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European Heart Journal 1982 3(3):223-229;
Copyright © 1982 by the European Society of Cardiology.
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© 1982 by The European Society of Cardiology

Coronary collaterals and left ventricular function early after acute transmural myocardial infarction

M. F. ROUSSEAU*,, M. E. BERTRAND{dagger}, J. M. R. DETRY*, P. M. DECOSTER* and J. M. LABLANCHE{dagger}

*Division of Cardiology, University of Louvain Brussels, Belgium
{dagger}Division of Cardiology and Hemodynamics, University Hospital Lille, France

Received 13 May 1981; revised 8 September 1981; .

Requests for reprints to: Dr M. Rousseau, Cardiopulmonary Laboratory, Division of Cardiology, Cliniques Universitaires Saint-Luc, avenue Hippocrate 10/2881, B-1200 Brussels, Belgium.

Abstract

The coronary collateral circulation and ventricular function, segmental wall motion and infarct size, were investigated from hemodynamic and angiographic data in 126 patients with acute transmural myocardial infarction and complete obstruction of a major coronary vessel. The patients were divided into two groups: 74 with obstruction of the right coronary artery and 52 with obstruction of the left anterior descending artery. The collateral circulation was rated as absent, poor, fair or adequate: two weeks after infarction, collateral vessels were observed in only 27% (poor 15.4%, fair 5.8%, adequate 5.8%) of the patients with an anterior myocardial infarction and in only 35% (poor 13.5%, fair 16.4%, adequate 4.5%) of the patients with an inferior myocardial infarction.

In both groups of patients, the presence of collateral vessels had no significant influence on the following parameters: left ventricular performance (left ventricular end-diastolic pressure, left ventricular enddiastolic volume, ejection fraction and mean velocity of fiber shortening), extent of abnormally contracting segment and segmental wall motion. After anterior myocardial infarction, there was an insignificant trend to lesser myocardial damage in patients with coronary collaterals.

Thus, coronary collaterals are infrequent in patients with acute transmural myocardial infarction and total obstruction of a coronary vessel; in these patients we conclude that the collaterals have no effect either on left ventricular function or on the size of the infarction.

Key Words: Acute myocardial infarction • collateral circulation • left ventricular function


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