Circulation / Q000502:physiology*; D003116:Color; D003287:Contrast Media; D017023:Coronary Angiography; D003331:Coronary Vessels; D004280:Dobutamine; D025401:Echocardiography, Stress; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D002316:Cardiotonic Agents; D003287:Contrast Media; D004280:Dobutamine