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Risk factors and major adverse cardiovascular events of isolated coronary artery ectasia: An observational study
Xiuchun Yang1, Yijun Zong2, Zhentian Zhang1
1Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China.
Insights
Coronary artery ectasia (CAE) is associated with thicker heart walls and altered diastolic function. However, isolated CAE did not show increased major adverse cardiovascular events (MACE) or death within one year.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Echocardiography
Background:
- Coronary artery ectasia (CAE) is a rare condition characterized by localized or diffuse widening of coronary arteries.
- The clinical implications and cardiac function in patients with isolated CAE require further investigation.
Purpose of the Study:
- To compare cardiac function and major adverse cardiovascular events (MACE) between patients with isolated CAE and a control group over a one-year follow-up period.
Main Methods:
- Dobutamine stress echocardiography (DSE) was performed on 18 patients with isolated CAE and 36 controls.
- Measurements included chamber size, wall thickness, ejection fraction, and diastolic function (E/A, e', E/e').
- MACE and all-cause death were monitored for one year post-discharge.
Main Results:
- Patients with CAE exhibited significantly higher interventricular septum thickness (IVSd), left ventricular posterior wall (LVPW) thickness, and E/e' ratio compared to controls.
- No significant differences were observed in MACE, angina, myocardial ischemia, readmission, or cardiovascular death between the groups.
- Body Mass Index (BMI) and IVSd were identified as independent risk factors for isolated CAE.
Conclusions:
- Isolated CAE is associated with specific echocardiographic findings of cardiac remodeling and diastolic dysfunction.
- Despite these findings, isolated CAE does not appear to increase short-term MACE or mortality risk.
- BMI and IVSd are valuable predictors for identifying patients with isolated CAE.
Abstract:
To evaluate the cardiac index and major adverse cardiovascular events (MACE) events between isolated coronary artery ectasia (CAE) and control groups over 1 year period from diagnosis. A total of 18 patients who were diagnosed with isolated CAE in the Second Hospital of Hebei Medical University from December 2020 to December 2021 were included in CAE group. About 36 patients with non-obstructive coronary artery lesions were included in the control group. All patients in 2 groups completed dobutamine stress echocardiography (DSE) during hospitalization. The chamber size, wall thickness, left ventricular ejection fraction, and left ventricular diastolic function indicators (including E/A ratio, e', and E/e' ratio) were measured. MACE and all-cause death were measured during follow-up after discharge. Interventricular septum thickness (IVSd), left ventricular posterior wall (LVPW) thickness in diastole and E/e' in CAE group were significantly higher than control group (P < .05). No significant differences were found in prognosis including angina, myocardial ischemia (MI), patient readmission and cardiovascular death (P > .05). In CAE group, coronary angiography showed dilation of left anterior descending (LAD) in 1 case, left circumflex (LCX) in 3 cases and right coronary artery (RCA) in 14 cases. Multivariate logistic regression analysis showed that BMI and IVSd were independent risk factors for CAE. IVSd, LVPW thickness in diastole and E/e' in CAE group were significantly higher than control group. BMI and IVSd were independent risk factors for isolated CAE, and had a good predictive value for isolated CAE.
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