Association Between Collateral Circulation And Blood Pressure Variability In Patients With Coronary Artery Chronic Total Occlusion

BackgroundCoronary chronic total occlusion(CTO)account for 10-30% of the disease confirmed by coronary angiography.Compared with non-CTO vascular lesions,patients with CTO with percutaneous coronary intervention have higher risk of surgical failure and cardiovascular events.Patients with CTO can often be found that collateral circulation was established by coronary angiography.And this procedure does not apply to 1/5 patients with coronary artery disease,especially severe coronary artery disease.The formation of coronary collateral circulation could improve the blood supply of distal occlusion of coronary artery compensatively,reduce the size of myocardial infarction,improve the left ventricle functions,prevent the formation of the patients with aneurysms,and reduce the rate of death,to improve the prognosis of patients is very important clinical significance.With the development of dynamic blood pressure monitoring technology,the blood pressure variability has gradually been paid more attention by clinicians,and the fluctuation of blood pressure is also considered as a risk factor for potential cardiovascular diseases.Genetic factors,age,degree of coronary artery stenosis,presence of total occlusion,myocardial ischemia,physical exercise,smoking,body mass index,hyperlipidemia,hyperhomocysteinemia,and diabetes mellitus have been proposed to be related with coronary collateral development.However,no study has been reported on the relationship between collateral circulation and blood pressure variability in patients with coronary artery chronic total occlusion.ObjectiveTo investigate the relationship between coronary collateral circulation and blood pressure variability in patients with coronary chronic total occlusion.MethodsContinuously collecting the patients with cardiovascular disease and received treatment in the first affiliated hospital of zhengzhou university in June 2017-February 2018.Retrospective study of 120 patients ith a single major coronary artery vascular chronic complete occlusion(left anterior descending branch,convoluted branch or right coronary artery)confirmed by coronary angiography.Collect the patient’s personal information and clinical data.According to the results of coronary angiography using Rentrop grading system to evaluate collateral circulation situation,patients were then classified as having poor CCC(Rentrop grades 0–1)or good CCC(Rentrop grades 2–3).Two groups of patients were analyzed in general condition,test index and blood pressure variability index.Result1.Compared with the poor CCC group,24hDBP、24hSCV and 24 hDCV were significantly higher in patients in good CCC group,the difference was statistically significant(P<0.05).2.Spearman correlation analysis showed 24 hSCV and 24 hDCV were positively correlated with the development of CC in CTO patients(P<0.05).3.Logistic regression analysis indicated that 24 hDCV was positively associated with the development of CC in CTO patients and was the important independent influence factor(OR=0.72,P<0.05).Conclusion1.The study showed compared with the poor CCC group,the patients in good CCC group had the higher blood pressure variability,suggesting that higher blood pressure variation may promoted the development of CC.2.24 hDCV was positively associated with the development of CC in CTO patients and was the important independent influence factor.