Prevalence and pattern of abnormal myocardial perfusion in patients with isolated coronary artery ectasia: study by 99mTc-sestamibi radionuclide scintigraphy

Ismail, A Mamdouh; Rayan, Mona; Adel, Amr; Demerdash, Salah; Atef, Mohamed; Abdallah, Magda A.; Nammas, Wail

doi:10.1007/s10554-013-0331-6

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…The topographical extent of CAE and the ectasia ratio correlated positively with the mean TIMI frame count [11,17]. In addition, reversible perfusion defects were rather prevalent in isolated CAE and were more frequently related to diffuse ectasia [22]. However, there were conflicting results.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Coronary Artery Stenoses, Markis Class, and Ectasia Ratio in Patients with Coronary Artery Ectasia

Zhang

Huang²,

Li³

et al. 2015

Cardiology

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Objectives: To assess the prognostic value of coexisting coronary artery disease (CAD), Markis class, and ectasia ratio for major adverse cardiovascular events in patients with coronary artery ectasia (CAE). Methods: A total of512consecutive patients with angiographically proven CAE were enrolled. Coronary ectasia extent was graded using the Markis class, and ectasia severity was assessed based on the ectasia ratio. Patients were followed up for a median of 34.6 months. Results: In the current study, 76 cases had isolated CAE, while the remaining 436 cases had coexisting CAD (mixture CAE). Males (84.4%) were predominantly affected, and the right coronary artery (55.1%) was most commonly involved. During follow-up, 86 overall major adverse cardiovascular events were diagnosed. Kaplan-Meier analysis failed to reveal any differences between isolated and mixture CAE in both cumulative and event-free survival analyses (p = 0.429 and p = 0.277, respectively). Moreover, when patients were divided into 4 groups according to Markis class (type I-IV) or 2 groups based on the ectasia ratio (1.5-2.0 and >2.0), there was no significant difference in survival outcomes among the groups (p > 0.05). Conclusions: In this follow-up study with a relatively large sample, the survival rate of patients with CAE appeared to be independent of coexisting CAD and ectasia extent and severity.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Coronary Artery Stenoses, Markis Class, and Ectasia Ratio in Patients with Coronary Artery Ectasia

Zhang

Huang²,

Li³

et al. 2015

Cardiology

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“…Reversible perfusion defects were rather prevalent, generally mild, and more likely to affect the basal and mid-segments of the myocardium. These were more frequently associated with diffuse ectasia [36].…”

Section: Pathophysiology Of Ischemia In Coronary Artery Ectasiamentioning

confidence: 97%

Coronary artery ectasia

Eitan

Roguin

2016

Coronary Artery Disease

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Coronary artery ectasia (CAE) is defined as a segment of the coronary artery that has a diameter of more than 1.5 times the normal adjacent segments. It was described many years ago, but many aspects of this phenomenon are still unknown. It can be found in 1.2-2% of patients referred for coronary angiography. Risk factors are similar to atherosclerosis, but not in all patients. Histology shows extensive destruction of the musculoelastic elements, with marked degradation of the medial collagen and elastin fibers with disruption of the internal and external elastic lamina. These patients have abnormal levels of matrix metalloproteinases and other related proteins. Yet, the actual etiology of CAE is still unknown. Advances in new and improved imaging modalities such as CT and magnetic resonance angiography enable easier and more accessible diagnosis and evaluation. Treatment is aimed mostly at common cardiovascular risk factors. In small series, CAE was associated with worse prognosis. Anticoagulation was never examined in large trials. Nitrates worsen the flow and should not be administered. Interventional treatments are also an option, but a challenging one. This review presents an update on the current knowledge on CAE.

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“…While the mixed group patients presented as ‘classical’ ASHD, clinically and angiographically, isolated CAE patients possibly suffer from ectasia related ischaemia , secondary to slow flow and/or thrombotic events. This latter mechanism in isolated CAE is supported by both clinical trials11 12 and cardiac imaging 13 14…”

Section: Discussionmentioning

confidence: 86%

Coronary artery ectasia: prevalence, angiographic characteristics and clinical outcome

et al. 2020

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ObjectiveDetermine coronary artery ectasia (CAE) prevalence and clinical outcome in a large cohort of patients underwent coronary angiography.MethodsIn an 11-year period, between 2006 and 2017, 20 455 coronary angiography studies were performed at a large university centre. Patients diagnosed with CAE based on procedure report were included in the final analysis.ResultsCAE was diagnosed in 174 out of 20 455 studies (0.85% per total angiograms, 161 patients). Patients’ average age was 59.6±11.2 years old with male predominance (90.7%). Diffuse ectasia morphology was most common (78.9%), followed by fusiform (16.1%) and saccular (5%). Mixed CAE and atherosclerotic heart disease (ASHD) was present in 75.2% of the patients and isolated CAE in 24.8%. The most common coronary artery involved was the right coronary artery (RCA) (79%). Following index angiography, all the isolated CAE group was managed conservatively, while 67% of the mixed CAE-ASHD group underwent coronary intervention. In an average follow-up of 6±3.6 years, adverse clinical event (a composite endpoint of any death, cerebrovascular accident, myocardial infarction, thromboembolic event, bleeding and stent thrombosis) occurred in 48.8% of the mixed CAE-ASHD group compared with 25% in the isolated CAE group (p<0.05).ConclusionsCAE is a rare phenomenon. The most common artery involved was the RCA, and the diffused type of CAE was the most frequent. Most patients with CAE have also concomitant ASHD, and those patients have higher mortality and complications rate, compared with isolated CAE disease.

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Prevalence and pattern of abnormal myocardial perfusion in patients with isolated coronary artery ectasia: study by 99mTc-sestamibi radionuclide scintigraphy

Cited by 7 publications

References 16 publications

Prognostic Value of Coronary Artery Stenoses, Markis Class, and Ectasia Ratio in Patients with Coronary Artery Ectasia

Prognostic Value of Coronary Artery Stenoses, Markis Class, and Ectasia Ratio in Patients with Coronary Artery Ectasia

Coronary artery ectasia

Coronary artery ectasia: prevalence, angiographic characteristics and clinical outcome

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