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[Correlation between Coronary Artery Tortuosity and Stenosis in Patients with Myocardial Bridge]
Dong Xu Cai1, Jin Xi Shi1, Xin Bin Zhao1
1Department of CT,the Affiliated Hospital of North China University of Science and Technology,Tangshan,Hebei 063000,China.
Insights
Patients with a tortuous left anterior descending artery (LAD) have a higher incidence of coronary artery stenosis. Mild tortuosity is associated with increased stenosis severity compared to non-tortuous or moderately tortuous arteries.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Myocardial bridges (MB) on the left anterior descending artery (LAD) are a known anatomical variation.
- Vascular tortuosity is increasingly recognized as a factor influencing coronary artery disease (CAD).
Purpose of the Study:
- To investigate the relationship between LAD tortuosity and the presence and severity of coronary artery stenosis in patients with MB.
- To determine if LAD tortuosity is an independent risk factor for coronary artery stenosis.
Main Methods:
- Retrospective analysis of coronary computed tomography angiography (CCTA) data from 556 patients with LAD MB.
- Patients were categorized into groups based on the presence and degree of LAD tortuosity (none, mild, moderate, severe).
- Clinical characteristics, incidence, and severity of LAD stenosis were compared between groups.
Main Results:
- The incidence of coronary artery stenosis was significantly higher in patients with LAD tortuosity (71.9%) compared to those without (57.6%).
- Mild tortuosity showed a significantly higher stenosis rate (78.5%) compared to non-tortuous (57.6%) and moderate tortuosity (61.5%) groups.
- A positive correlation was found between the degree of tortuosity and the severity of stenosis (r=0.169, P<0.001).
Conclusions:
- Coronary artery tortuosity, particularly mild tortuosity, is associated with a higher likelihood and severity of coronary artery stenosis in patients with LAD MB.
- Patients with non-tortuous LAD are more prone to milder stenosis, while tortuous LAD is linked to more severe stenosis.
Abstract:
Objective To analyze the correlation between tortuosity and stenosis in patients with myocardial bridge(MB)on the left anterior descending artery(LAD). Methods Data of patients with MB on the LAD,which was discovered by coronary computed tomography angiography(CCTA),in the Affiliated Hospital of North China University of Science and Technology from October 2015 to December 2018 were retrospectively analyzed.Among them 278 patients with tortuosity on LAD and 278 patients without tortuosity were selected.The clinical charateristics(age,gender,hypertension,hyperlipidemia,diabetes,smoking history,and family history)as well as the incidence and severity of stenosis of LAD were recorded and compared. Results The incidence of coronary artery stenosis in the non-tortuosity group(57.6%)was significantly lower than that in the tortuosity group(71.9%)($\bar{χ}$=12.608,P<0.001).It was also significantly higher in mild tortuosity group(78.5%)than in non-tortuosity group(57.6%)($\bar{χ}$=20.462,P<0.001)and moderate tortuosity group(61.5%)($\bar{χ}$=7.872,P=0.005).The degree of coronary artery stenosis was significantly different between tortuosity group and non-tortuosity group,and the tortuosity group was more likely to have more severe stenosis than the non-tortuosity group(Z=-3.292,P=0.001).The stenosis degree of the patients with no,mild,moderate and severe tortuosity was significantly different(H=17.787,P<0.001),and the differences had a rank correlation(r=0.169,P=0.000).However,the incidence of stenosis was not significantly different among the none,moderate,and severe tortuosity groups(all P>0.05).There was no significant difference among the incidence of stenosis among the mild,moderate,and severe coronary artery tortuosity group(all P>0.05). Conclusions Patients with coronary artery tortuosity are more likely to have coronary artery stenosis than those without tortuosity.The stenosis rate in patients with mild tortuosity is higher than in patients without tornuosity or with moderate tortuosity.Patients with mild tortuosity are more likely to experience more severe stenosis,while those without tortuosity are more likely to have milder stenosis.
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