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Anatomical Risk Factors of Coronary Heart Disease

Year 2010, Volume: 2010 Issue: 4, 248 - 252, 01.04.2010
https://doi.org/10.5174/tutfd.2009.01749.1

Abstract

Objectives: The aim of this study was to explore the possible anatomical risk factors of coronary heart disease (CHD) such as vascular geometry of the left coronary artery and its branches using coronary angiography. Patients and Methods: The trunk length (T) of the left coronary artery, the curve angle of the left anterior descending artery (LAD) and the bifurcation angle between the LAD and the circumflex artery (Cx) were measured in 77 patients (age range 20-83, mean 58.9±11.68). Results: The atherosclerotic plaque existence was investigated in LAD and Cx. The mean values of the T length, LAD curve angle and the LAD-Cx bifurcation angle were respectively 12.86 mm, 140.99° and 94.07°. In patients who have atherosclerotic plaques in LAD, the mean value of the T lengths was found 2.5 mm shorter than those of the patients whose LADs are intact (p=0.020). On the other hand a significant negative correlation between the LAD curve angle and the bifurcation angle was found (p<0.001). Conclusion: In view of our results it can be suggested that geometrical pattern of LAD and its branches may be a congenital risk factor in development of CHD in patients who have no other risk factors. Amaç: Çalışmanın amacı koroner anjiografi kullanarak sol koroner arterin vasküler geometrik özellikleri gibi konjenital kalp hastalıklarının muhtemel anatomik risk faktörlerini açıklamaktı. Hastalar ve Yöntemler: Sol koroner arterin trunk uzunluğu (T), arteria interventricularis anterior (LAD)'un dönüş açısı, LAD ve arteria circumflexa (Cx) arasındaki bifurkasyon açısı 77 hastada (yaş aralığı 20-83, ort. 58.9±11.68) ölçüldü. Bulgular: Arteria interventricularis anterior (LAD) ve Cx'de aterosklerotik plak varlığı araştırıldı. Sol koroner arterin trunk uzunluğu, LAD dönüş açısı ve LAD-Cx bifurkasyon açıları değerleri sırasıyla ortalama 12.86 mm, 140.99° ve 94.07° idi. Arteria interventricularis anterior'de aterosklerotik plağı olan hastalarda ortalama T değerleri LAD'leri intakt olan hastalarınkinden 2.5 mm daha kısa bulundu (p=0.020). Diğer taraftan LAD dönüş açısı ile bifurkasyon açısı arasında negatif korelasyon bulundu (p<0.001). Sonuç: Sonuçlarımıza göre LAD ve dallarının geometrik özellikleri, başka risk faktörü olmayan CHD'li hastaların gelişiminde bir risk faktörü olabilir.

