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Local dilatory reserve in chronic experimental coronary occlusion without infarction. Quantitation of collateral development

Lokale Dilatationsreserve bei experimentellem Koronarverschluß ohne Myokardinfarkt. Quantitative Erfassung der koronaren Kollateralentwicklung

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Summary

The local dilatory reserve of the canine coronary vasculature was studied with the particle distribution technique. Normal ventricles and hearts with slowly progressive narrowing of both the left circumflex coronary artery and the right coronary artery were studied. In spite of chronic occlusion of 2 coronary arteries myocardial infarction did not occur in the majority of animals because of collateral development. Coronary reserve was determined by producing graded to maximal coronary vasodilation. In normal hearts flow increased homogeneously over the entire left ventricle. In hearts with chronic coronary occlusion coronary vasodilation produced non-homogeneous increases in flow: collateral dependent myocardium received less blood flow than myocardium supplied by normal coronary arteries. Early after coronary occlusion the total coronary reserve was less than normal and the dilatory reserve of collateral dependent vessels was markedly diminished. Late (6 months) after coronary occlusion the total coronary reserve was still below normal but the dilatory reserve of collateral dependent vessels had improved. A new quantitative index of collateral function is defined as the level of coronary flow (delivered through normal coronary arteries) at which collateral flow deviates from homogeneous perfusion. Collateral function, when so defined, increases by a factor of almost 6 times between 4 weeks (early after coronary occlusion) and 6 months (late after occlusion) after the implantation of occluding devices.

Zusammenfassung

Die lokale Myokarddurchblutung und Dilatationsreserve wurde bei Hunden mit der Partikelverteilungsmethode bestimmt. Normaltiere und Hunde mit chronischem Verschluß des Ramus circumflexus der linken Koronararterie und der rechten Koronararterie wurden untersucht. Bei Verschluß von zwei Koronararterien kam es beim größten Teil der Tiere durch ausreichende Kollateralisierung zu keiner Myokardinfarcierung. Die Koronarreserve wurde bei maximaler Koronardilatation gemessen. In normalen Herzen war im ganzen linken Ventrikel die Durchblutungszunahme homogen. Bei chronischem Koronarverschluß kam es bei Koronardilatation zu einer inhomogenen Durchblutungsverteilung: über Kollateralen perfundiertes Myokard wird schlechter durchblutet als von normalen Koronararterien versorgtes Gewebe. Kurze Zeit nach völligem Koronarverschluß war die Koronarreserve insgesamt erniedrigt, und besonders deutlich war die Dilatationsreserve über Kollateralen versorgten Myokards eingeschränkt. Zu einem späteren Zeitpunkt (6 Monate nach Koronarverschluß) war die gesamte Koronarreserve immer noch geringfügig vermindert, aber die Koronarreserve des von Kollateralen abhängigen Myokards war wesentlich verbessert. Ein neuer quantitativer Index der Kollateralfunktion wird definiert als das Niveau der Koronardurchblutung, bei dem der Kollateralfluß nicht mehr zunimmt bei zunehmender Koronardurchblutung. Die Funktion der Kollateralen, wenn so definiert, nimmt um den Faktor 6 zu, wenn man Tiere vier Wochen (=Frühstadium) mit solchen von sechs Monaten (spätes Stadium) nach der Operation miteinander vergleicht.

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Author notes

  1. W. Schaper

    Present address: Department of Experimental Cardiology Max-Planck-Institut für Physiologische und Klinische Forschung, Bad Nauheim, (Germany)

Authors and Affiliations

  1. Department of Experimental Cardiology Max-Planck-Institut für Physiologische und Klinische Forschung, Bad Nauheim, (Germany)

    B. Wüsten, W. Flameng, J. Scholtholt, B. Winkler & S. Pasyk

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Schaper, W., Wüsten, B., Flameng, W. et al. Local dilatory reserve in chronic experimental coronary occlusion without infarction. Quantitation of collateral development. Basic Res Cardiol 70, 159–173 (1975). https://doi.org/10.1007/BF01905617

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