Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Local disturbance of main blood flow as a mechanism of failure of ischemic compensation in stenotic lesions of the vascular bed (based on the example of the coronary pool)

Authors: Bocharov A.V.1 2, Popov L.V.3, Savostyanov K.A.4

Company:
1 Central Clinical Hospital of St. Alexy Metropolitan of Moscow of the Moscow Patriarchate of the Russian Orthodox Church, Moscow, Russian Federation
2 Pirogov Russian National Research Medical University, Moscow, Russian Federation
3 National Medical and Surgical Center named after N.I. Pirogov, Moscow, Russian Federation
4 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2024-21-4-290-299

UDC: 616.132.2-007.271

Link: Clinical Physiology of Blood Circulaiton. 2024; 21 (4): 290-299

Quote as: Bocharov A.V., Popov L.V., Savostyanov K.A. Local disturbance of main blood flow as a mechanism of failure of ischemic compensation in stenotic lesions of the vascular bed (based on the example of the coronary pool). Clinical Physiology of Circulation. 2024; 21 (4): 290–299 (in Russ.). DOI: 10.24022/1814-6910-2024-21-4-290-299

Received / Accepted:  30.10.2024 / 20.11.2024

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Abstract

The basic models of hemodynamic disturbances are considered, namely: collateral circulation, competitive blood flow, critical stenosis model. The presented basic models of local hemodynamic disturbances, in our opinion, can explain the cause of local disturbances of the main blood flow with a significant impact of one factor or a combination of several factors of minor severity, such as insufficiency of collateral circulation, occurrence of competitive blood flow and stenotic lesion, which will lead to a significant decrease in the volumetric blood flow velocity in the distal bed.

