Impact of coronary artery tortuosity in ischemic and non-ischemic cardiovascular pathology

Mihai, Dumitru Emilian; Lupasteanu, Ioana; Dan, Gheorghe Andrei

doi:10.2478/rjim-2021-0003

Cited by 5 publications

(7 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This insufficiently explored entity may play a significant role in the development of ischemic signs and symptoms in patients without significant coronary obstruction. Several previous studies proposed coronary tortuosity as a potential cause of ischemia in non-obstructive CAD, but there are a lack of studies to confirm this relationship in the clinical setting [ 4 , 20 , 21 ]. A possible mechanism for developing ischemia is a reduction in distal perfusion pressure and coronary flow in the myocardial regions supplied by tortuous coronary arteries.…”

Section: Discussionmentioning

confidence: 99%

The Association of Severe Coronary Tortuosity and Non-Obstructive Coronary Artery Disease

Zebic Mihic,

Saric,

Bilic Curcic

et al. 2023

Medicina

View full text Add to dashboard Cite

Background and Objectives: There is an increasing interest in the coronary tortuosity as a novel pathophysiological mechanism of ischemia in coronary artery disease without significant obstruction, but there are a lack of studies to confirm this relationship in the clinical setting. The aim of our study was to evaluate the association of severe coronary tortuosity and the potential role of coronary blood supply dominance in the appearance of myocardial ischemia in patients with non-obstructive coronary artery disease (non-CAD), compared to patients with obstructive coronary artery disease (CAD). Materials and Methods: The study enrolled 131 participants (71 male and 60 female), recruited among patients referred to cardiologists due to angina symptoms with ischemic alterations established by cardiac stress tests, as well as those admitted to the hospital for acute coronary syndrome. Results: Mean age of recruited patients was 61.6 (±10.1) years. According to the coronary angiography, they were divided into two groups: non-obstructive and obstructive CAD (77 and 54, respectively). There were significantly more women (61% vs. 24%, p < 0.001) in the non-CAD group. Both tortuous coronary arteries (50.6% vs. 14.8%, p < 0.001) and left coronary dominance (37.7% vs. 16.7%, p = 0.006) were more frequent in the non-CAD group compared to the CAD group. Female sex (OR = 17.516, p = 0.001), tortuous coronary arteries (OR = 7.962, p = 0.006) and left dominance of blood supply were significant predictors for non-CAD. Conclusions: Non-obstructive CAD is common among patients, especially women, who are referred for coronary angiography. Severe coronary artery tortuosity is the strongest independent predictor of non-obstructive CAD, followed by female gender and left coronary dominance.

show abstract

Section: Discussionmentioning

confidence: 99%

The Association of Severe Coronary Tortuosity and Non-Obstructive Coronary Artery Disease

Zebic Mihic,

Saric,

Bilic Curcic

et al. 2023

Medicina

View full text Add to dashboard Cite

show abstract

“…Consequently, postadjustment results could differ from preadjustment ones. Coronary flow impairment in these conditions is correlated with myocardial function impairment, and it does not denote a causal relationship between impaired coronary flow and myocardial dysfunction. Several factors, such as inflammation and ischemia, might accompany these conditions, leading to myocardial dysfunction 1,2,4 The literature includes a dearth of data on issues such as the diastolic function of the LV and the atrial phasic function in CSFP, CAE, and CAT.…”

Section: Discussionmentioning

confidence: 99%

“…Several factors, such as inflammation and ischemia, might accompany these conditions, leading to myocardial dysfunction. 1,2,4 8. The literature includes a dearth of data on issues such as the diastolic function of the LV and the atrial phasic function in CSFP, CAE, and CAT.…”

Section: Caementioning

confidence: 99%

“…Objectively, the thrombolysis in myocardial infarction (TIMI) frame count rises in these three conditions 1–3 . CSFP is described as the late opacification of the contrast material in the distal portion of the coronary arteries during coronary angiography, CAE is defined as the dilation of 1 or more segments of the coronary arteries greater than 1.5 times the size of a normal contiguous segment, and CAT is defined as the spiral course of the epicardial coronary arteries during the cardiac cycle in at least 1 epicardial coronary artery, with each bend showing a 45° change in vessel direction 1,2,4 . The prevalence rates of CSFP, CAE, and CAT vary among studies and range from 1% to 7%, 0.85% to 5.3%, and 12% to 40% of patients having undergone coronary angiography, respectively 4–6 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of cardiac chamber functions by speckle‐tracking echocardiography in the presence of coronary artery flow disturbances other than stenosis: A review

Khederlou

Hosseinsabet

2023

J of Clinical Ultrasound

View full text Add to dashboard Cite

Conditions other than stenosis also disturb the coronary flow. Such conditions include the coronary slow flow phenomenon, coronary artery ectasia, and coronary artery tortuosity. Evidence exists regarding myocardial dysfunction in these conditions. In this review, we present studies that have used speckle-tracking echocardiography to determine whether coronary flow disturbances are accompanied by myocardial dysfunction. Additionally, we seek to show the gaps in knowledge concerning this issue and the dimensions that future studies should consider.

show abstract

“…Several previous studies showed that coronary tortuosity may have an important role in the development of ischemic alterations in non-obstructive coronary artery disease [ 8 , 14 , 28 ]. Our study confirms this finding since we detected significantly more tortuous coronary arteries in the group of patients without significant obstruction of coronary arteries, including all three main coronary arteries.…”

Section: Discussionmentioning

confidence: 99%

Coronary Tortuosity Index vs. Angle Measurement Method for the Quantification of the Tortuosity of Coronary Arteries in Non-Obstructive Coronary Disease

Zebic Mihic,

Arambasic,

Mlinarevic

et al. 2023

Diagnostics

View full text Add to dashboard Cite

Coronary tortuosity has been recognized as a potential pathophysiological mechanism in the development of non-obstructive coronary artery disease (CAD). The aim of this study was to examine the role of two coronary tortuosity measurement methods in the detection of clinically significant coronary tortuosity. The study included 160 patients with angina symptoms and myocardial ischemia detected by cardiac stress tests in chronic settings and those diagnosed with acute coronary syndrome. After coronary angiography, tortuosity of coronary arteries was assessed by two methods, including measurement of tortuosity angles and calculating of tortuosity index. Significantly more tortuous coronary arteries were detected in the group with non-obstructive CAD (p < 0.01 for all three arteries), with significantly higher tortuosity index (TI) for all three coronary arteries in this group of patients, compared to patients with obstructive CAD. The highest TI for LCX was found in patients with lateral ischemia (p < 0.001) and for LAD in patients with anterior ischemia (p < 0.001). When measured by the angle method, the only association was found between LCX tortuosity and lateral ischemia (OR 4.9, p = 0.046). In conclusion, coronary tortuosity represents a pathophysiological mechanism for myocardial ischemia in non-obstructive CAD. The coronary tortuosity index could be a reliable and widely applicable tool for the quantification of coronary tortuosity.

show abstract

Impact of coronary artery tortuosity in ischemic and non-ischemic cardiovascular pathology

Cited by 5 publications

References 33 publications

The Association of Severe Coronary Tortuosity and Non-Obstructive Coronary Artery Disease

The Association of Severe Coronary Tortuosity and Non-Obstructive Coronary Artery Disease

Evaluation of cardiac chamber functions by speckle‐tracking echocardiography in the presence of coronary artery flow disturbances other than stenosis: A review

Coronary Tortuosity Index vs. Angle Measurement Method for the Quantification of the Tortuosity of Coronary Arteries in Non-Obstructive Coronary Disease

Contact Info

Product

Resources

About