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Journal of molecular and cellular cardiology
Apr, 2012;52 (4): 905-11.

Coronary collateral growth--back to the future.

William M Chilian, Marc S Penn, Yuh Fen Pung, Feng Dong, Maritza Mayorga, Vahagn Ohanyan, Suzanna Logan, Liya Yin
Author Information
  1. William M Chilian: Department of Integrative Medical Sciences, Northeast Ohio Medical University, Rootstown, Ohio 44272, USA. wchilian@neomed.edu
PMID: 22210280 DOI: 10.1016/j.yjmcc.2011.12.006

Abstract

The coronary collateral circulation is critically important as an adaptation of the heart to prevent the damage from ischemic insults. In their native state, collaterals in the heart would be classified as part of the microcirculation, existing as arterial-arterial anastomotic connections in the range of 30 to 100 μM in diameter. However, these vessels also show a propensity to remodel into components of the macrocirculation and can become arteries larger than 1000 μM in diameter. This process of outward remodeling is critically important in the adaptation of the heart to ischemia because the resistance to blood flow is inversely related to the fourth power of the diameter of the vessel. Thus, an expansion of a vessel from 100 to 1000 μM would reduce resistance (in this part of the circuit) to a negligible amount and enable delivery of flow to the region at risk. Our goal in this review is to highlight the voids in understanding this adaptation to ischemia-the growth of the coronary collateral circulation. In doing so we discuss the controversies and unknown aspects of the causal factors that stimulate growth of the collateral circulation, the role of genetics, and the role of endogenous stem and progenitor cells in the context of the normal, physiological situation and under more pathological conditions of ischemic heart disease or with some of the underlying risk factors, e.g., diabetes. The major conclusion of this review is that there are many gaps in our knowledge of coronary collateral growth and this knowledge is critical before the potential of stimulating collateralization in the hearts of patients can be realized. This article is part of a Special Issue entitled "Coronary Blood Flow".

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Grants

  1. R01 HL032788-22/NHLBI NIH HHS
  2. RC1 HL100828/NHLBI NIH HHS
  3. HL100828Z/NHLBI NIH HHS
  4. HL83366/NHLBI NIH HHS
  5. R01 HL032788/NHLBI NIH HHS
  6. R01 HL083366/NHLBI NIH HHS
  7. HL32788/NHLBI NIH HHS
  8. RC1 HL100828-02/NHLBI NIH HHS
  9. R01 HL083366-04/NHLBI NIH HHS

MeSH Term

Collateral Circulation
Coronary Artery Disease
Coronary Circulation
Humans
Myocardial Ischemia
Neovascularization, Physiologic
Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Review
Article has an altmetric score of 1

Word Cloud

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