References

  • Fox C, Davies MJ, Webb-Peploe MM. Length of left main coronary artery. Br Heart J 1973;35:796-8.
  • Berndt T, Shettigar UR, Lipton MJ, Hultgren HN. Left anterior descending coronary artery obstruction. Clinical, electrocardiographic, and angiographic correlates. Br Heart J 1976;38:633-40.
  • Friedman MH, Ding Z. Relation between the structural asymmetry of coronary branch vessels and the angle at their origin. J Biomech 1998;31:273-8.
  • Zhu H, Friedman MH. Relationship between the dynamic geometry and wall thickness of a human coronary artery. Arterioscler Thromb Vasc Biol 2003;23:2260-5.
  • Reig J, Petit M. Main trunk of the left coronary artery: ana- tomic study of the parameters of clinical interest. Clin Anat 2004;17:6-13.
  • Rodriguez-Granillo GA, Rosales MA, Degrossi E, Durbano I, Rodriguez AE. Multislice CT coronary angiography for the detection of burden, morphology and distribution of atherosclerotic plaques in the left main bifurcation. Int J Cardiovasc Imaging 2007;23:389-92.
  • Gazetopoulos N, Ioannidis PJ, Karydis C, Lolas C, Kiriakou K, Tountas C. Short left coronary artery trunk as a risk factor in the development of coronary atherosclerosis. Pathological study. Br Heart J 1976;38:1160-5.
  • Frings AM, Mayer B, Böcker W, Hengstenberg C, Willemsen D, Riegger GA, et al. Comparative coronary anatomy in six twin pairs with coronary artery disease. Heart 2000;83:47-50.
  • Green GE, Bernstein S, Reppert EH. The length of the left main coronary artery. Surgery 1967;62:1021-4.
  • Glagov S. Hemodynamic risk factors: mechanical stress, mural architecture, medial nutrition and the vulnerabil- ity of arteries to atherosclerosis. In: Wissler RW, Geer JC, editors. The Pathogenesis of atherosclerosis. Baltimore: Williams and Wilkins; 1972. p. 164-99.
  • Lewis BS, Gotsman MS. Relation between coronary artery size and left ventricular wall mass. Br Heart J 1973;35:1150-3.
  • Gazetopoulos N, Ioannidis PJ, Marselos A, Kelekis D, Lolas C, Avgoustakis D, et al. Length of main left coronary artery in relation to atherosclerosis of its branches. A coronary arteriographic study. Br Heart J 1976;38:180-5.
  • Baroldi G, Scomazzoni G. Coronary circulation in the nor- mal heart. In: Baroldi G, Scomazzoni G, editors. Coronary cir- culation in the normal and the pathologic heart. Washington: Armed Forces Institute of Pathology, Office of the Surgeon General, Department of the Army. 1965. p. 5–73.
  • Baptista CA, DiDio LJ, Prates JC. Types of division of the left coronary artery and the ramus diagonalis of the human heart. Jpn Heart J 1991;32:323-35.
  • Lewis CM, Dagenais GR, Friesinger GC, Ross RS. Coronary arteriographic appearances in patients with left bundle- branch block. Circulation 1970;41:299-307.
  • Benther P, Barra JA, Blanc JJ. Descriptive anatomical study of the major coronary trunks and the principal epicardial col- laterals. 125 cases. Nouv Presse Med 1976;5:71-5. [Abstract]
  • Kalbfleisch H, Hort W. Quantitative study on the size of coronary artery supplying areas postmortem. Am Heart J 1977;94:183-8.
  • Kronzon I, Deutsch P, Glassman E. Length of the left main coronary artery: its relation to the pattern of coronary arte- rial distribution. Am J Cardiol 1974;34:787-9.
  • Angelini P, Villason S, Chan AV Jr, Diez JG. Normal and anomalous coronary arteries in humans. In: Angelini P, edi- tor. Coronary artery anomalies: a comprehensive approach. Philadelphia: Lippincott Williams and Wilkins; 1999. p. 27-151.
  • Vlodaver Z, Edwards JE. Editorial: Occlusion of coronary grafts--result of injury? Ann Thorac Surg 1975;20:719-20.
  • McAlpine WA, editor. Heart and coronary arteries: an ana- tomical atlas for clinical diagnosis, radiological investigation, and surgical treatment. New York: Springer-Verlag; 1975.
  • Leguerrier A, Calmat A, Honnart F, Cabrol C. Anatomic varia- tions of the common trunk of the left coronary artery (apropos of 80 dissections). Bull Assoc Anat 1976;60:733-9. [Abstract]
  • Reig J, Loncán MP, Martin S, Doménech JM. The circumflex branch of the left coronary artery in the human infant. J Anat 1987;155:7-10.

Koroner Kalp Hastalığının Anatomik Risk Faktörleri

Year 2010, Volume: 2010 Issue: 4, 248 - 252, 01.04.2010
https://doi.org/10.5174/tutfd.2009.01749.1

