Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, West Yanjiang Road 107, Guangzhou, People's Republic of China.
Clin Res Cardiol. 2011 Mar;100(3):227-33. doi: 10.1007/s00392-010-0233-8. Epub 2010 Sep 25.
The development of coronary collaterals is crucial to survival through acute ischemia. Mild to moderate loss of renal function has been suggested to play a role in this event, but evidential data are scarce. The aim of this study was to investigate the relationship between mild to moderate renal insufficiency and coronary collateral development in patients with chronic total coronary artery occlusion.
A total of 83 patients with mild to moderate loss of renal function (30 mL/min/1.73 m(2) ≤ eGFR < 90 mL/min/1.73 m(2)) with chronic total coronary artery occlusion were included in our study. The collateral circulation was graded according to Rentrop classification and the function of collateral circulation was graded according to Werner collateral connection (CC) grades. Compared to patients with good collateral circulation (Rentrop = 2,3), eGFR was found to be lower in those patients with poor coronary collateral circulation (Rentrop = 0,1) (63.30 ± 10.51 vs. 54.13 ± 10.56, P = 0.02). eGFR was also found to be lower in poorly functioning coronary collateral circulation (CC = 0,1) than in efficiently functioning coronary collateral circulation (CC = 2) (55.22 ± 9.98 vs. 66.28 ± 9.16, P = 0.03). Multiple logistic regression analysis showed that low eGFR was independently associated with poor coronary collateral circulation (Rentrop = 0,1, 95% CI, 0.09-1.09, P = 0.044) and poor function of coronary collateral circulation (CC = 0,1, 95% CI, 0.02-0.17, P = 0.02).
Lower eGFR is associated with poorer coronary collateral vessel development in patients experiencing mild to moderate renal insufficiency. Moreover, eGFR represents an independent factor affecting coronary collateral vessel development.
侧支循环的发展对于急性缺血患者的存活至关重要。轻度至中度肾功能丧失被认为在此事件中起作用，但证据数据稀缺。本研究旨在探讨慢性完全性冠状动脉闭塞患者中轻度至中度肾功能不全与侧支循环发展之间的关系。
共纳入 83 例轻度至中度肾功能丧失（30ml/min/1.73m²≤eGFR<90ml/min/1.73m²）的慢性完全性冠状动脉闭塞患者。根据Rentrop 分类对侧支循环进行分级，并根据 Werner 侧支连接（CC）分级对侧支循环功能进行分级。与侧支循环良好（Rentrop=2,3）的患者相比，侧支循环较差（Rentrop=0,1）的患者的 eGFR 较低（63.30±10.51 比 54.13±10.56，P=0.02）。功能较差的冠状动脉侧支循环（CC=0,1）的 eGFR 也低于功能良好的冠状动脉侧支循环（CC=2）（55.22±9.98 比 66.28±9.16，P=0.03）。多变量逻辑回归分析显示，低 eGFR 与较差的冠状动脉侧支循环（Rentrop=0,1，95%CI，0.09-1.09，P=0.044）和较差的冠状动脉侧支循环功能（CC=0,1，95%CI，0.02-0.17，P=0.02）独立相关。
在轻度至中度肾功能不全的患者中，较低的 eGFR 与较差的冠状动脉侧支血管发育相关。此外，eGFR 是影响冠状动脉侧支血管发育的独立因素。
