Significance of arterial hypertension on coronary collateral circulation development and left ventricular function in coronary artery disease

Karpanou, Eva A.; Vyssoulis, Gregory P.; Skoumas, John; Zervopoulos, George; Moundaki, Vaso S.; Toutouzas, Pavlos

doi:10.1097/00004872-198812040-00044

Cited by 12 publications

(6 citation statements)

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“…Many evidences showed that hypertension impaired the angiogenesis or CCC formation [21, 22]. The hypertension-related impairment of angiogenesis was associated with restrain of EC activity and VEGF expression, which are important for angiogenesis [21, 22]. Interestingly, other reports found that patients with coronary artery disease more often developed coronary collateral circulation in the presence of arterial hypertension [23].…”

Section: Discussionmentioning

confidence: 99%

Reduced Plasma miR-146a Is a Predictor of Poor Coronary Collateral Circulation in Patients with Coronary Artery Disease

Wang

Yan

Song

et al. 2016

BioMed Research International

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Coronary collateral circulation (CCC), an alternative blood supply for ischemic myocardium, improves survival rates among patients with coronary artery disease (CAD). However, there remains a lack of biomarkers to discriminate between patients with poor or good CCC. In this study, we aimed to observe the relationship between plasma microRNA-146a (miR-146a) levels and the coronary collateral circulation (CCC). Additionally, we aimed to explore whether the plasma miR-146a level could serve as a blood-based biomarker for CCC in patients with CAD. We measured the plasma levels of vascular endothelial growth factor A (VEGF-A) and miR-146a in patients with CCC by ELISA and real-time PCR, respectively, according to the Rentrop grades. The results showed that the plasma miR-146a level is significantly increased in CAD patients with good CCC and significantly decreased in those with poor CCC. In contrast, although VEGFA expression in patients followed a similar trend as the CCC, the differences between the groups were not statistically significant. There was a positive correlation between plasma miR-146a levels and the Rentrop grading. In addition, receiver operator characteristic analysis showed that miR-146a could be a potent biomarker for identifying patients with poor CCC.

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Section: Discussionmentioning

confidence: 99%

Reduced Plasma miR-146a Is a Predictor of Poor Coronary Collateral Circulation in Patients with Coronary Artery Disease

Wang

Yan

Song

et al. 2016

BioMed Research International

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“…Fujita et al 8 studied 248 patients undergoing coronary angiography within 12 h after the onset of a first acute MI, and found hypertension to be equally present among the patients with and The controversy regarding the role of BP or hypertension in determining the presence and extent of CCs may in part be explained by differences in the patients studied and the methods used. A positive relation between BP or hypertension and the presence of CCs may be explained by an increased myocardial oxygen demand, which may trigger the formation or development of collaterals, 10 or enlargement of collateral arteries. 9 Another potential explanation for this controversy may be in the vasculature under study.…”

Section: Discussionmentioning

confidence: 99%

“…2 High blood pressure (BP) has been suggested to influence the development of CCs, but conflicting results remain, and the exact mechanism is still unknown at present. [6][7][8][9][10][11] In the present study, we sought to determine whether high BP is related to the presence and extent of CC circulation.…”

Section: Introductionmentioning

confidence: 99%

High blood pressure is inversely related with the presence and extent of coronary collaterals

et al. 2005

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Patients with hypertension have an increased case fatality during acute myocardial infarction (MI). Coronary collateral (CC) circulation has been proposed to reduce the risk of death during acute ischaemia. We determined whether and to which degree high blood pressure (BP) affects the presence and extent of CC circulation. A cross-sectional study in 237 patients (84% males), admitted for elective coronary angioplasty between January 1998 and July 2002, was conducted. Collaterals were graded with Rentrop's classification (grade 0-3). CC presence was defined as Rentrop-grade X1. BP was measured twice with an inflatable cuff manometer in seated position. Pulse pressure was calculated by systolic blood pressure (SBP)Àdiastolic blood pressure (DBP). Mean arterial pressure was calculated by DBP þ 1/3 Â (SBPÀDBP). Systolic hypertension was defined by a reading X140 mmHg. We used logistic regression with adjustment for putative confounders. SBP (odds ratio (OR) 0.86 per 10 mmHg; 95% confidence interval (CI) 0.73-1.00), DBP (OR 0.67 per 10 mmHg; 95% CI 0.49-0.93), mean arterial pressure (OR 0.73 per 10 mmHg; 95% CI 0.56-0.94), systolic hypertension (OR 0.49; 95% CI 0.26-0.94), and antihypertensive treatment (OR 0.53; 95% CI 0.27-1.02), each were inversely associated with the presence of CCs. Also, among patients with CCs, there was a graded, significant inverse relation between levels of SBP, levels of pulse pressure, and collateral extent. There is an inverse relationship between BP and the presence and extent of CC circulation in patients with ischaemic heart disease.

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“…4 Karpanou et al showed that the patients of CAD with arterial hypertension developed coronary collaterals more frequently, especially high grade coronary collaterals. 5 Kilian et al found a positive relation between hypertension and Rentrop grade '3' collaterals. 16 In multivariate logistic regression analysis for the relation of hypertension with coronary collateral circulation adjusting for possible confounders showed that the patients with hypertension had approximately 3.8 times more chance of developing good collaterals, which was statistically significant (p=0.001).…”

Section: Discussionmentioning

confidence: 99%

Association of Hypertension on Development of Coronary Collaterals in Severe Coronary Artery Disease

et al. 2015

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Objectives: Coronary collaterals appear to play important role in coronary artery disease morbidity and mortality. In this study it was intended to determine whether hypertension is associated with development of coronary collaterals in patients with severe coronary artery disease. Methods: This was an observational cross-sectional study carried out in the department of cardiology of National Institute of Cardiovascular Diseases, Dhaka, Bangladesh during the period from October 2010 to June 2011. A total of 334 patients were examined to include in the study. Among them 118 patient of severe coronary artery disease (CAD) were included who fulfilled the inclusion and exclusion criteria. From where 63 patients were CAD with hypertension (Group -I) and 55 patients were CAD without hypertension (Group -II). Based on Rentrop Grading the study patients were divided in two groups, patients with poor collaterals (Grade 0& 1) and good collaterals (Grade 2&3). Data compared the coronary collaterals in hypertensive patients with those without hypertension with severe coronary artery disease. Results: The data showed that good collateral circulations were higher with duration of hypertension. The difference were statistically significant in duration <5 years and duration >10 years in both groups (p<0.05). The pattern of vessel involvement in double vessel disease and triple vessel disease (p <.001) and dyslipidemia (p<0.004) appeared to be significant predictor of hypertension controlling for other factors in the model. People with hypertension are around four times more likely to have good collateral circulation, multiple vessel disease and around 12 times more likely to have dyslipidemia. Conclusion: It is concluded that the patients of hypertension develop higher grades of coronary collaterals which increases with duration of hypertension in patients of severe coronary artery disease. Involvements of coronary arteries were more extensive in patients of hypertension with coronary artery disease. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22250 Cardiovasc. j. 2015; 7(2): 98-103

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Significance of arterial hypertension on coronary collateral circulation development and left ventricular function in coronary artery disease

Cited by 12 publications

References 0 publications

Reduced Plasma miR-146a Is a Predictor of Poor Coronary Collateral Circulation in Patients with Coronary Artery Disease

Reduced Plasma miR-146a Is a Predictor of Poor Coronary Collateral Circulation in Patients with Coronary Artery Disease

High blood pressure is inversely related with the presence and extent of coronary collaterals

Association of Hypertension on Development of Coronary Collaterals in Severe Coronary Artery Disease

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