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Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
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Impact of coronary artery tortuosity in ischemic and non-ischemic cardiovascular pathology

Dumitru Emilian Mihai1,2, Ioana Lupasteanu1, Gheorghe Andrei Dan3,1,2

  • 1Cardiology Department, Colentina Clinical Hospital, Bucharest, Romania.

Romanian Journal of Internal Medicine = Revue Roumaine De Medecine Interne
|February 5, 2021
PubMed

Insights

Coronary artery tortuosity, a condition where arteries curve abnormally, can cause ischemia in non-obstructive coronary artery disease. This review explores its link to hypertension, heart function, and interventional challenges.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Medical Imaging

Background:

  • Coronary artery tortuosity is increasingly recognized as a significant factor in cardiovascular pathology.
  • Existing literature suggests a potential link between arterial tortuosity and ischemic events, particularly in non-obstructive coronary artery disease (CAD).
  • Hypertension is frequently associated with a higher prevalence of coronary tortuosity, necessitating further investigation into the underlying physio-pathological mechanisms.

Observation:

  • This review synthesizes current research on the physio-pathological implications of coronary artery tortuosity.
  • The study examines the role of tortuosity in inducing myocardial ischemia, especially in patients without obstructive coronary lesions.
  • Particular attention is given to the association between severe hypertension, hypertrophic heart conditions, and increased coronary tortuosity, exploring fluid dynamics and physiological changes.

Findings:

  • Coronary artery tortuosity can act as an independent physio-pathological mechanism contributing to ischemia in non-obstructive CAD.
  • The physio-pathological processes and altered fluid dynamics in hypertrophic hearts, exacerbated by severe hypertension, are linked to a higher prevalence of coronary tortuosity.
  • Coronary tortuosity negatively impacts systolic function, specifically longitudinal function and ventricular relaxation, and presents significant technical challenges during percutaneous coronary interventions.

Implications:

  • Understanding the role of coronary tortuosity is crucial for diagnosing and managing ischemia in patients with non-obstructive CAD.
  • Further research into the interplay between hypertension, cardiac structure, and coronary tortuosity may reveal novel therapeutic targets.
  • Addressing the technical complexities associated with tortuous coronary arteries is essential for improving outcomes in interventional cardiology.

Keywords:
arterial hypertensioncoronary tortuositymyocardial ischemiapercutaneous coronary interventionsystolic function

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