ROLE OF CORONARY COLLATERAL CIRCULATION I N THE COMPENSATION OF DISTURBANCES OF MYOCARDIAL PERFUSION AND LEFT-VENTRICULAR FUNCTION IN PATIENTS WITH PRIMARY ANGINA-PECTORIS

The myocardial perfusion and left ventricular function were evaluated by bicycle ergometry and myocardial scintigraphy in 23 patients with p rimary angina taking into account the status of coronary collateral ci rculation in response to stenotic and occlusive atherosclerosis. In ad dition to severe occlusive disease of the coronary bed, most patients had significant disturbances of myocardial perfusion and left ventricu lar function, which were detected during exercise tests. In patients w ith compensatory collateral circulation in the coronary bed, such dist urbances were less marked than in those without anastomoses. However c ollateral coronary circulation cannot be regarded to be of real value as it compensates impaired perfusion incompletely, but in some cases i t can result in impaired myocardial vascularization apparently due to the steal syndrome.