Tortuosity of coronary arteries: an indicator for impaired left ventricular relaxation?

Area of Science:

• Cardiology
• Vascular Biology
• Cardiac Physiology

Background:

• Coronary artery tortuosity is an anatomical variation.
• Left ventricular relaxation is a critical component of diastolic function.

Purpose of the Study:

• To examine the association between coronary artery tortuosity and impaired left ventricular relaxation.
• To determine if coronary tortuosity can be an indicator of diastolic dysfunction.

Main Methods:

• 104 subjects undergoing coronary angiography were analyzed.
• Coronary tortuosity was defined by the presence of ≥3 bends (≥45° change in direction) in at least one major coronary artery.
• Pulsed-wave Doppler and two-dimensional echocardiography assessed left ventricular functions, including transmitral inflow velocities (E, A), E/A ratio, deceleration time (DT), and isovolumic relaxation time (IVRT).

Main Results:

• Subjects with coronary tortuosity exhibited significantly lower early transmitral inflow (E) velocity, higher late transmitral inflow (A) velocity, and a smaller E/A ratio compared to those without tortuosity (P < 0.001).
• Coronary tortuosity was associated with prolonged deceleration time of E velocity (DT) and isovolumic relaxation time (IVRT) (P < 0.001).
• Increased end-diastolic interventricular septal and left ventricular posterior wall thicknesses were observed in subjects with tortuosity (P = 0.01 and P = 0.005).
• A significant inverse correlation was found between the number of tortuous arteries and the E/A ratio (r = -0.750, P < 0.001).
• The number of tortuous arteries correlated positively with DT (r = 0.723, P < 0.001) and IVRT (r = 0.703, P < 0.001).

Conclusions:

• Coronary artery tortuosity is significantly associated with impaired left ventricular relaxation.
• Coronary tortuosity may serve as a potential indicator for identifying patients with impaired left ventricular relaxation and diastolic dysfunction.