Objective: To explore the relationship between coronary collateral circulation following percutaneous coronary intervention (PCI) for a single left anterior descending artery and the recovery of cardiac function.
Methods: A total of 625 patients with coronary heart disease were retrospectively analyzed, who received selective coronary angiography demonstrating lesions involving a single left anterior descending artery and underwent stent placement between January, 2010 and December, 2012. According to Rentrop's classification, the patients were divided into group A (n=280) with Rentrop grades 1-3 and group B (n=325) with Rentrop grade 0. Group A were further divided into 3 subgroups according to the source of collateral circulation, namely group A1 (n=200) with contralateral collateral circulation, group A2 (n=44) with contralateral+ ipsilateral collateral circulation, and group A3 (n=36) with ipsilateral collateral circulation. The outcomes of cardiac function recovery were compared between groups A and B and between the 3 subgroups in group A.
Results: Compared with patients without collateral circulation, patients with collateral coronary circulation showed greater left ventricular ejection fraction increment and reduction in brain natriuretic peptide and red cell volume distribution width with also lower expansion left ventricular end-diastolic volume. Among the 3 subgroups in group A, cardiac function improvement was the most obvious in patients with contralateral+ ipsilateral collateral circulation (group A2) followed by those in group A3, and was the worst in group A1.
Conclusion: The presence of collateral coronary circulation promotes cardiac function recovery in patients receiving PCI for lesions involving a single left anterior descending artery. Patients with contralateral+ipsilateral collateral circulation have the best cardiac function improvement followed by those with contralateral collateral circulation.