title: The relation between endothelial dependent flow mediated dilation of the brachial artery and coronary collateral development - a cross sectional study.
abstract: BACKGROUND
  Endothelial dysfunction is thought to be a potential mechanism for the decreased presence of coronary collaterals. The aim of the study was to investigate the association between systemic endothelial function and the extent of coronary collaterals.
  
  
  METHODS
  We investigated the association between endothelial function assessed via flow mediated dilation (FMD) of the brachial artery following reactive hyperemia and the extent of coronary collaterals graded from 0 to 3 according to Rentrop classification in a cohort of 171 consecutive patients who had high grade coronary stenosis or occlusion on their angiograms.
  
  
  RESULTS
  Mean age was 61 years and 75% were males. Of the 171 patients 88 (51%) had well developed collaterals (grades of 2 or 3) whereas 83 (49%) had impaired collateral development (grades of 0 or 1). Patients with poor collaterals were significantly more likely to have diabetes (p = 0.001), but less likely to have used statins (p = 0.083). FMD measurements were not significantly different among good and poor collateral groups (11.5 +/- 5.6 vs. 10.4 +/- 6.2% respectively, p = 0.214). Nitroglycerin mediated dilation was also similar (13.4 +/- 5.9 vs. 12.8 +/- 6.5%, p = 0.521).
  
  
  CONCLUSIONS
  No significant association was found between the extent of angiographically visible coronary collaterals and systemic endothelial function assessed by FMD of the brachial artery.
authors.affiliation: Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey. aongun@msn.com
authors.forename: Aydan Ongun
authors.initials: AO
authors.lastname: Ozdemir
authors.forename: Sadi
authors.initials: S
authors.lastname: Gulec
authors.forename: Nihal
authors.initials: N
authors.lastname: Uslu
authors.forename: Cansin Tulunay
authors.initials: CT
authors.lastname: Kaya
authors.forename: Cagdas
authors.initials: C
authors.lastname: Ozdol
authors.forename: Sibel
authors.initials: S
authors.lastname: Turhan
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Atmaca
authors.forename: Timucin
authors.initials: T
authors.lastname: Altin
authors.forename: Cetin
authors.initials: C
authors.lastname: Erol
mesh_terms: D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003097:Collateral Circulation; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D014664:Vasodilation