Shraddha Shah, Lakshman Iyer, Sanjay Ganapathi, Ramachandran Padmakumar, Abraham Samuel Babu, Barry A Franklin
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引用次数: 0
Abstract
Introduction: Coronary collaterals are vascular connections that bridge epicardial arteries and supply blood to the oxygen-deprived myocardium in patients with coronary artery disease (CAD). This comprehensive review aimed to identify and evaluate potential interventions that may enhance the growth of coronary collateral vessels.
Methods: We conducted a scoping review of five databases to identify relevant studies that focused on interventions that may promote coronary collateral circulation in patients with CAD.
Results: Our search identified 23 studies that met our inclusion criteria. Studies (n = 7) using pharmacologic agents (i.e., angiotensin-converting enzyme inhibitors, granulocyte macrophage colony stimulating factor, statins, human recombinant basic fibroblast growth factor, and granulocyte macrophage colony stimulating factor) were found to improve collateralization, as did the non-pharmacologic studies (n = 13) (i.e., exercise training, electrical stimulation, and enhanced external counterpulsation), which formed most of the studies. Three studies found benefits of a combination of exercise and heparin. Improvements were seen in collateralization as measured by the coronary flow index and Rentrop scores across all interventions. Effect sizes from randomized trials with pharmacologic, non-pharmacologic, and exercise-based interventions ranged between 0.4 and 0.7.
Conclusion: This review provides a comprehensive overview and update of the existing literature on interventions that may promote coronary collateralization (CC). In summary, we observed a few pharmacological and non-pharmacological (exercise, electrical stimulation, and enhanced external counterpulsation) interventions that have shown a positive effect on CC. These data provide a framework for more robust trials regarding the proliferation and clinical significance of enhanced CC in cardiovascular outcomes in patients with known or occult CAD.
期刊介绍：
''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.
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