title: Salient features of the coronary collateral circulation and its clinical relevance.
abstract: The coronary collateral circulation provides an alternative source of blood supply to myocardium jeopardised by ischaemia. Collaterals enlarge with obstructive coronary artery disease to allow bulk flow, but blood flow deliverable by the native, pre-formed collateral extent can already be sizeable. Genetic determinants contribute significantly to the wide variability observed in both native collateral extent and its capacity to enlarge, and the severity of the coronary stenosis is the most significant environmental determinant for collateral enlargement. The protective effect of a well-developed coronary collateral circulation translates into relevant improvements in all-cause and cardiac mortality in the acute and chronic phases of coronary artery disease, as well as into a reduction of future adverse cardiovascular events.
authors.affiliation: Department of Cardiology, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Stoller
authors.affiliation: Department of Cardiology, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Seiler
mesh_terms: D000367:Age Factors; D003097:Collateral Circulation / Q000235:genetics / Q000502:physiology*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology*; D003326:Coronary Circulation / Q000235:genetics / Q000502:physiology*; D023921:Coronary Stenosis / Q000503:physiopathology; D050171:Dyslipidemias / Q000503:physiopathology; D020022:Genetic Predisposition to Disease; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index