Coronary artery tortuosity: a narrative review

Area of Science:

• Cardiovascular Medicine
• Vascular Biology
• Medical Imaging

Background:

• Coronary artery tortuosity (CAT) is a frequent angiographic observation.
• It is often linked to aging, hypertension, and atherosclerosis.
• Elastin degradation in the vascular wall is a potential cause of CAT.

Purpose of the Study:

• To review the clinical significance and implications of coronary artery tortuosity.
• To highlight the association of CAT with myocardial ischemia, atherosclerosis, and procedural challenges.
• To discuss CAT as a potential indicator of other vasculopathies.

Main Methods:

• Review of existing literature and preliminary evidence on coronary artery tortuosity.
• Analysis of the clinical implications of CAT in various cardiovascular contexts.
• Discussion of the diagnostic and prognostic aspects of CAT.

Main Results:

• CAT can lead to reduced coronary perfusion and myocardial ischemia.
• Increased shear stress in tortuous arteries may promote atherosclerosis and acute coronary syndrome.
• Severe tortuosity can complicate coronary interventions and indicate other vascular diseases.

Conclusions:

• Coronary artery tortuosity has significant clinical implications, affecting coronary flow and potentially increasing cardiovascular risk.
• While generally considered benign, CAT may serve as a diagnostic clue for other vasculopathies.
• Further research is needed to fully understand the pathogenesis and prognostic impact of CAT.