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The importance of having collateral.

The body has a backup system for bringing blood to the heart muscle. And the extent of the backup system may determine an individual's likelihood of surviving a heart attack, according to Marc Cohen and Peter Rentrop of the Mt. Sinai School of Medicine in New York City.

The heart muscle is fed by coronary arteries; when a large one is blocked, the backup system--nearby collateral arteries--sometimes fills in. But often the process is not enough to keep a critical situation from becoming fata. While people who have good collateral development following a heart attack are generally thought to have a better prognosis than those who don't, this is the first trial to show that some people have a better collateral system than others even before a heart attack occurs, Cohen says.

The collateral aren't used by healthy hearts, so to get a picture of them Cohen and Rentrop took advantage of coronary angioplasty (SN: 11/29/80, p. 341). In the process, a tiny balloon is threaded into a clogged coronary artery and inflated, enlarging the bore of the vessel. Heart muscle downstream from the balloon is temporarily deprived of blood flow, creating a mini (and reversible) heart attack.

Cohen and Rentrop injected a radiopaque dye into the hearts of 21 patients getting coronary angiplasty and used X-rays to wacth the dye backflow into the blood-starved area. They found differing degrees of filling, and in two patients no filling. Patients with a better collateral system had a smaller segment of the heart that stopped moving when the blood supply was down, and patients without collaterals had a larger segment that stopped moving, Cohen says. Why some people have better collaterals, and thus a better chance of surviving a heart attack, than other remains to be determined, he says.
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Title Annotation:research on backup system of coronary arteries
Author:Silberner, Joanne
Publication:Science News
Date:Nov 23, 1985
Previous Article:The heart and heredity.
Next Article:Listen to the ears.

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