Exercise Training as a Mediator for Enhancing Coronary Collateral Circulation: A Review of the Evidence

NICKOLAY, Thomas, NICHOLS, Simon, INGLE, Lee and HOYE, Angela (2019). Exercise Training as a Mediator for Enhancing Coronary Collateral Circulation: A Review of the Evidence. Current Cardiology Reviews, 15.

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Official URL: http://www.eurekaselect.com/174303/article
Link to published version:: https://doi.org/10.2174/1573403x15666190819144336

Abstract

Coronary collateral vessels supply blood to areas of myocardium at risk after arterial occlusion. Flow through these channels is driven by a pressure gradient between the donor and occluded artery. Concomitant with increased collateral flow is an increase in shear force, a potent stimulus for collateral development (arteriogenesis). Arteriogenesis is self-limiting, often ceasing prematurely when the pressure gradient is reduced by the expanding lumen of the collateral vessel. After the collateral has reached its self- limited maximal conductance, the only way to drive further increases is to re-establish the pressure gradient. During exercise, the myocardial oxygen demand is increased, subsequently increasing coronary flow. Therefore, exercise may represent a means of driving augmenting arteriogenesis in patients with stable coronary artery disease. Studies investigating the ability of exercise to drive collateral development in humans are inconsistent. However, these inconsistencies may be due to the heterogeneity of assessment methods used to quantify change. This article summarises current evidence pertaining to the role of exercise in the development of coronary collaterals, highlighting areas of future research.

Item Type: Article
Uncontrolled Keywords: Cardiovascular System & Hematology
Identification Number: https://doi.org/10.2174/1573403x15666190819144336
SWORD Depositor: Symplectic Elements
Depositing User: Symplectic Elements
Date Deposited: 02 Sep 2019 09:10
Last Modified: 02 Sep 2019 09:15
URI: http://shura.shu.ac.uk/id/eprint/25036

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