Article Text

Download PDFPDF
Influence of diabetes mellitus on coronary collateral flow: an answer to an old controversy
  1. R Zbinden,
  2. S Zbinden,
  3. M Billinger,
  4. S Windecker,
  5. B Meier,
  6. C Seiler
  1. Department of Cardiology, University Hospital Bern, Bern, Switzerland
  1. Correspondence to:
    Professor Christian Seiler
    University Hospital Bern, CH-3010 Bern, Switzerland;


Objectives: To determine the influence of diabetes mellitus on coronary collateral flow by accurate means of collateral flow measurement in a large population with variable degrees of coronary artery disease.

Methods: 200 patients (mean (SD) age 64 (9) years; 100 diabetic and 100 non-diabetic) were enrolled in the study. Coronary collateral flow was assessed in 174 stenotic and in 26 angiographically normal vessels with a pressure guidewire (n  =  131), Doppler guidewire (n  =  36), or both (n  =  33) to calculate pressure or flow velocity derived collateral flow index (CFI). Diabetic patients were perfectly matched with a non-diabetic control group for clinical, haemodynamic, and angiographic parameters.

Results: CFI did not differ between the diabetic and the non-diabetic patients (0.21 (0.12) v 0.19 (0.13), not significant). Likewise, CFI did not differ when only angiographically normal vessels (0.20 (0.09) v 0.15 (0.08), not significant) or chronic total coronary occlusions (0.30 (0.14) v 0.30 (0.17), not significant) were compared. Fewer patients in the diabetic group tended to have angina pectoris during the one minute vessel occlusion (60 diabetic v 69 non-diabetic patients, p  =  0.15).

Conclusion: Quantitatively measured coronary CFI did not differ between diabetic and non-diabetic patients with stable coronary artery disease.

  • CAD, coronary artery disease
  • CFI, collateral flow index
  • CFIp, pressure derived collateral flow index
  • CFIv, velocity derived collateral flow index
  • CVP, central venous pressure
  • DM, diabetes mellitus
  • Pao, mean aortic pressure
  • Poccl, distal coronary pressure at the end of a one minute balloon occlusion
  • collateral circulation
  • diabetes mellitus
  • angiogenesis
  • collateral flow index

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • None of the authors involved in this work have any financial conflicts of interest.