title: Pathophysiology of coronary collaterals.
abstract: While the existence of structural adaptation of coronary anastomoses is undisputed, the potential of coronary collaterals to be capable of functional adaptation has been questioned. For many years, collateral vessels were thought to be rigid tubes allowing only limited blood flow governed by the pressure gradient across them. This concept was consistent with the notion that although collaterals could provide adequate blood flow to maintain resting levels, they would be unable to increase blood flow sufficiently in situations of increased myocardial oxygen demand. However, more recent studies have demonstrated the capability of the collateral circulation to deliver sufficient blood flow even during exertion or pharmacologic stress. Moreover, it has been shown that increases in collateral flow could be attributed directly to collateral vasomotion. This review summarizes the pathophysiology of the coronary collateral circulation, ie the functional adapation of coronary collaterals to acute alterations in the coronary circulation.
authors.forename: Michael
authors.initials: M
authors.lastname: Stoller
authors.affiliation: Department of Cardiology, University Hospital, CH-3010 Bern, Switzerland. christian.seiler@insel.ch.
authors.forename: Christian
authors.initials: C
authors.lastname: Seiler
mesh_terms: D000241:Adenosine / Q000494:pharmacology; D000818:Animals; D003097:Collateral Circulation / Q000502:physiology*; D003326:Coronary Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000503:physiopathology* / Q000628:therapy; D003331:Coronary Vessels / Q000502:physiology*; D004195:Disease Models, Animal; D015444:Exercise / Q000502:physiology; D006801:Humans; D017202:Myocardial Ischemia / Q000503:physiopathology; D062645:Percutaneous Coronary Intervention; D013312:Stress, Physiological / Q000502:physiology; D014655:Vascular Resistance / Q000502:physiology; D014665:Vasodilator Agents / Q000494:pharmacology; D014666:Vasomotor System / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine