Functional significance of collateral blood flow in patients with recent acute myocardial infarction

A study using myocardial contrast echocardiography

Peter J. Sabia, Eric R. Powers, Ananda R. Jayaweera, Michael Ragosta, Sanjiv Kaul

Research output: Contribution to journalArticle

186 Citations (Scopus)

Abstract

Background. We hypothesized that myocardial contrast echocardiography (MCE) can be used to both measure collateral blood flow as well as assess the functional significance of collaterals in patients with acute myocardial infarction (AMI). Methods and Results. MCE was performed in 33 patients with recent AMI (12±7 days) and an occluded infarct-related artery (IRA), both before and after attempted percutaneous transluminal coronary angioplasty (PTCA). The size of the occluded bed was defined in patients with successful PTCA by injecting contrast directly into the opened IRA and expressed as a percent of the myocardium in the short-axis view. The percent of the perfusion bed supplied by collaterals before PTCA was determined. Transit rates of the microbubbles within the collateralized regions were also measured and were expressed as a percent of the transit rates in the normal adjacent beds. Regional function within the occluded bed was assessed using echocardiography and was graded as 1 (normal) to 5 (dyskinetic). Collaterals were graded on coronary angiography as 0 (none) to 3 (abundant). The perfusion bed size was larger for the left anterior descending (LAD) than for the right (RCA) and left circumflex (LCx) coronary arteries (37±6% versus 27±12% of the myocardium, p=0.02). The percent of the occluded bed supplied by collateral flow was greater for RCA and LCx compared with the LAD (87±30% versus 72±22%, p

Original languageEnglish (US)
Pages (from-to)2080-2089
Number of pages10
JournalCirculation
Volume85
Issue number6
StatePublished - Jun 1992
Externally publishedYes

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Coronary Balloon Angioplasty
Hospital Bed Capacity
Echocardiography
Myocardial Infarction
Myocardium
Arteries
Perfusion
Microbubbles
Coronary Angiography
Coronary Vessels

Keywords

  • Collateral circulation
  • Echocardiography, contrast

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Functional significance of collateral blood flow in patients with recent acute myocardial infarction : A study using myocardial contrast echocardiography. / Sabia, Peter J.; Powers, Eric R.; Jayaweera, Ananda R.; Ragosta, Michael; Kaul, Sanjiv.

In: Circulation, Vol. 85, No. 6, 06.1992, p. 2080-2089.

Research output: Contribution to journalArticle

Sabia, Peter J. ; Powers, Eric R. ; Jayaweera, Ananda R. ; Ragosta, Michael ; Kaul, Sanjiv. / Functional significance of collateral blood flow in patients with recent acute myocardial infarction : A study using myocardial contrast echocardiography. In: Circulation. 1992 ; Vol. 85, No. 6. pp. 2080-2089.
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