Collateral Circulation

Collateral Circulation
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I thought I'd try to begin a thread on the very important issue of collateral circulation as it realated to cardiac survival.
It's a remarkable process where myriad routes of tiny arterioles and capillaries expand in size and number to carry blood around an arterial blockage (and presumbably in venous blockage also!)
The collateral circulation can be from the top of a blockage (proximal) to a point beyond the blockage at the bottom (distal) thus mititgating the effect of an otherwise damaging and often deadly cessation of blood flow.
Amazingly sometimes the routing is even from one artery to another often spanning accross the heart from the left decending system to the circumflex or even RCA (right) system.

Obviously the blockage spurs the circulation and it becomes a race to see if the collateralization keeps up or a heart attack occurs!

I survived for at least a decade with collaterals around a virtually complete RCA blockage from top proximal to distal right artery (same one.) I only noticed the deficiency of blood flow during peak stress....maybe 5-10 minutes a day max!

Now, HOW do we make the collateralization progress faster than the blocking? Neither drug companies nor cardiologists really seem to care about the topic (quite naturally- we live in a capitalist society.)
But WE MUST care! We MUST find a way to enhance this process.

Let me throw a couple of my thoughts out ("Partially baked ideas", if you will: an old Mensa term for decent thoughts not fleshed out...NEVER to be confused with HALF baked ideas )

I'm an engineer and I know that hydraulics demonstrates that a way to push a new channel through is higher pressure. Is perhaps high blood pressure a way that evolution has blessed mankind in its need for coronary and cerebral collaterals...not likely that the everpresent hypertension developed from cave man days solely to enrich doctors and drug manufacturers...or to give us red faces when we get angry!

This line of thinking also goes to the subject of hard cardiac workouts to get BP up so high that it can safely force through some new arteries when needed (without blowing any out )...I'm thinking Ubernier's peak exercising (and mine lately as well )

It has always struck me a wrong-thinking to use drugs that weaken the heart's pumping ability and strength (beta and calcium channel blockers) in an effort to develop cardiac health. Lessening of pain frequency may be admirable but what if it's at the cost of slowing down auto-revascularization.
Perhaps all the studies that show that people with high blood pressure are at higher risk of heart disease have it asp backwards. Maybe the growing blockages are putting the body into a state where it it most able to revascularize with higher hydraulic pressure to force new channels! If this is correct then perhaps ALL methods of BP overcontrol are counterproductive for cardiac health, fighting the body's best efforts to survive!

Of course, it would seem any method to stop clotting (such as daily aspirin) which will prevent catastrophic total blockage, or any any anti inflammatories (also aspirin) which will prevent plaques from becoming unstable and blowing open...also causing clotting and blocking are HIGHLY desirable to buy time for the slow coollateraliztion.

I've seen some research last week on drugs that hope to stop cancer's ability to "call" vascularization from adjoining vessels, a process which allows the tumor to feed. These drugs might be effective at blocking certain receptors on blood vessels so they don't grow over to the nearby tumor, thus starving it.

Maybe we should be learning from the cancer cell and develop some of it's chemical devices to SPUR vascularization where needed...perhaps in people with 40% blockages, or some arbitrary break even point between benefit and risk.

Any thoughts?
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Last edited by zip2play : 06-17-2004 at 03:52 PM.

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#2
06-17-2004, 04:57 PM

wordworks2001
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Join Date: May 2004
Posts: 133



Re: Collateral Circulation
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There are two sources I found when I was researching noninvasive alternatives to treatment for CAD. One is from the journal Circulation. 2002;105:666 and the other is from Reviews in Cardiovascular Medicine 2002;3:5.

The Veterans Affairs Non-Q-Wave Infarctions Strategies in Hospital (VANQWISH) trial showed the noninvasive strategies not only to be more economical, but those who were treated medically had better survival 76% of the time.

This is one of the more recent studies I cited to Dr. Wayne's detractors on this board and that no one was able to effectively refute. But that is an old discussion from another flood.

Thanks for renewing the debate Zip2play. I will review what is written here faithfully and perhaps even contribute now and then. However, I am far from a candidate for MENSA, so I will probably be more of an observer.

Jeff