Coronary tortuosity relation with carotid intima-media thickness, coronary artery disease risk factors, and diastolic dysfunction: is it a marker of early atherosclerosis?
| Autor: | Samuel Yakoub, Waleed Ammar, Ahmed Elamragy, Mohamed Abdelghany |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system Intima-media thickness atherosclerosis Ischemia Diastole Coronary Tortuosity 030204 cardiovascular system & hematology Coronary artery disease 03 medical and health sciences 0302 clinical medicine Internal medicine Hyperlipidemia Medicine 030212 general & internal medicine cardiovascular diseases Carotid business.industry Research Area under the curve Odds ratio medicine.disease medicine.anatomical_structure Intima-media thickness lcsh:RC666-701 Cardiology business Artery |
| Zdroj: | The Egyptian Heart Journal, Vol 73, Iss 1, Pp 1-9 (2021) The Egyptian Heart Journal |
| Popis: | Background Coronary tortuosity (C-Tor) is a common finding in coronary angiography (CAG). There are conflicting data about its link to atherosclerosis: one study found a negative relationship with coronary artery disease (CAD), although it had been linked to age and hypertension (HTN), which are CAD risk factors. Carotid intima-media thickness (C-IMT) is a measure of early atherosclerosis and a surrogate for CAD, diastolic dysfunction is also associated with CAD risk factors. In this retrospective case-control study, we investigated the relationship between C-Tor, C-IMT, diastolic dysfunction, and the other risk factors in patients undergoing CAG in a tertiary hospital between July 2017 and June 2018, after excluding patients with significant CAD. C-Tor was defined as the presence of ≥ 3 bends (≥ 45°) along the trunk of at least one main coronary artery in CAG. Results After excluding 663 patients due to exclusion criteria, 30 patients with C-Tor were compared with age and gender-matched controls. HTN was significantly more common in the C-Tor group (86.7% vs. 30%, p < 0.002); other clinical characteristics were similar. The C-IMT was abnormal in the C-Tor group only (p: 0.007). The diastolic dysfunction parameters differed between the two groups: the E/A ratio was 1 in the normal group (p: p: 0.001 and p: 0.005, p: 0.078). The C-Tor group had higher total cholesterol and LDL (p: 0.003 and 0.006 respectively). All C-Tor patients undergoing stress tests had positive results. The only independent C-Tor predictors in a regression analysis were HTN, total cholesterol, A-wave velocity, and deceleration time (DT) (odds ratio: 14.7, 1.03, 1.15, and 0.95, all p: Conclusion C-Tor is associated with increased C-IMT, HTN, hyperlipidemia, and left ventricular diastolic dysfunction; all contributing to an ongoing atherosclerotic process. A-wave velocity and DT were independent predictors of C-Tor. C-Tor may cause microvascular ischemia that merits further investigation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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