References

  1. Здравоохранение. Федеральная служба государственной статистики. https://rosstat.gov.ru/folder/13721# (дата обращения 13.05.2024)
  2. 10 ведущих причин смерти в мире. Всемирная организация здравоохранения. https://who.int/ru/news-room/fact-sheets/detail/the-top-10-causes-of-death (дата обращения 11.05.2024)
  3. Byrne R.A., Rossello X., Coughlan J.J..,Barbato E., Berry C., Chieffo A. et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur. Heart J. 2023; 44 (38): 3720–3826. DOI: 10.1093/eurheartj/ehad191
  4. Барбараш О.Л., Дупляков Д.В., Затейщиков Д.А., Панченко Е.П., Шахнович Р.М., Явелов С.И. и др. Острый коронарный синдром без подъема сегмента ST электрокардиограммы. Клинические рекомендации 2020. Российский кардиологический журнал. 2021; 26 (4): 4449. DOI:10.15829/1560-4071-2021-4449
  5. Оппель В.А. Коллатеральное кровообращенiе. СПб.: Типографiя М. Меркушева; 1911.
  6. Тонков В.Н. Руководство нормальной анатомии человека. 3-е изд. Казань: типография Имп.университета; 1916–1918.
  7. Тонков В.Н. Учебник нормальной анатомии человека. М.: Медгиз; 1933.
  8. Cooper A.P. Some experiments and observations on tying the carotid and vertebral arteries, and the pneumogastric, phrenic and sympathetic nerves. Guy’s Hospital Reports. 1836; 1: 457–475.
  9. Nothnagel G. Über Anpassungen und Ausgleichungen bei pathol Zustanden. Zeitachrift f. clin. Medicin. 1885; 15: 42.
  10. Lerish R. Arterial aneurisms and arteriovenous fistulas. Paris: Masson & Cie; 1949.
  11. Lerish R. Surgery, Discipline of Knowledge. Nice: La Diane Française; 1949.
  12. Lerish R. The philosophy of surgery. Paris: Flammarion; 1951.
  13. Rentrop K.P., Cohen M., Blanke H., Philips R.A. Changes in collateral channel filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects. J. Am. Coll. Cardiol. 1985; 5 (3): 587–592. DOI: 10.1016/S0735-1097(85)80380-6
  14. Rockstroh J., Brown B.G. Coronary collateral size, flow capacity and growth: estimates from the angiogram in patients with obstructive coronary artery disease. Circulation. 2002; 105 (2): 168–173. DOI: 10.1161/hc0202.102120
  15. Seiler C., Fleisch M., Garachemani A., Meier B. Coronary collateral quantitation in patients with coronary artery disease using intravascular flow velocity or pressure measurements. J. Am. Coll. Cardiol. 1998; 32 (5): 1272–1279. DOI: 10.1016/s0735-1097(98)00384-2
  16. Buschmann I., Schaper W. The pathophysiology of the collateral circulation (arteriogenesis). J. Pathol. 2000; 190 (3): 338–342. DOI: 10.1002/(SICI)1096-9896(200002)190:3<338::AID-PATH594>3.0.CO;2-7
  17. Shumacher B., Pecher P., von Specht B.U., Stegmann Th. Induction of neoangiogenesis in ischemic myocardium by human growth factors. Circulation. 1998; 97 (7): 645–650. DOI: 10.1161/01.cir.97.7/645
  18. Ofili E., Kern M.J., Tatineni S., Deligonul U., Aguirre F., Serota H., Labovitz A.J. Detection of coronary collateral flow by a Doppler-tipped guide wire during coronary angioplasty. Am. Heart J. 1991; 122 (1): 221–225. DOI:10.1016/0002-8703(91)90780-L
  19. Piek J.J., Liebergen R., Koch K.T., Peters R.J.G., David G.K. Clinical, angiographic and hemodynamic predictors of recruitable collateral flow assessed during ballon angiolasty coronary occlusion. JACC. 1997; 29 (2): 275–282. DOI:10.1016/s0735-1097(96)00499-8/
  20. Петровский Б.В. (ред.) Большая медицинская энциклопедия. Изд. 3-е. Т. 11. М.: Сов. Энциклопедия; 1979.
  21. Бочаров А.В., Попов Л.В. Конкурентный кровоток: определение, биофизические основы, механизмы возникновения в клинической практике, клинико-ангиографические критерии диагностики. Клиническая физиология кровообращения. 2021; 18 (2): 165–171. DOI: 10.24022/1814-6910-2021-18-2-165-171
  22. Gorlin R., Gorlin S.G. Hydraulic formula for calculation of the area of the stenotic mitral valve, other cardiac valves and central circulatory shunts. Am. Heart J. 1951; 41 (1): 1–29. DOI: 10.1016/0002-8703(51)-90002-6
  23. McMillan I.K.R. Aortic stenosis. British Heart Journal. 1955; 17 (1): 56–60. DOI: 10.1136/Lrt.17.1.56
  24. Соловьев Г.М., Попов Л.В., Игнатов Ю.В., Алишин И.И. Митральный стеноз и проблема критического сужения в кровообращении. Кардиология. 1988; XXVIII (9): 10–12.
  25. Gensini G.G., Costa B.C.B. The coronary collateral circulation in living man. Am. J. Cardiol. 1969; 24 (3): 393–400. DOI: 10.1016/0002-9149(69)90434-2
  26. Sheldon W.C. On the significance of coronary collaterals. Am. J. Cardiol. 1969; 24 (3): 303–304. DOI: 10.1016/0002-9149(69)90421-4
  27. Pijls N.H.J., Son J.A.M., Kirkeeide R.L, Bryune B.D., Gould K.L. Experimental basis of determining maximum coronary, myocardial and collateral blood flow by pressure measurements for assessing functional stenosis severity before and after percutaneous transluminal coronary angioplasty. Circulation. 1993; 87 (4): 1354–1367. DOI: 10.1161/01.cir.87.4.1354
  28. FFR, iFR. https://www.philips.ru/healthcare/resources/landing/igt-devices-physiology#_main2 (дата обращения 14.05.2024)
  29. Neumann F.-J., Sousa-Uva M., Ahlsson A., Alfonso F., Banning A.P., Benedetto U. et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur. Heart J. 2019; 40 (2): 87–165. DOI: 10.1093/eurheartj/ehy394
****
  1. Healthcare. Federal State Statistics Service. Available at: https://rosstat.gov.ru/folder/13721# (accessed 13.05.2024)
