Relationship Between Coronary Collateral Circulation and Left Ventricular Aneurysm Formation in Acute Inferior Myocardial Infarction

Purpose: Aim of this study is to investigate relationship between coronary collateral circulationand left ventricular aneurysm formation in acute inferior miyocardial infarction. Material and Methods: Retrospectively, we reviewed 348 patients who had their first acute inferior myocardial infarction and underwent coronary angiography. Twenty-three patients who had total occluded right coronary artery were included in this study. Left coronary system of these patients was normal. Angiography was performed 18-56 days after the start of symptoms. Collateral circulation was assessed according to Rentrop classification. Rentrop 0 and 1 were definited as insufficient circulation (Group A, n= 6), Rentrop 2 and 3 were definited as sufficient circulation (Group B n= 17). Left ventricular aneurysm was evaluated in left ventriculography. Results: Six patients had grade 0-1, 17 patients had grade 2-3 collateral circulation. Age and sex were similar in both groups. QRS score was found 4.0±1.26 and 2.52±1.12 in group A and B, respectively (p=0.014). There was no statistically difference between group A (33.3%) and group B (76.5%) when preinfarction angina frequency was compared (p=0.131). While left ventricular aneurysm was monitored in 11.8% of patients in group B, all patients in group A had left ventricular aneurysm (P 0.001). Conclusion: Coronary collateral circulation might prevent left ventricular aneurysm formation in acute inferior myocardial infarction and this effect is attributed to decreased infarction area.