The Atrial Coronary Arteries in Man

James, Thomas N.; Burch, George E.

doi:10.1161/01.cir.17.1.90

Cited by 127 publications

(48 citation statements)

References 15 publications

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“…27 Otherwise, someone could be concerned that LA function should reduce in patients with LCX stenosis since LA is supplied predominantly by branches arising from LCX, with variable contributions from RCA. 28 There are some discrepant results. For instance, the report by Stefanadis et al 29 concluding LA active pump function is unable to increase in LCX stenosis is against the result of Murata et al demonstrating LA active pump function increased to 144% at 60 min of LCX occlusion.…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Distensibility and E/e' for Estimating Left Ventricular Filling Pressure in Patients With Stable Angina - A Comparative Echocardiography and Catheterization Study -

Hsiao

Chiou

Lin

et al. 2011

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp iastolic dysfunction has a significant impact on prognosis in a wide range of cardiac disorders. 1 Noninvasive methods of estimating left ventricular filling pressure (LVFP) are often helpful for diagnosing and treating diastolic heart failure. Some echocardiographic parameters associated with left ventricular (LV) diastolic function, such as mitral inflow velocities, deceleration time, and pulmonary venous flow velocities, are significantly influenced by preload. 2,3 Tissue Doppler imaging (TDI) is relatively preload independent, 4,5 and E/e' (the ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity) has been proposed to provide a non-invasive measure of LVFP. 6 However, TDI was developed to assess regional function, 7-12 and its value for estimating global diastolic function in coronary artery disease (CAD) with regional function abnormalities is by implication limited. Thus, the application of E/e' for estimating LVFP might be more appropriate for patients with global LV dysfunction. Our previous report 13 indicated that left atrial (LA) distensibility correlates logarithmically with LVFP in patients with severe mitral regurgitation. It was the first comparative echocardiographic-catheterization study to demonstrate the correlation between a LA volume parameter and LVFP. We hypothesized that LA distensibility could become an indicator of global diastolic function and might be useful for assessing LVFP not only in patients with mitral regurgitation but also in those with stable angina. Thus, we analyzed the relationship between LA volume parameters and LVFP in CAD patients with stable angina and performed a head-to-head comparison of those 2 parameters (E/e' and LA volume parameter) for the accuracy of assessing LVFP Background: Although E/e' (the ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity) is widely used to measure left ventricular filling pressure (LVFP), its accuracy is questionable in coronary artery disease patients.

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Section: Discussionmentioning

confidence: 99%

Left Atrial Distensibility and E/e' for Estimating Left Ventricular Filling Pressure in Patients With Stable Angina - A Comparative Echocardiography and Catheterization Study -

Hsiao

Chiou

Lin

et al. 2011

Circ J

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“…15,16 (2) The left atrial circumflex artery that arises from the proximal left circumflex artery and supplies most of the left atrium. 15, 17 (3) The atrioventricular nodal artery that originates from the right coronary artery in 90% of patients and from the left circumflex artery in 10% of patients and supplies the atrioventricular node and also the left atrium directly and/or by anastomoses with other left atrial branches.…”

Section: Methodsmentioning

confidence: 99%

“…15, 17 (3) The atrioventricular nodal artery that originates from the right coronary artery in 90% of patients and from the left circumflex artery in 10% of patients and supplies the atrioventricular node and also the left atrium directly and/or by anastomoses with other left atrial branches. [5][6][7][8][9][10][11][12][13][14][15][16][17][18] Early atrial fibrillation. Only seven of the 214 patients (3%) developed atrial fibrillation within 3 hr of the onset of chest pain.…”

Section: Methodsmentioning

confidence: 99%

Early atrial fibrillation during evolving myocardial infarction: a consequence of impaired left atrial perfusion.