  2. 10 leading causes of death in the world. World Health Organization. Available at: https://who.int/ru/news-room/fact-sheets/detail/the-top-10-causes-of-death (accessed 11.05.2024)
  3. Byrne R.A., Rossello X., Coughlan J.J..,Barbato E., Berry C., Chieffo A. et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur. Heart J. 2023; 44 (38): 3720–3826. DOI:10.1093/eurheartj/ehad191
  4. Barbarash O.L., Duplyakov D.V., Zateischikov D.A., Panchenko E.P., Shakhnovich R.M., Yavelov I.S. et al. 2020 Clinical practice guidelines for Acute coronary syndrome without ST segment elevation. Russian Journal of Cardiology. 2021; 26 (4): 4449 (in Russ.). DOI:10.15829/1560-4071-2021-4449
  5. Oppel V.A. Collateral circulation. St. Petersburg: M. Merkushev Printing House; 1911 (in Russ.).
  6. Tonkov V.N. A Guide to Normal Human Anatomy. 3rd ed. Kazan: printing house of the Imperial University; 1916–1918 (in Russ.).
  7. Tonkov V.N. Textbook of normal human anatomy. Moscow; 1933 (in Russ.).
  8. Cooper A.P. Some experiments and observations on tying the carotid and vertebral arteries, and the pneumogastric, phrenic and sympathetic nerves. Guy’s Hospital Reports. 1836; 1: 457–475.
  9. Nothnagel G. Über Anpassungen und Ausgleichungen bei pathol Zustanden. Zeitachrift f. clin. Medicin. 1885; 15: 42.
  10. Lerish R. Arterial aneurisms and arteriovenous fistulas. Paris: Masson & Cie; 1949.
  11. Lerish R. Surgery, Discipline of Knowledge. Nice: La Diane Française; 1949.
  12. Lerish R. The philosophy of surgery. Paris: Flammarion; 1951.
  13. Rentrop K.P., Cohen M., Blanke H., Philips R.A. Changes in collateral channel filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects. J. Am. Coll. Cardiol. 1985; 5 (3): 587–592. DOI: 10.1016/S0735-1097(85)80380-6
  14. Rockstroh J., Brown B.G. Coronary collateral size, flow capacity and growth: estimates from the angiogram in patients with obstructive coronary artery disease. Circulation. 2002; 105 (2): 168–173. DOI: 10.1161/hc0202.102120
  15. Seiler C., Fleisch M., Garachemani A., Meier B. Coronary collateral quantitation in patients with coronary artery disease using intravascular flow velocity or pressure measurements. J. Am. Coll. Cardiol. 1998; 32 (5): 1272–1279. DOI: 10.1016/s0735-1097(98)00384-2
  16. Buschmann I., Schaper W. The pathophysiology of the collateral circulation (arteriogenesis). J. Pathol. 2000; 190 (3): 338–342. DOI: 10.1002/(SICI)1096-9896(200002)190:3<338::AID-PATH594>3.0.CO;2-7
  17. Shumacher B., Pecher P., von Specht B.U., Stegmann Th. Induction of neoangiogenesis in ischemic myocardium by human growth factors. Circulation. 1998; 97 (7): 645–650. DOI: 10.1161/01.cir.97.7/645
  18. Ofili E., Kern M.J., Tatineni S., Deligonul U., Aguirre F., Serota H., Labovitz A.J. Detection of coronary collateral flow by a Doppler-tipped guide wire during coronary angioplasty. Am. Heart J. 1991; 122 (1): 221–225. DOI:10.1016/0002-8703(91)90780-L
  19. Piek J.J., Liebe rgen R., Koch K.T., Peters R.J.G., David G.K. Clinical, angiographic and hemodynamic predictors of recruitable collateral flow assessed during ballon angiolasty coronary occlusion. JACC. 1997; 29 (2): 275–282. DOI:10.1016/s0735-1097(96)00499-8/
  20. Petrovsky B.V. (Eds.) Great Medical Encyclopedia. Ed. 3rd. Vol. 11 Moscow; 1979 (in Russ.).
  21. Bocharov A.V., Popov L.V. Competitive blood flow: definition, biophysical basis, mechanisms of occurrence in clinical practice, clinical and angiographic diagnostic criteria. Clinical Physiology of Circulation. 2021; 18 (2): 165–171 (in Russ.). DOI: 10.24022/1814-6910-2021-18-2-165-171
  22. Gorlin R., Gorlin S.G. Hydraulic formula for calculation of the area of the stenotic mitral valve, other cardiac valves and central circulatory shunts. Am. Heart J. 1951; 41 (1): 1–29. DOI: 10.1016/0002-8703(51)-90002-6
  23. McMillan I.K.R. Aortic stenosis. British Heart Journal. 1955; 17 (1): 56–60. DOI: 10.1136/Lrt.17.1.56
  24. Solovyov G.M., Popov L.V., Ignatov Yu.V., Alishin I.I. Mitral stenosis and the problem of critical narrowing in the blood circulation. Cardiology. 1988; XXVIII (9): 10–12 (in Russ.).
  25. Gensini G.G., Costa B.C.B. The coronary collateral circulation in living man. Am. J. Cardiol. 1969; 24 (3): 393–400. DOI:10.1016/0002-9149(69)90434-2
  26. Sheldon W.C. On the significance of coronary collaterals. Am. J. Cardiol. 1969; 24 (3): 303–304. DOI: 10.1016/0002-9149(69)90421-4
  27. Pijls N.H.J., Son J.A.M., Kirkeeide R.L, Bryune B.D., Gould K.L. Experimental basis of determining maximum coronary, myocardial and collateral blood flow by pressure measurements for assessing functional stenosis severity before and after percutaneous transluminal coronary angioplasty. Circulation. 1993; 87 (4): 1354–1367. DOI: 10.1161/01.cir.87.4.1354
  28. FFR, iFR. https://www.philips.ru/healthcare/resources/landing/igt-devices-physiology#_main2 (дата обращения 14.05.2024)
  29. Neumann F.-J., Sousa-Uva M., Ahlsson A., Alfonso F., Banning A.P., Benedetto U. et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur. Heart J. 2019; 40 (2): 87–165. DOI: 10.1093/eurheartj/ehy394

About Authors

  • Aleksandr V. Bocharov, Dr. Med. Sci.; ORCID
  • Leonid V. Popov, Dr. Med. Sci., Professor; ORCID
  • Kirill A. Savostyanov, Cand. Med. Sci.; ORCID

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