Abstract

Amaç: Çalışmanın amacı koroner anjiografi kullanarak
sol koroner arterin vasküler geometrik özellikleri gibi
konjenital kalp hastalıklarının muhtemel anatomik risk
faktörlerini açıklamaktı.
Hastalar ve Yöntemler: Sol koroner arterin trunk
uzunluğu (T), arteria interventricularis anterior (LAD)’un
dönüş açısı, LAD ve arteria circumflexa (Cx) arasındaki
bifurkasyon açısı 77 hastada (yaş aralığı 20-83, ort.
58.9±11.68) ölçüldü.
Bulgular: Arteria interventricularis anterior (LAD)
ve Cx’de aterosklerotik plak varlığı araştırıldı. Sol
koroner arterin trunk uzunluğu, LAD dönüş açısı
ve LAD-Cx bifurkasyon açıları değerleri sırasıyla
ortalama 12.86 mm, 140.99° ve 94.07° idi. Arteria
interventricularis anterior’de aterosklerotik plağı
olan hastalarda ortalama T değerleri LAD’leri intakt
olan hastalarınkinden 2.5 mm daha kısa bulundu
(p=0.020). Diğer taraftan LAD dönüş açısı ile bifurkasyon
açısı arasında negatif korelasyon bulundu
(p < 0.001).
Sonuç: Sonuçlarımıza göre LAD ve dallarının geometrik
özellikleri, başka risk faktörü olmayan CHD’li hastaların
gelişiminde bir risk faktörü olabilir

References

  • Fox C, Davies MJ, Webb-Peploe MM. Length of left main coronary artery. Br Heart J 1973;35:796-8.
  • Berndt T, Shettigar UR, Lipton MJ, Hultgren HN. Left anterior descending coronary artery obstruction. Clinical, electrocardiographic, and angiographic correlates. Br Heart J 1976;38:633-40.
  • Friedman MH, Ding Z. Relation between the structural asymmetry of coronary branch vessels and the angle at their origin. J Biomech 1998;31:273-8.
  • Zhu H, Friedman MH. Relationship between the dynamic geometry and wall thickness of a human coronary artery. Arterioscler Thromb Vasc Biol 2003;23:2260-5.
  • Reig J, Petit M. Main trunk of the left coronary artery: ana- tomic study of the parameters of clinical interest. Clin Anat 2004;17:6-13.
  • Rodriguez-Granillo GA, Rosales MA, Degrossi E, Durbano I, Rodriguez AE. Multislice CT coronary angiography for the detection of burden, morphology and distribution of atherosclerotic plaques in the left main bifurcation. Int J Cardiovasc Imaging 2007;23:389-92.
  • Gazetopoulos N, Ioannidis PJ, Karydis C, Lolas C, Kiriakou K, Tountas C. Short left coronary artery trunk as a risk factor in the development of coronary atherosclerosis. Pathological study. Br Heart J 1976;38:1160-5.
  • Frings AM, Mayer B, Böcker W, Hengstenberg C, Willemsen D, Riegger GA, et al. Comparative coronary anatomy in six twin pairs with coronary artery disease. Heart 2000;83:47-50.
  • Green GE, Bernstein S, Reppert EH. The length of the left main coronary artery. Surgery 1967;62:1021-4.
  • Glagov S. Hemodynamic risk factors: mechanical stress, mural architecture, medial nutrition and the vulnerabil- ity of arteries to atherosclerosis. In: Wissler RW, Geer JC, editors. The Pathogenesis of atherosclerosis. Baltimore: Williams and Wilkins; 1972. p. 164-99.
  • Lewis BS, Gotsman MS. Relation between coronary artery size and left ventricular wall mass. Br Heart J 1973;35:1150-3.
  • Gazetopoulos N, Ioannidis PJ, Marselos A, Kelekis D, Lolas C, Avgoustakis D, et al. Length of main left coronary artery in relation to atherosclerosis of its branches. A coronary arteriographic study. Br Heart J 1976;38:180-5.
  • Baroldi G, Scomazzoni G. Coronary circulation in the nor- mal heart. In: Baroldi G, Scomazzoni G, editors. Coronary cir- culation in the normal and the pathologic heart. Washington: Armed Forces Institute of Pathology, Office of the Surgeon General, Department of the Army. 1965. p. 5–73.
  • Baptista CA, DiDio LJ, Prates JC. Types of division of the left coronary artery and the ramus diagonalis of the human heart. Jpn Heart J 1991;32:323-35.
  • Lewis CM, Dagenais GR, Friesinger GC, Ross RS. Coronary arteriographic appearances in patients with left bundle- branch block. Circulation 1970;41:299-307.
  • Benther P, Barra JA, Blanc JJ. Descriptive anatomical study of the major coronary trunks and the principal epicardial col- laterals. 125 cases. Nouv Presse Med 1976;5:71-5. [Abstract]
  • Kalbfleisch H, Hort W. Quantitative study on the size of coronary artery supplying areas postmortem. Am Heart J 1977;94:183-8.
  • Kronzon I, Deutsch P, Glassman E. Length of the left main coronary artery: its relation to the pattern of coronary arte- rial distribution. Am J Cardiol 1974;34:787-9.
  • Angelini P, Villason S, Chan AV Jr, Diez JG. Normal and anomalous coronary arteries in humans. In: Angelini P, edi- tor. Coronary artery anomalies: a comprehensive approach. Philadelphia: Lippincott Williams and Wilkins; 1999. p. 27-151.
  • Vlodaver Z, Edwards JE. Editorial: Occlusion of coronary grafts--result of injury? Ann Thorac Surg 1975;20:719-20.
  • McAlpine WA, editor. Heart and coronary arteries: an ana- tomical atlas for clinical diagnosis, radiological investigation, and surgical treatment. New York: Springer-Verlag; 1975.
  • Leguerrier A, Calmat A, Honnart F, Cabrol C. Anatomic varia- tions of the common trunk of the left coronary artery (apropos of 80 dissections). Bull Assoc Anat 1976;60:733-9. [Abstract]
  • Reig J, Loncán MP, Martin S, Doménech JM. The circumflex branch of the left coronary artery in the human infant. J Anat 1987;155:7-10.
There are 23 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Nesrin Çandır This is me

