Accelerated atherosclerosis in subjects with some minor deviations from the common type of distribution of human coronary arteries
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Anatomical variations in coronary artery branching patterns were identified in young adults. These deviations, particularly imbalances between left and right coronary systems, are linked to accelerated atherosclerosis and increased coronary heart disease risk.
Area of Science:
- Cardiovascular Anatomy
- Pathology
- Genetics
Background:
- The coronary arteries' anatomical branching patterns are crucial for cardiac function.
- Understanding variations in these patterns may reveal predispositions to cardiovascular disease.
- Atherosclerosis development is influenced by both genetic and environmental factors.
Purpose of the Study:
- To investigate the prevalence of common and variant coronary artery branching patterns in a young population.
- To determine the association between specific anatomical deviations and the early onset/progression of atherosclerosis.
- To evaluate the potential of these deviations as genetically transmitted risk factors for coronary heart disease.
Main Methods:
- Gross dissection of coronary arteries from 566 subjects aged 0-45 years from an unselected Bucharest population.
- Identification and classification of anatomical branching patterns, noting deviations from a common type.
- Correlation of identified deviations with intima thickness, atherosclerotic plaque characteristics, and luminal obstruction.
Main Results:
- A similar anatomical branching pattern was observed in 58% of subjects.
- Fifteen minor deviations from the common pattern were identified, with varying associations with atherosclerosis.
- A significant deviation involving disproportionate development of the left and right coronary arterial systems was present in 29% of cases and associated with accelerated atherosclerosis.
Conclusions:
- Specific anatomical deviations in coronary artery distribution, particularly asymmetric development, are linked to accelerated atherosclerosis.
- These atherogenic deviations appear to be an important genetically transmitted risk factor for coronary heart disease.
- Further research into the genetic basis of these variations is warranted.
Abstract:
Gross dissection of the coronary arteries of 566 subjects aged 0--45 years from an unselected population sample of Bucharest revealed the presence of a similar anatomical branching pattern in 58% of cases. Starting from this common type of distribution of coronary arteries, some minor deviations were detected coexisting with a thicker intima, a more rapid onset and evolution of atherosclerotic plaques, and a more important degree of luminal obstruction. Among the 15 minor deviations described in this paper, 3 were constantly associated, 9 only occasionally associated and 3 not associated with an accelerated atherosclerosis. The most important of these atherogenic deviations was present in 29% of cases or in 1 out of every 3 or 4 subjects. In essence, these deviations consisted of an excessive increase in external diameter and length of the left coronary arterial system, coexisting with an underdeveloped right coronary arterial system, or vice versa. The atherogenic deviations from the common type of distribution of the coronary arteries seemed to represent an important genetically transmitted risk factor for coronary heart disease.