Significance of collateral circulation in reversible left ventricular asynergy by nitroglycerin in patients with relatively recent myocardial infarction

American Heart Journal
M FujitaS Sasayama

Abstract

To evaluate the functional role of coronary collateral circulation in reversible asynergy of the left ventricle, cineventriculography was performed before and after the administration of sublingual nitroglycerin in 19 patients with complete occlusion of the proximal part of the left anterior descending coronary artery. In nine patients who had significant collateral circulation to the infarct-related coronary artery (group A), there was significant improvement in both the left ventricular ejection fraction (53% to 60%, p less than 0.05) and regional wall motion in the infarct zone (8% to 18%, p less than 0.01 in the anterolateral area) with administration of nitroglycerin. In contrast, in the remaining 10 patients without significant collateral perfusion (group B), there were no detectable changes in either global function (49% versus 50%) or regional wall motion (6% versus 8% in the anterolateral area) before and after nitroglycerin. Changes in heart rate and left ventricular peak systolic and end-diastolic pressures with nitroglycerin were comparable in both groups. These results suggest that angiographically demonstrable collaterals preserve viable myocardium, which can improve its contraction when the supply-demand relation...Continue Reading

References

Jan 1, 1975·Circulation·J H McAnultyS H Rahimtoola
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Citations

Mar 31, 2004·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Assuero GiorgettiAntonio L'abbate
Jun 26, 1997·The American Journal of Cardiology·H C Lewin, D S Berman
Jun 4, 1998·Cardiovascular Surgery : Official Journal of the International Society for Cardiovascular Surgery·C GrecoB Marino
Oct 31, 1998·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·A PeixD García-Barreto
May 4, 2002·The American Journal of Cardiology·Morten BøttcherTorsten Toftegaard Nielsen
Jun 26, 1998·Journal of Cardiovascular Pharmacology·B B QuebbemannR J Bache
Apr 5, 2020·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Kenia PadrónYoel Fernandez

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