Hasan Ozan This is me

Necdet Kocabıyık This is me

Hürkan Kuşaklıgil This is me

Publication Date April 1, 2010
Published in Issue Year 2010 Volume: 2010 Issue: 4

Cite

APA Çandır, N., Ozan, H., Kocabıyık, N., Kuşaklıgil, H. (2010). Koroner Kalp Hastalığının Anatomik Risk Faktörleri. Balkan Medical Journal, 2010(4), 248-252. https://doi.org/10.5174/tutfd.2009.01749.1
AMA Çandır N, Ozan H, Kocabıyık N, Kuşaklıgil H. Koroner Kalp Hastalığının Anatomik Risk Faktörleri. Balkan Medical Journal. April 2010;2010(4):248-252. doi:10.5174/tutfd.2009.01749.1
Chicago Çandır, Nesrin, Hasan Ozan, Necdet Kocabıyık, and Hürkan Kuşaklıgil. “Koroner Kalp Hastalığının Anatomik Risk Faktörleri”. Balkan Medical Journal 2010, no. 4 (April 2010): 248-52. https://doi.org/10.5174/tutfd.2009.01749.1.
EndNote Çandır N, Ozan H, Kocabıyık N, Kuşaklıgil H (April 1, 2010) Koroner Kalp Hastalığının Anatomik Risk Faktörleri. Balkan Medical Journal 2010 4 248–252.
IEEE N. Çandır, H. Ozan, N. Kocabıyık, and H. Kuşaklıgil, “Koroner Kalp Hastalığının Anatomik Risk Faktörleri”, Balkan Medical Journal, vol. 2010, no. 4, pp. 248–252, 2010, doi: 10.5174/tutfd.2009.01749.1.
ISNAD Çandır, Nesrin et al. “Koroner Kalp Hastalığının Anatomik Risk Faktörleri”. Balkan Medical Journal 2010/4 (April 2010), 248-252. https://doi.org/10.5174/tutfd.2009.01749.1.
JAMA Çandır N, Ozan H, Kocabıyık N, Kuşaklıgil H. Koroner Kalp Hastalığının Anatomik Risk Faktörleri. Balkan Medical Journal. 2010;2010:248–252.
MLA Çandır, Nesrin et al. “Koroner Kalp Hastalığının Anatomik Risk Faktörleri”. Balkan Medical Journal, vol. 2010, no. 4, 2010, pp. 248-52, doi:10.5174/tutfd.2009.01749.1.
Vancouver Çandır N, Ozan H, Kocabıyık N, Kuşaklıgil H. Koroner Kalp Hastalığının Anatomik Risk Faktörleri. Balkan Medical Journal. 2010;2010(4):248-52.