Abstract:
BACKGROUND:The presence or absence of collateral circulation to the infarct-related coronary artery in acute myocardial infarction (AMI) significantly impacts on infarct size and resulting left ventricular function. However, the determinants of collateral development have not been clarified. HYPOTHESIS:The purpose of this study was to elucidate the determinants of collateral development in humans. METHODS:The study group consisted of 248 patients (178 men, 70 women; mean age 63 years) undergoing coronary angiography within 12 h after the onset of a first AMI. All patients exhibited complete occlusion of the infarct-related artery. The extent of collateral circulation to the area perfused by the infarct-related artery was graded as none, or poorly or well developed, depending on the degree of opacification of the occluded coronary artery on the contralateral injection of contrast. RESULTS:Well-developed collateral circulation was observed in 92 of the 248 patients (37.1%). The prevalence of well-developed collaterals was 57% in patients with a history of angina pectoris prior to AMI, which was significantly (p < 0.0001) higher than the 26% in those without a history of angina. Multivariate stepwise logistic regression analysis was then applied to identify predictors of collateral development. Possible determinants of collateral development were long-standing preinfarction angina, severity of coronary artery disease, age, gender, and coronary risk factors (hypertension, diabetes, hypercholesterolemia, smoking). This analysis revealed that only the presence of a history of angina pectoris prior to AMI was a significant predictor of collateral development (p < 0.0001). CONCLUSIONS:A history of angina pectoris prior to AMI is a clinical marker for coronary stenoses. Since severe coronary stenoses can provide stimuli that lead to collateral development, it is reasonable that a history of angina would also be a clinical marker for collateral vessels.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Fujita M,Nakae I,Kihara Y,Hasegawa K,Nohara R,Ueda K,Tamaki S,Otsuka K,Sasayama Sdoi
10.1002/clc.4960220911subject
Has Abstractpub_date
1999-09-01 00:00:00pages
595-9issue
9eissn
0160-9289issn
1932-8737journal_volume
22pub_type
杂志文章abstract::The designation of atherosclerosis as a chronic inflammatory process represents an exciting and logical paradigm shift for cardiologists. Monocyte chemoattractant protein-1 (MCP-1) plays an important role in the recruitment and activation of monocytes and thus in the development of atherosclerosis. Enhanced MCP-1 expr...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960250403
更新日期:2002-04-01 00:00:00
abstract::Patients with coronary artery disease have a variety of treatment options available to them. These include medications to control anginal episodes and, when appropriate, revascularization interventions in the form of coronary artery bypass graft and angioplasty. Despite advances in the treatment of angina, a substanti...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
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更新日期:2017-08-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:2016-11-01 00:00:00
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journal_title:Clinical cardiology
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更新日期:2004-11-01 00:00:00
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journal_title:Clinical cardiology
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更新日期:1997-10-01 00:00:00
abstract::This report reviews the available evidence for and against the combined use of clonidine and prazosin in treating hypertension. Clinical studies have resulted in modest or no enhancement of the antihypertensive effects when prazosin has been added to clonidine. This report discusses the possible mechanisms of an inter...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960081206
更新日期:1985-12-01 00:00:00
abstract::Approximately 5% of patients with acute myocardial infarction do not have atherosclerotic coronary artery disease but have other causes for their luminal narrowing. The third part of this three-part review of nonatherosclerotic causes of coronary narrowing focuses on coronary vasculitis, infectious diseases, Kawasaki'...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960190814
更新日期:1996-08-01 00:00:00
abstract::The left ventricular filling and regional wall motion patterns were compared in 6 normal subjects, 20 patients with coronary artery disease, and 10 patients with syndrome X by means of Doppler and two-dimensional echocardiography during high-dose (0.9 mg/kg body weight in 10 min) dipyridamole infusion. During the proc...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960141009
更新日期:1991-10-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190112
更新日期:1996-01-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960111202
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journal_title:Clinical cardiology
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doi:10.1002/clc.20295
更新日期:2009-06-01 00:00:00
abstract::Research protocols often utilize serial exercise testing to examine the efficacy of anti-ischemic therapies. These tests, however, are prone to multiple sources of bias. This investigation sought to determine the influence of varying precordial electrocardiographic (ECG) electrode placement on the detection of exercis...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960180409
更新日期:1995-04-01 00:00:00
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journal_title:Clinical cardiology
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doi:10.1002/clc.22215
更新日期:2014-02-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2010-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1002/clc.4960150105
更新日期:1992-01-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960260209
更新日期:2003-02-01 00:00:00
abstract::In the past decade, catheter ablation techniques and implantable devices have revolutionized the treatment of ventricular arrhythmias, junctional arrhythmias, and atrial flutter. For most patients presenting with atrial fibrillation (AF), the treatment available today is similar to that used a century ago, although no...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960200416
更新日期:1997-04-01 00:00:00
abstract::In order to assess the diagnostic value of dipyridamole (D) testing, we studied the responses of 34 patients with chest pain and 10 normal subjects. Blood pressure and 12-lead ECG were recorded during and after intravenous infusion of 0.6 mg/kg dipyridamole for 10 minutes. Coronary arteriography and maximal or symptom...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960050402
更新日期:1982-04-01 00:00:00
abstract::A 55-year-old Caucasian woman suddenly developed substernal chest pain at rest accompanied by pallor, diaphoresis, nausea, and vomiting. Physical examination was otherwise unremarkable. The resting ECG showed T-wave inversion in all anterior leads which returned to normal 24 h after the onset of the symptoms. The pain...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100614
更新日期:1987-06-01 00:00:00
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doi:10.1002/clc.4950260806
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pub_type: 杂志文章,评审
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doi:10.1002/clc.4960211206
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journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2004-10-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20241
更新日期:2008-08-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究
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更新日期:2019-01-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960140216
更新日期:1991-02-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960060605
更新日期:1983-06-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960170508
更新日期:1994-05-01 00:00:00
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journal_title:Clinical cardiology
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更新日期:2020-04-01 00:00:00