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Exercise training as a mediator for enhancing coronary collateral circulation: A review of the evidence

Nickolay, Thomas; Nichols, Simon; Ingle, Lee; Hoye, Angela


Thomas Nickolay

Simon Nichols

Angela Hoye


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 the 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 augmented 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.


Nickolay, T., Nichols, S., Ingle, L., & Hoye, A. (2020). Exercise training as a mediator for enhancing coronary collateral circulation: A review of the evidence. Current Cardiology Reviews, 16(3), 212-220.

Journal Article Type Article
Acceptance Date Aug 16, 2019
Online Publication Date Aug 19, 2019
Publication Date Sep 9, 2020
Deposit Date Aug 21, 2019
Publicly Available Date Aug 20, 2020
Journal Current Cardiology Reviews
Print ISSN 1573-403X
Electronic ISSN 1875-6557
Publisher Bentham Science Publishers
Peer Reviewed Peer Reviewed
Volume 16
Issue 3
Pages 212-220
Keywords Chronic total occlusion; Angiogenesis; Arteriogenesis; Shear force; Collateral; Coronary; Artery
Public URL
Publisher URL
Contract Date Aug 21, 2019


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