Charney R, Cohen M
Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467.
Am Heart J. 1993 Oct;126(4):937-45. doi: 10.1016/0002-8703(93)90710-q.
The role of coronary collateral circulation in limiting ischemia and infarction has been studied prospectively. Transient occlusion of a coronary artery angioplasty has provided evidence that collateral circulation decreases wall motion abnormalities, ST segment changes, and lactate production. Patients who have collateral flow also have a better outcome after coronary artery dissection and acute closure than patients without collateral flow. Collateral circulation also limits infarct size during acute myocardial infarction with and without thrombolysis. Although collateral flow may decrease coronary artery bypass graft patency in certain subgroups of patients, the perioperative infarct rate and mortality is decreased. Growth factors have been identified that increase the development collateral circulation and may improve ventricular function in the setting of myocardial infarction.
冠状动脉侧支循环在限制心肌缺血和梗死方面的作用已得到前瞻性研究。冠状动脉血管成形术时的短暂闭塞已提供证据表明，侧支循环可减少室壁运动异常、ST段改变和乳酸生成。有侧支血流的患者在冠状动脉夹层和急性闭塞后的预后也比无侧支血流的患者更好。在急性心肌梗死期间，无论有无溶栓治疗，侧支循环均可限制梗死面积。虽然在某些患者亚组中，侧支血流可能会降低冠状动脉搭桥术的通畅率，但围手术期梗死率和死亡率会降低。已鉴定出一些生长因子，它们可促进侧支循环的发育，并可能改善心肌梗死情况下的心室功能。
