Isolated coronary artery ectasia debate: Inflammation versus atherosclerosis

Daoud, Eid M.; Abdelaziz, Ayman Ahmed; Hassan, Nahed Abdallah

doi:10.1016/j.ehj.2012.06.001

Cited by 5 publications

(3 citation statements)

References 36 publications

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“…Patients with isolated CAE, as compared with CAD and control group, showed higher concentration of soluble ICAM-1 suggesting the presence of a more severe chronic inflammation in the coronary circulation in these patients. 28 England et al 29 has reported an increased frequency of CAE in individuals who had been exposed to acetylcholinesterase inhibitors containing herbicide sprays, thus implicating the role of nitric oxide in the pathogenesis of CAE.…”

Section: Discussionmentioning

confidence: 99%

Isolated coronary artery ectasia: Clinical, angiographic, and follow up characteristics

Malviya

Jha

Mishra

2017

Indian Heart Journal

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BackgroundIsolated Coronary artery ectasia (CAE) is considered an uncommon angiographic finding with varying patterns of presentation and carries significant morbidity burden to the patient. Our objective was to evaluate the prevalence of this condition, to analyse its clinical, angiographic, and follow up characteristics.Patients and methodsCoronary angiography was performed in 4950 patients from January 2009 to August 2014. The epidemiological, clinical, angiographic, and follow up characteristics of 52 patients with isolated CAE were examined.ResultsOf the 4950 angiograms analysed, isolated CAE was found in 52 patients, a prevalence of 1.05 %. The mean age of patients was 53.4 years. A predominance of the male sex was observed (71.1%). Angina on exertion was the most common presenting symptom (61.5%). Single vessel was involved in 61.5%. Left anterior descending artery was the most commonly involved vessel followed by right coronary artery, left circumflex and left main coronary artery. Type IV CAE as per Markis classification was the most common involvement. The median follow-up was 28 ± 20 months, during which 10 patients (19.2%) had recurrent chest pain, and four patients were re-hospitalised, three for unstable angina, one for myocardial infarction.ConclusionThe prevalence of isolated coronary ectasia was 1.05%. The majority of patients had single vessel involvement, and left anterior descending branch was the most common involved vessel. This condition may not be considered completely benign, as it is associated with atherosclerotic risk factors and occurrence of coronary events including angina and myocardial infarction.

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Section: Discussionmentioning

confidence: 99%

Isolated coronary artery ectasia: Clinical, angiographic, and follow up characteristics

Malviya

Jha

Mishra

2017

Indian Heart Journal

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“…The search yielded 22 potentially relevant nonrandomized and retrospective studies published from 2000 to 2013. [6][7][8][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Exclusion criteria described in the articles selected included the following: recent or current myocardial infarction, acute coronary syndromes, left ventricular dysfunction, left ventricular hypertrophy, cardiomyopathies, congenital heart disease, valvular heart disease, inflammatory arrhythmias or immunologic diseases, active infection, hepatic, renal or thyroid functional abnormalities, immunosuppressive therapy and statin use.…”

Section: Methodsmentioning

confidence: 99%

“…25 Patients with isolated CAE have elevated levels of plasma soluble ICAM-1, VCAM-1 and E-selectin in comparison with patients with obstructive CAD but without CAE and in comparison with NCA subjects, with ICAM-1 being the only independent variable associated with isolated CAE, suggesting that ectasia develops in an intensively inflammatory vascular wall that predisposes to plaque instability. 15 VEGF is a key regulator of physiological angiogenesis during embryogenesis, skeletal growth and reproductive functions. VEGF, which increases in response to inflammation, may play a role in the pathogenesis of coronary artery lesions.…”

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confidence: 99%

Inflammatory mediators of coronary artery ectasia

Yuan

2014

J. vasc. bras.

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The exact mechanisms underlying coronary artery ectasia (CAE) remain uncertain. This study aims to investigate whether and how inflammatory mediators play a role in the pathogenesis of CAE. The data sources of this study were located by literature searches on MEDLINE, Highwire Press and Google search engine for the year range 2000-2013. The most sensitive of the four types of plasma inflammatory mediators were cell adhesion molecules and systemic inflammatory markers followed by cytokines, while proteolytic substances were the least sensitive indicators of CAE. Hypersensitive C-reaction protein, homocysteine, intercellular adhesion molecule 1, vascular cell adhesion molecule 1, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-2, vascular endothelial growth factor and neopterin levels were significantly higher in CAE and coronary artery disease (CAD) patients than in controls without CAE. The percentage of granulocytes was higher in CAE, in comparison with individuals with normal coronary arteries. Polymerase chain reaction determination of angiotensin converting enzyme genotypes showed that the DD genotype was more prevalent in CAE patients than in CAD patients, while prevalence of the I allele was higher in CAD than in CAE patients. CAE is more a result of inflammatory processes than of extracellular matrix degradation, as demonstrated by investigations of plasma inflammatory mediators, activation markers and angiotensin converting enzyme genotypes. Contemporary theories are unable to explain CAE' s predilection for the right coronary artery or the occurrence of multi-vessel and multi-segment involvement.Keywords: coronary aneurysm; extracellular matrix; inflammation mediators. ResumoOs mecanismos exatos da ectasia de artérias coronárias (EAC) não são completamente compreendidos. Este estudo busca verificar, em detalhes, se e como os mediadores inflamatórios funcionam na pathogenesis de EAC. A fonte de dados do presente estudo veio da recuperação de literatura das investigações relevantes em MEDLINE, na Prensa de Highwire e na ativação de pesquisa do Google, do ano 2000 para 2013. Dos quatro tipos de mediadores inflamatórios do plasma, as moléculas de adesão de célula e os marcadores inflamatórios sistêmicos foram os mais sensíveis, sendo que cytokines foram mais sensíveis e substâncias de protease foram menos sensíveis na indicação da presença de EAC. A proteína C reativa hipersensível, o homocysteine, a molécula de adesão intercelular 1, a molécula de adesão de célula vascular 1, a matriz metalloproteinase-9, o nervo inibidor de tecido de metalloproteinase-2, o fator de crescimento endothelial vascular e os níveis de neopterin foram mais altos nos pacientes com EAC do que nos controles sem EAC. A porcentagem de granulocytes foi mais alta no grupo EAC, comparando-se com os indivíduos com a artéria coronária normal. A determinação de genótipo de enzima do angiotensin-conversão utilizando-se a técnica de reação em cadeia da polimerase revelou que o genótipo DD foi prevalecente na EAC, ma...

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