Collateralization

collateral circulationCollateralization is a term used to describe tiny blood vessels that exist in the coronary arteries that provide new alternate pathways of blood flow to restricted or blocked areas of the myocardium (heart muscle). Collateral circulation is typically minimal in the human heart but is proven to increase in development (growth) in response to increasing severity of ischemic coronary disease. This is a natural healing mechanism of the body as an attempt to supplement blood flow to the heart as restriction from Coronary Artery Disease progresses. When restriction or blockages deteriorate, symptoms of chest pain or Angina can cause great discomfort and can lead to more significant events such as a heart attack or stroke.   

As Coronary Artery Disease progresses, the performance of the heart is compromised due to a deteriorating lack of blood flow. Although research shows that there can be considerable variability to which collateralization can impact cardiovascular risk factors related to coronary collateral development, it is well documented that collateral circulation improves myocardial perfusion, contractile function, infarct size, and ECG abnormalities of the ischemic myocardium which can be linked to improve long-term cardiac survival. With that being said, we can safely conclude that therapeutic augmentation and/or function of collateral circulation represents a desirable goal in the management of Coronary Artery Disease.

A large amount of evidence has provided favorable protective and therapeutic benefits of exercise training ‘effects’ from such aerobic training in patients with coronary artery disease. Reductions in the influences of major recognized risk factors are clearly involved as major preventative and therapeutic benefits of exercise training programs in both health and disease. However, the response of the collateralized heart to increases in physical activity represents additional complex and dynamic aspects. These include potential effects of exercise training on the degree of anatomical and functional collateralization, as well as potentially important effects on regulation of coronary tone in a complex hemodynamic circuitry involving both collateral and noncollateral (collateral-dependent) arteries and microvasculature. Analysis of exercise training programs on extent of collateralization in human patients with coronary disease has provided clinically relevant but often controversial findings. This review highlights effects of exercise training on the extent and function of enhanced collateralization as well as effects of exercise training on vascular smooth muscle and endothelial control of regional coronary tone in the collateralized heart.

Now that we have established the benefits of collateralization of the heart, we can now discuss how Cardiac Therapy or the treatment of External Counterpulsation Therapy can be a clinically effective, non-surgical treatment for Angina from Coronary Artery disease. Tremendous evidence has provided documentation for the therapeutic benefits in patients with coronary artery disease (and collateralization); mechanisms that underlie these benefits are numerous and multifaceted. The treatment process of mechanically inflating to deliver blood flow back to the heart with such great force over time promotes the growth and development of collateralization.  Cardiac Therapy is proven in more than 150 published clinical research trials to improve symptoms of chest pain, shortness of breath, fatigue and other symptoms by naturally restoring blood flow to the heart.