Hod¹,

Lew²,

Keltai³

et al. 1987

Circulation

106

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Seven of 214 patients (3%) with acute myocardial infarction (120 inferior and 94 anterior) developed atrial fibrillation within 3 hr of the onset of chest pain. All seven patients had an inferior infarction and in all seven the left circumflex artery was occluded proximal to the origin of its left atrial circumflex branch. In five patients this occlusion was acute and was the cause of inferior infarction and in the remaining two patients the occlusion was old and the inferior infarction was due to an acute occlusion of the right coronary artery that also supplied extensive collaterals to the previously occluded left circumflex artery. All seven patients also had impaired perfusion to the atrioventricular nodal artery, as evidenced by total occlusion proximal to its origin or by stenosis proximal to its origin associated with second-or third-degree atrioventricular block. In contrast, early atrial fibrillation did not occur in any of the 18 patients with inferior myocardial infarction due to acute occlusion of the distal left circumflex artery or in any of the five patients with inferior infarction due to acute occlusion of the proximal left circumflex artery if perfusion to the atrioventricular nodal artery was not impaired. Early atrial fibrillation did not occur in any of the 90 patients with inferior infarction due to acute occlusion of the right coronary artery, including 12 patients with occlusion proximal to the sinus nodal artery, but without coexistent occlusion of the left circumflex artery. Our data indicate that early atrial fibrillation in acute myocardial infarction occurs when there is coexistent occlusion of the left circumflex artery proximal to the origin of its left atrial circumflex branch and impaired perfusion of the atrioventricular nodal artery. Since these two arteries both contribute to left atrial perfusion, our data suggest that acute left atrial ischemia is the pathophysiologic mechanism of early atrial fibrillation.Circulation 75, No. 1, 146-150, 1987. ATRIAL FIBRILLATION complicates acute myocardial infarction in about 20% of patients. It usually occurs later than 24 hr after the onset of infarction as a consequence of either pericarditis or heart failure.1 In contrast, atrial fibrillation during the early hours of myocardial infarction is rare`and its pathogenesis is poorly understood. The purpose of this study was to investigate the pathogenesis of atrial fibrillation in the early hours of an acute myocardial infarction in a population of patients who were admitted within 3 hr of the

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“…The SAN artery most often arises as a small branch from the RCA, but in 40% of patients it originates from the LCx [4,5]. If it arises from the LCx then in approximately one-third of cases the SAN artery adopts a long S-shaped course [6].…”

Section: Case Reportmentioning

confidence: 99%

An S-shaped sinoatrial nodal artery coronary artery fistula demonstrated by multidetector CT

MacDuff

Roditi²

2011

BJR

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ABSTRACT. The presented case and discussion illustrate the use of CT coronary angiography to depict coronary artery fistulae. A 41-year-old man presented with an acute myocardial infarction. Invasive angiography revealed an incidental coronary artery fistula but was unable to depict its course. CT coronary angiography was undertaken to define the course and termination of the fistula. This confirmed a fistulous connection between the left circumflex artery and the superior vena cava that followed the typical course of an S-shaped sinoatrial nodal artery. Even in such an unusual anomaly this case highlights the ability of CT coronary angiography to accurately depict the coronary artery anatomy. A coronary artery fistula is an abnormal communication between a coronary artery and a cardiac chamber, great artery or vein. In this report we present an unusual case of a patient who had a fistula between the left circumflex (LCx) artery and the superior vena cava (SVC), which followed the course of an S-shaped sinoatrial nodal artery (SSNA). Case reportA 41-year-old man presented to the accident and emergency department with chest pain. Initial investigations confirmed an acute posterior myocardial infarction. Invasive coronary angiography was undertaken with a view to primary angioplasty. Angiography demonstrated a stenosis of the mid-segment of a non-dominant ''circumflex vessel''. In view of the small size of the vessel and symptom resolution, no intervention was performed. However, a large coronary artery fistula was shown arising from the LCx artery. The site of fistulation could not be accurately determined. Therapeutic embolisation of the fistula was considered and a multidetector CT (MDCT) coronary angiography was subsequently performed to accurately characterise the coronary artery fistula (Figure 1).A prospectively electrocardiogram (ECG)-gated helical cardiac CT was conducted using a Toshiba Aquilion 64-slice multidetector CT (MDCT) (Toshiba Medical Systems Europe BV, the Netherlands). 125 ml of Ultravist 370 (Bayer Schering Pharma, Berkshire, UK) intravenous contrast with a saline flush was used. The injection protocol and scan delay was determined by P3T software (MEDRAD UK Ltd, Cambridgeshire, UK) following a transit bolus. Total volume CT dose index was 88 mGy and the dose length product was 847 mGy cm -1 . Coronary CT angiography (CTA) confirmed a left dominant system. There was plaque with mild to moderate stenosis of both the right coronary artery (RCA) and left anterior descending (LAD) artery. The LCx artery gave a small obtuse marginal branch, critically stenosed and corresponding to the culprit lesion on conventional angiography. The LCx proper then continued as a large calibre vessel of almost 8 mm in diameter that descended in the posterior atrioventricular groove and then followed a tortuous course. The vessel passed laterally over the posterior surface of the left atrium before turning sharply, cranially coursing beneath the lower left pulmonary vein. The vessel could then be traced crossing th...

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The Atrial Coronary Arteries in Man

Cited by 127 publications

References 15 publications

Left Atrial Distensibility and E/e' for Estimating Left Ventricular Filling Pressure in Patients With Stable Angina - A Comparative Echocardiography and Catheterization Study -

Left Atrial Distensibility and E/e' for Estimating Left Ventricular Filling Pressure in Patients With Stable Angina - A Comparative Echocardiography and Catheterization Study -

Early atrial fibrillation during evolving myocardial infarction: a consequence of impaired left atrial perfusion.

An S-shaped sinoatrial nodal artery coronary artery fistula demonstrated by multidetector CT

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