SIZE OF VIABLE MYOCARDIUM AND COLLATERAL BLOOD FLOW IN PATIENTS WITH CORONARY ARTERY OCCLUSION

V.I. Ganyukov, A.A. Shilov, U.Yu. Bravve, N.I. Susoev, I.N. Shigantsov, E.A. Levchenko, M.V. Demina
Department of Radiosurgical Methods for Cardiovascular Disease Diagnosis and Treatment,
Novosibirsk Regional Cardiological Health Center,
Novosibirsk, Russia

The aim of the study was to investigate correlation between collateral blood flow to occluded coronary vessel and the size of viable myocardium in the area fed by that artery. Total 295 patients with coronary artery occlusion were divided into 2 groups. The 1st group included 193 patients with the history of Q-wave myocardial infarction (MI), the 2nd group – 102 patients with non-Q-wave MI or without MI. Left ventriculography evidenced lesser volume of viable myocardium in the 1st group compared with the 2nd.

All patients were assessed for collateral blood flow (CBF) to occluded vessel. There was significantly higher incidence of minor (grade I) or absent (grade 0) CBF in the 1st group – 71 (36.9%) and 10 (5.1%) cases, respectively – compared with the 2nd group – 15 (14.7%) and 0 (0%) cases, respectively (p<0.05). Unlike this, satisfactory (grade II) and good (grade III) CBF to distal segments of occluded artery was more frequent in the 2nd group – 71 (69.6%) and 16 (15.7%) cases, respectively, compared with the 1st group – 102 (52.9%) and 10 (5.1%) cases, respectively (p<0.05). The authors conclude that evaluation of CBF level can complement the assessment of viable myocardium in the occluded coronary artery area, and the presence of the II-III grade CBF can support the necessity of occluded vessel angioplasty.

KEY WORDS: coronary artery occlusion, collateral blood flow, coronary angioplasty.

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