Fate of nonobstructive aneurysmatic coronary artery disease: Angiographic and clinical follow-up report

Rath, Shmuel; Har-Zahav, Yadael; Battler, Alexander; Agranat, Oren; Rotstein, Zeev; Rabinowitz, Babeth; Neufeld, Henry N.

doi:10.1016/0002-8703(85)90639-8

Cited by 143 publications

(122 citation statements)

References 35 publications

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“…The basic measurements of LV dimensions in diastole and systole, thickness of interventricular septum and posterior wall were measured by the M-mode technique. LV mass (LVM) was calculated by using the Devereux's formula: 11 LVM =0.8×[1.04×(septal thickness + posterior wall thickness + LV end diastolic diameter) 3 -(LV end diastolic diameter) 3 ]+0.6 g. LVM was then divided by body surface area to obtain LVM index (LVMI). The LV diameters, volumes and systolic functions were measured according to the recommendations of the American Society of Echocardiography.…”

Section: Echocardiographic Measurementsmentioning

confidence: 99%

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Aortic Elastic Properties in Patients With Coronary Artery Ectasia

Tüzün

Tanrıverdi

Evrengül

et al. 2007

Circ J

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oronary ectasia (CE) is a clinical situation which is characterized by luminal widening of the coronary arteries and the resultant decrease in the coronary blood flow. Its incidence has been reported to be between 0.3% and 4.9% in the autopsy and cardiac catheterization series. 1 Coronary atherosclerosis (50%), congenital diseases (20%), inflammatory diseases (10-20%), collagenous and connective tissue diseases are presumed to be responsible for its cause. 2 The essential histopathological finding in the diagnosis of CE is the replacement of coronary artery media layer smooth muscle cells with hyalinized collagen, as a consequence of the increased degeneration of the media layer. 3 As a result, the loss of musculo-elastic components is observed in the media. 2 Thus, progressive artery dilatation occurs. Moreover, along with this disease, the presence of extracardiac artery dilatation has been reported in the previous studies. 4,5 Arterial stiffness, which is defined as the arterial rigidity caused by the loss of elastic tissue in the artery wall, decreases the widening capacity of the artery. Many studies searching the effects of the cardiovascular risk factors on the arteries showed that, as a consequence of the structural changes in the arteries caused by these risk factors, arterial rigidity develops and arterial widening capacity is deteriorated. It has been established that as the stiffness of the large arteries such as aorta increases, cardiovascular mortality and morbidity also increase. 6 Consequently, aortic stiffness has recently been regarded as a risk factor that needs to be treated. 7 It has also been established that aortic stiffness is increased in individuals with coronary artery disease (CAD) and in those with atherosclerosis and that it is an independent predictor of CAD. 8 In the present study, we reported that there might possibly be a relationship between the increment in aortic stiffness and left ventricular (LV) diastolic dysfunction. 9 In the current study our objective was to investigate the elastic properties of the aorta in the patients with CE and the relationship between these characteristics and LV diastolic functions. Methods Study PopulationThe cases were selected from the patients who admitted to our cardiology department for coronary angiography between the years 2001 and 2004. The study population was divided into 3 groups according to the results of the coronary angiograms. A total of 105 patients were enrolled in the present study; in the first group there were 35 patients with CE, the second group consisted of 35 patients with CAD (coronary lesion causing ≥50% luminal narrowing in at least 1 coronary artery) and the third group consisted of 35 patients with normal coronary arteries. CE was defined as localized or diffuse non-obstructive lesions of the epicardial Aortic Elastic Properties in Patients WithCoronary Artery Ectasia Nurullah Tuzun, MD; Halil Tanriverdi, MD*; Harun Evrengul, MD*; Deniz Seleci Kuru, MD*; Asim Oktay Ergene, MD** Background The purpose of the present...

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Section: Echocardiographic Measurementsmentioning

confidence: 99%

“…2 The essential histopathological finding in the diagnosis of CE is the replacement of coronary artery media layer smooth muscle cells with hyalinized collagen, as a consequence of the increased degeneration of the media layer. 3 As a result, the loss of musculo-elastic components is observed in the media. 2 Thus, progressive artery dilatation occurs.…”

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confidence: 99%

Aortic Elastic Properties in Patients With Coronary Artery Ectasia

Tüzün

Tanrıverdi

Evrengül

et al. 2007

Circ J

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“…Considering that thrombus formation and distal embolization play crucial roles in pathogenesis of CEA [5,[11][12][13], anticoagulation and antiplatelet therapy should be beneficial to reduce cardiovascular events. In case series of Rath [14], 5 patients without obstructive coronary aneurysms developed acute myocardial infarction and complete occlusion of aneurysmal vessels without any anticoagulation and antiplatelet medications. Alloul [15] reported a case with isolated coronary aneurysm, who developed acute myocardial infarction when withdrawal of warfarin after 6 months of preventive anticoagulation.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and coronary features of coronary ectasia and aneurysm in China

