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Arterial bending angle and wall morphology correlate with slow coronary flow: determination with multidetector CT
Mecit Kantarci1, Fuat Gündogdu, Selim Doganay
1Department of Radiology, Medical Faculty, Atatürk University, Erzurum, Turkey. akkanrad@hotmail.com
Insights
A smaller origin angle of the main coronary arteries from the aorta is linked to slow coronary flow (SCF). This finding, assessed using MDCT angiography and TIMI frame count, may explain blood flow reduction in these vessels.
Area of Science:
- Cardiovascular imaging and hemodynamics.
- Interventional cardiology and anatomical variations.
Background:
- Slow coronary flow (SCF) is a condition affecting coronary arteries.
- The anatomical factors contributing to SCF require further investigation.
Purpose of the Study:
- To evaluate the association between coronary artery origin angles and SCF.
- To assess vessel wall morphology in patients with SCF.
Main Methods:
- 51 patients diagnosed with SCF (via TIMI frame count) and 51 controls underwent MDCT coronary angiography.
- Coronary artery origin angles relative to the aorta were measured.
- Coronary artery walls were evaluated for morphology.
Main Results:
- Patients with SCF exhibited significantly smaller mean angles of the left main coronary artery (LMCA) origin compared to controls.
- A smaller angle of origin was also observed in patients with SCF in the right coronary artery (RCA).
Conclusions:
- A smaller origin angle of the main coronary arteries from the aorta, identified via MDCT, correlates with slow blood flow.
- This anatomical variation may contribute to the pathophysiology of slow coronary flow.
Background And Purpose:
The purpose of this study was to assess angulations and vessel wall morphology that could lead to bending head loss in the RCA and LMCA arteries of patients with slow coronary flow (SCF) evaluated by MDCT coronary angiography.
Methods:
The study involved 51 patients (45 males, mean age: 59.6 years) who were diagnosed with SCF by coronary angiography. Diagnosis of SCF was based on thrombolysis in myocardial infarction (TIMI) frame count. Fifty-one patients with absence of slow flow were selected as the control group. The angulations of the main coronary arteries with the aorta were measured from the axial images obtained through MDCT coronary angiography, and the findings were recorded. In addition, the coronary artery walls of these patients were evaluated. For statistical analysis, SPSS for Windows 10.0 (SPSS Inc., Chicago, IL) was used. For comparisons of the angles, either independent samples t test or the Mann-Whitney U test was used where appropriate.
Results:
The results of the study indicated that 38 patients had SCF in the LAD. Comparisons of patients with SCF with the controls revealed that in the patients with SCF, the mean angle of the LMCA with the aorta (40.9±20.5°) was statistically significantly smaller than the mean angle of the LMCA with the aorta in the control cases (71.8±11°). In 12 patients, slow flow was detected in the RCA. Those with slow flow in the RCA had significantly smaller angles (mean: 33.2±20.4°) than the other cases (mean: 78.9±10.7°).
Conclusion:
A small angle of origin of the main coronary arteries from the aorta, measured on MDCT examinations is correlated with slow blood flow in those vessels, as calculated by the TIMI frame count in catheter coronary angiography.
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