| Coronary collaterals are nonfunctional conduits in healthy subjects whose diameter vary from 20 to 350 m. They are recruited secondary to the failure of the native vessel to supply sufficient flow. Timi - 1 research indicates that pa-tient's collateral circulation reaching or filling the target in diagnostic angiograms has a small infarct size and a high left ventricular ejection fraction (LVEF). So the presence of collaterals may preserve function in myocardium, reduce evolution of left ventricular aneurysm formation and failure of heart. Therefore, it plays an important role in protecting left ventricular function in patients with chronic total coronary occlusion. Bercher reported lower function of left ventricular in insufficient collaterals, compared with sufficient collaterals.This study assesses the effect of collateral circulation developed on left ventricular function and the relationship between the development of collateral and angina pectoris in patient with total coronary occlusion.Methods1. ObjectivesPatient; 56 out of the total in - patients from January 2000 to June 2000 in the Chinese Medical University were confirmed that at least one vessel was totally occluded by coronary arteriography. 56 patients were divided into 2 groups in according to the Rentrop class. Group A had either poor or no collateral circulation ( Rentrop Grade 0 or 1) , 27 cases composed of 20 males and 7 females, aged from 44 to 75 ( average62 ). Group B had good collateral circulation ( Rentrop Grade 2 ~ 3) 29 cases, 25 males and 4 females, aged from 37 to 77(average59). The occlusion of Left anterior descending coronary artery ( LAD) or Right coronary artery (RCA) may also be further respectively classified into Group C/D (n = 14/11) and Group E/F (n = 10/15). Group C and E had good collateral circulation. However, Group D and F had poor collateral circulation. All have a history of myocardial infarction. Patient with acute myocardial infarction, valvular lesion, bundle - branch block, and Primary cardio - myopa-thy were not included. 2. Study Method2.1 General Information:All cases have complete clinical information such as history, electrocardiogram (ECG) , echocardiography (UCG) and blood lipid .2.2 Coronary AngiographyCoronary arteriography was performed use judkins technique in multiple projections and cineangiography time was enough. Resting left ventricular cine-angiography was performed in the right anterior oblique (30 ) projection left ventricular ﹑acification was achieved by injection of 30 to 40ml of radiopaque contract medium at a rate of 10 ~ 14ml/sec. Film were exposed at a rate of 25frames/sec, LVEF were calculated using the area - length method. Five segments were divided as described by Contina. Left ventricular contraction was described regionally in. Five segments by method of Contina. Every segmental wall motion was scored by; 0 = normokinetic, 1 = lypokinetic slightly, 2 = lypokinetic significiently, 3 = akinetic, 4 = paradoxical. The grade of collateral vessels were assessed according to the Rentrops classification, In brief; 0: no visible filling of any collateral channels. 1; collateral filling of branches of the stenosed vessel without any dye reading or filling the epicardial segment of the target vessel. 2: partial collateral filling of the epicardial segment of the stenosed vessel. 3: complete collateral filling of the target vessel. Complete coronary occlusion was defined as the occlusion ( Thrombolysis in myocardial infarction [ TIMI] trail grade 0 flow). All result was determined by the independent three observers.2.3 Statistical analysis.Quantitative date is expressed in Mean standard deviation ( x s ) , using student T test to compare between two groups. Qualitative date is analysis withX2 test. The difference is significant if p <0. 05. statistical analyses were performed using the SPSSl 1.0 windows statistical package.Result1. the relationship of collateral circulation with LVEF, Contina Score and Frequency of Angina Pectoris between Two...
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