PERFUSION RESERVE OF CORONARY COLLATERAL CIRCULATION AND ITS SIGNIFICANCE IN THE DEVELOPMENT OF EXERCISE-INDUCED ISCHEMIA IN PATIENTS WITH MULTIVESSEL DISEASE

• Published in: JAPANESE CIRCULATION JOURNAL Vol. 58; no. 1; pp. 15 - 21
• Main Authors: MIYAKODA, HIROYUKI, NOGUCHI, NORIYASU, OMODANI, HIROKI, OSAKI, SHUICHI, KITAMURA, HIDEYUKI, MATSUMOTO, TATSUHIKO, OGINO, KAZUHIDE, HOSHIO, AKIRA, KOTAKE, HIROSHI, MASHIBA, HIROTO
• Format: Journal Article
• Language: English
• Published: The Japanese Circulation Society 1993
• Subjects: Collateral circulation; Coronary artery disease; Exercise-stress tomographic thallium-201; myocardial imaging
• ISSN: 0047-1828; 1347-4839
• DOI: 10.1253/jcj.58.15

To assess the perfusion reserve of coronary collateral circulation, we analyzed exercise-stress tomographic thallium-201 myocardial images in 12 patients who had total occlusion in the right coronary artery (RCA) or left circumflex coronary artery (LCX) with well-developed collateral circulation and 90% stenosis in the left anterior descending coronary artery (LAD). In 6 of the 12 patients, the collateral circulation was non-jeopardized (group A). In the remaining 6 patients, the collateral circulation was jeopardized (group B). All 6 of the patients in group A had an exercise-induced decrease in thallium uptake in the segments supplied by the occluded RCA or LCX with collateral circulation, and 3 (50%) of these 6 also showed a decrease in thallium uptake in the segments supplied by the LAD. All 6 of the patients in group B also had an exercise-induced decrease in thallium uptake in the segments supplied by the occluded RCA or LCX with collateral circulation, but none showed a decrease in thallium uptake in the segments supplied by the LAD. In conclusion, the perfusion reserve of collateral circulation is equal to or less than 90% stenosis and myocardial ischemia occurs first in the collateralized segments during exercise in patients with jeopardized collateral circulation.