1993 Fiscal Year Final Research Report Summary
Significance of myocardial ischemia as a factor of the development of coronary collateral vessels
| Project/Area Number |
04670523
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Circulatory organs internal medicine
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| Research Institution | KYOTO UNIVERSITY (1993)
Toyama Medical and Pharmaceutical University (1992) |
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Principal Investigator |
FUJITA Masatoshi KYOTO UNIVERSITY, College of Medical Technology, Professor, 医療技術短期大学部, 教授 (50190046)
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| Co-Investigator(Kenkyū-buntansha) |
MIWA Kunihisa Toyama Med.& Pharm.Univ., Assistant, 医学部, 助手 (70166221)
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| Project Period (FY) |
1992 – 1993
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| Keywords | Coronary collaterals / Myocardial ischemia / Angina pectoris / Coronary angiography / Acute myocardial infarction |
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| Research Abstract |
1. Relationship between preinfarction angina and left ventricular function after acute myocardial infarction
Preinfarction angina is useful for the preservation of left ventricular function after acute myocardial function regardless of the early reperfusion of the infarct-related coronary artery The beneficial effect is, at least in part, due to the development of collateral circulation. On the other hand, ischemic preconditioning by preinfarction angina plays an important role in the preservation of left ventricular function in patients with the early reperfusion, whereas ischemic preconditioning is not useful for the preservation of left ventricular function in those with the persistently occluded infarct-related coronary artery
2. The development of coronary collateral circulation in patients with effort angina or acute myocardial infarction
In the presence of myocardial ischemic stimuli, collateral vessels are developed in all patients. The development of collateral channels is assess
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ed quantitatively as an increase in the diameter of recipient coronary arteries. The functional state of collateral circulation is determined by the anatomical presence of collateral vessels and pressure gradient across the collateral network.
3. Long-term efficacy of heparin exercise treatment for patients with stable effort angina
Repeated exercise with heparin pretreatment is useful for improving exercise capacity in patients with stable effort angina, and the beneficial effect of the treatment is maintained over a long follow-up period. The severity score of exercise thallium-201 myocardial scintigrams with the same work-load was significantly decreased long after heparin exercise treatnent.
4. Significance of stenosis of donating coronary arteries for collateral flow reserve
Coronary collateral circulation is further augmented in response to an increase in myocardial oxygen demand in patients with non-stenosed donating coronary arteries, whereas significant stenoses in donating arteries compromise an increase in collaterai blood flow. Less
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