Cheng¹,

Liu²,

Zhang³

et al. 2013

WJCD

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Objective: To describe the clinical characteristics and coronary features of patients with coronary ectasia and aneurysm (CEA) in China. Methods: This was a single center, retrospective clinical study. Patients with CEA who diagnosed by coronary artery angiography (CAG) from April 2003 to October 2009, were enrolled. All patients were followed up by the call or clinic visit. The primary outcome was all-cause mortality or cardiovascular readmission. Results: A total of 39 patients (27 males, mean age 59.5 ± 12.6 years) diagnosed with CEA, with a prevalence of 0.6% (a total of 6130 patients underwent CAG during the same period). Thirty-six patients constituted the study population, due to 3 patients lost of followup. The median follow-up was 27 months (1 -76). The single vessel was involved in 11 patients (31%), two vessels were involved in 14 patients (38%) and three or more vessels were involved in 11 patients (31%). The most common involved vessel was left anterior descending branch (n = 27), followed by right coronary artery (n = 23), left circumflex branch (n = 20) and left main branch (n = 9). There was no death during the follow-up. The primary outcome was observed in 8 (22%) patients. The use of clopidogrel and statins were associated with lower rate of cardiovascular readmission. Conclusion The incidence of CEA was low among patients who referred for CAG in China. The majority of patients had the involvement of multiple vessels, and left anterior descending branch was the most common involved vessel. The CEA patients may benefit from clopidogrel and statins.

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“…For symptomatic coronary artery aneurysm, most authors agree that surgery should be reserved for those patients with significant coronary stenosis, or those with significant angina despite adequate medical treatment. [8][9][10] Surgical experience (resection of the aneurysm with end-to-end interposition of a saphenous vein autograft) has shown an excellent outcome if performed when indicated. [11][12][13] A few authors recommend prophylactic surgical repair for saccular aneurysms with higher risk of thrombosis or rupture, 12,14 although the evidence to support this recommendation is lacking.…”

Section: Discussionmentioning

confidence: 99%

Giant Coronary Artery Aneurysm

Assiri

2000

Ann Saudi Med

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Coronary artery aneurysm is an uncommon disease. It is defined as a coronary artery dilatation, which can be saccular or fusiform, and exceeds the diameter of the normal adjacent segment or the diameter of the patient's largest coronary vessel by 1.5-2 times.1,2 The natural history and prognosis of this disease remain obscure, and management continues to be a therapeutic dilemma, as most of the published recommendations are based on anecdotal experience. We report a giant left circumflex artery aneurysm, which we believe is the largest reported coronary aneurysm in the English literature. Case ReportA 72-year-old man with no previous history of coronary artery disease presented to another hospital with a history of fever, chills, productive cough and shortness of breath for two months, progressing to hypercarbic respiratory failure on admission. He required intubation for two days, and was managed with intravenous antibiotics for the working diagnosis of pneumonia, based on clinical and radiological features. The patient was then transferred to our institution for further management. There was no history of smoking, diabetes or hypertension. He had a history of chronic bronchitis for 10 years, which had been treated intermittently with bronchodilators. He had no previous history of congestive heart failure.On physical examination, the patient was obese, afebrile, and in mild respiratory distress. His blood pressure was 100/60 mm Hg, and his heart rate was 80 beats/minute, which was regular. Jugular venous pressure was elevated at 8 cm above the sternal angle. Chest examination revealed bilateral coarse crepitations, and bronchial breath sounds were present over the left lower lung zone. Mitral and tricuspid valve regurgitation murmurs were present. Lower limb pitting edema was present up to the knees.On admission, the patient's arterial blood gas analysis showed a PO 2 of 60 mm Hg, PCO 2 of 106 mm Hg, and pH of 7.2 on room air. ECG revealed voltage criteria for left ventricular hypertrophy and nonspecific ST-segment changes. Cardiac enzymes (CK and troponin) were normal. Pulmonary function tests and a sleep study suggested central hypoventilation with no evidence of obstructive lung disease. Chest x-ray showed widened mediastinum, cardiomegaly, left lower lobe consolidation and small bilateral pleural effusions. CT scan of the thorax without contrast revealed a probable left ventricular aneurysm, and a very unusual dilated vessel with some calcification in its wall. The aneurysm was located along the superior aspect of the left atrium, and had the appearance of an aneurysmally dilated coronary artery, possibly the circumflex artery.The transthoracic echocardiography was a technically difficult study. Transesophageal echocardiography revealed moderate mitral regurgitation and a 6.6-cm vascular mass arising from the left circumflex artery. There was no evidence of a connection between the vascular mass and coronary sinus, pulmonary artery or any cardiac chambers. Left ventricular function was normal.Coronary angio...

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Fate of nonobstructive aneurysmatic coronary artery disease: Angiographic and clinical follow-up report

Cited by 143 publications

References 35 publications

Aortic Elastic Properties in Patients With Coronary Artery Ectasia

Aortic Elastic Properties in Patients With Coronary Artery Ectasia

Clinical characteristics and coronary features of coronary ectasia and aneurysm in China

Giant Coronary Artery Aneurysm

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