PATIENTS WITH CORONARY COLLATERALS AND NORMAL LEFT-VENTRICULAR SYSTOLIC FUNCTION - CLINICAL, HEMODYNAMIC, AND ANGIOGRAPHIC CHARACTERISTICS

One hundred and twenty consecutive patients with significant coronary artery disease, normal left ventricular systolic function, and coronar y collaterals were compared with 111 patients with the same characteri stics but with no collaterals. No significant differences were found b etween the two groups in hypertension, diabetes mellitus, and smoking. The left ventricular end diastolic pressure was 16.4 +/- 7 in the stu dy group and 16.9 +/- 6.9 in the controls (NS). Significantly more dis eased vessels were observed in the study group than in the control gro up (2.1 +/- 0.6 versus 1.7 +/- 0.6, p = <0.001). One hundred and one t otally occluded vessels were found in the study group but only two in the control group. The richest collateral supply was to the right coro nary artery: 94 sources to 85 diseased vessels (111%) including 66 sou rces to 52 totally occluded arteries (127%); to the left anterior desc ending: 59 sources to 89 diseased vessels (66%) including 37 sources t o 33 totally occluded arteries (112%). The poorest supply was to the l eft circumflex: 17 sources to 69 diseased vessels (25%), including nin e sources to 16 totally occluded arteries (56%). No collaterals were o bserved in 14 totally occluded vessels in the study group and in two o f the controls, while the systolic function at rest was still normal. It is suggested that coronary collaterals are important in preserving left ventricular systolic and diastolic performance at least at rest. Not readily visible collaterals may also prevent systolic dysfunction.