Exercise training as a mediator for enhancing coronary collateral circulation: A review of the evidence
Nickolay, Thomas; Nichols, Simon; Ingle, Lee; Hoye, Angela
Professor Lee Ingle L.Ingle@hull.ac.uk
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.
|Journal Article Type||Article|
|Publication Date||Aug 19, 2019|
|Journal||Current Cardiology Reviews|
|Publisher||Bentham Science Publishers|
|Peer Reviewed||Peer Reviewed|
|APA6 Citation||Nickolay, T., Nichols, S., Ingle, L., & Hoye, A. (2019). Exercise training as a mediator for enhancing coronary collateral circulation: A review of the evidence. Current Cardiology Reviews, 15, https://doi.org/10.2174/1573403x15666190819144336|
|Keywords||Cardiology and Cardiovascular Medicine; General Medicine|
This file is under embargo until Aug 20, 2020 due to copyright restrictions.