TÜRKİYEʹNİN GÜNEYİNDE KORONER ARTER ÇAPLARI, ANATOMİK BULGULARI VE DAĞILIMLARI

Yıl 2020, , 1 - 8, 07.04.2020

İbrahim Kurt Yurdaer Dönmez , Abdullah Yıldırım Ömer Genç Armağan Acele Abdullah Demirtaş Atilla Bulut Hasan Koca Ahmet Arslan

https://doi.org/10.5505/deutfd.2020.59023

Cited By: 1

Öz

Amaç: Sol ana koroner arter (SAKA) başta olmak üzere majör koroner arterlerin çapları, yapılacak revaskülarizasyon tedavilerinin başarısı için önemli bir öngördürücüdür. Uluslararası literatüre bakıldığında çeşitli popülasyonlarda koroner arterlerin anjiyografik bulgularına dair yayınlar görülmektedir. Amacımız Türkiye’nin Doğu Akdeniz bölgesindeki bir toplulukta SAKA ve majör epikardiyal arterlerin çaplarını “Quantitative Coronary Analysis” (QCA) yazılımı ile incelemek, koroner anjiyografik bulguları ve dağılımlarını ortaya koymaktı.

Gereç ve Yöntem: 2016 yılında koroner arterleri normal saptanan 1139 hasta retrospektif olarak çalışmaya alındı. Hastaların anjiyografi görüntüleri incelendi ve QCA yazılımı aracılığıyla koroner arter çapları değerlendirildi.
Bulgular: Çalışma grubumuzda 528 kadın (%46,4), 611 erkek (%53,6) yer alıyordu. Ortalama yaş 57,3±11,4 yıl idi. Hipertansiyon sıklığı %46,3 (527 hasta) ve diyabetes mellitus sıklığı %12,2 idi (139 hasta). Sigara içen hasta sayısı 497 idi (%43,6). İntermedier arter 183 hastada görüldü (%16,1). Az gelişmiş sağ koroner arter 106 (%9,3), az gelişmiş sirkumfleks arter 56 (%4,9) ve az gelişmiş sol ön inen arter 1 (%0,1) hastada saptandı. Proksimal ve distal SAKA çapı ve alanı erkeklerde anlamlı olarak daha fazlaydı. Vücut yüzey alanına göre endekslendiğinde bu farkın ortadan kalktığı saptandı.

Sonuç: Çalışmamız Türkiye’nin Doğu Akdeniz bölgesinde koroner arter çaplarının incelenmesine yönelik en geniş kapsamlı çalışmadır. Bulgularımız genel olarak beyaz ırk verilerine benzerdir. Çeşitli popülasyonlara ait SAKA proksimal, distal çapları, uzunluğu ve alanına ilişkin verileri içeren yayınlar ile uluslararası literatürün daha da zenginleşeceğine inanmaktayız.

Anahtar Kelimeler

Koroner arter, çap, dağılım, kantitatif koroner analiz

Coronary artery dimensions, anatomic findings, and distributions of Southern Turkey

Öz

Objective: Major coronary artery (CA) diameters, including those of the left main coronary artery (LMCA) are important predictors of the success of revascularization therapies. In the international literature, there are some studies regarding angiographic CA findings in various populations. Our aim was to assess the LMCA and major CA diameters with Quantitative Coronary Analysis (QCA) software, and to report their distributions of East Mediterranean Turkish population.
Materials and Methods: In 2016, 1139 patients who had normal CA were retrospectively included. Angiographic views were evaluated and CA diameters were measured using QCA.

Results: There were 528 women (46.4%), and 611 men (53.6%) in our study group. The mean age was 57.3±11.4 years. Hypertension frequency was 46.3% (527 patients), and the frequency of diabetes mellitus was 12.2% (139 patients). There were 497 smoking patients (43.6%). The intermediate artery was seen in 183 (16.1%) patients. There were 106 (9.3%) rudimentary right CAs, 56 (4.9%) rudimentary circumflex arteries, and 1 (0.1%) rudimentary left anterior descending artery. Proximal and distal LMCA diameters and their circular areas were significantly greater in men. When coronary artery diameters were indexed to body surface area, there was no difference between genders.

Conclusion: Our work is the largest scale study regarding quantification of coronary artery diameters of East Mediterranean Turkish population. Our findings are similar to those of Caucasians in general. We believe that the international literature will become richer with studies containing information regarding proximal and distal diameters, lengths, and areas of LMCA in various populations

Anahtar Kelimeler

coronary artery, diameter, distribution, quantitative coronary analysis

Kaynakça

• Bourassa MG. The history of cardiac catheterization. Can J Cardiol. 2005;21:1011-4.
• Serruys PW, Reiber JH, Wijns W, van den Brand M, Kooijman CJ, ten Katen HJ, et al. Assessment of percutaneous transluminal coronary angioplasty by quantitative coronary angiography: Diameter versus densitometric area measurements. Am J Cardiol. 1984;54:482–88.
• Raut BK, Patil VN, Cherian G. Coronary artery dimensions in normal Indians. Indian Heart J. 2017;69:512-14.
• Dodge JT, Brown BG, Bolson EL, Dodge HT. Lumen diameter of normal human coronary arteries: influence of age, sex, anatomic variation, and left ventricular hypertrophy or dilation. Circulation. 1992;86:232–46.
• Leung WH, Stadius ML, Alderman EL. Determinants of normal coronary artery dimensions in humans. Circulation. 1991;84:2294–306.
• Turamanlar O, Adali F, Acay MB, HorataE, Tor O, Macar O, et al. Angiographic analysis of normal coronary artery lumen diameter in a Turkish population. Anatomy. 2016;10:99–104.
• Sunman H, Erat M, Yayla KG, Algül E, Aytürk M , Asarcıklı LD, et al. Comparison of coronary artery dimensions in patients with chronic aortic regurgitation or stenosis. Turk Kardiyol Dern Ars. 2016;44: 656-62.
• McManus DD, Gore J, Yarzebski J, Spencer F, Lessard D, Goldberg RJ. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med. 2011;124:40-7.
• Schunkert H, Harrell L, Palacios IF. Implications of small reference vessel diameter in patients undergoing percutaneous coronary revascularization. J Am Coll Cardiol. 1999;34:40-8.
• Ray S, Penn I. Intracoronary stents. In: Greech ED, Ramsdale DR, editors. Practical interventional cardiology. London: Martin Dunitz, 1998; p.215–32.
• Kürüm T, Korucu C, Özçelik F, Öztekin E, Eker H, Türe M, et al. Effect of Epicardial Coronary Artery Diameter on the Occuring of Atherosclerosis. Turkiye Klinikleri J Cardiol. 2000;13:297-303.
• Mazhar J, Shaw E, Allahwala UK, Figtree GA, Bhindi R. Comparison of two dimensional quantitative coronary angiography (2D-QCA) with optical coherence tomography (OCT) in the assessment of coronary artery lesion dimensions. Int J Cardiol Heart Vasc. 2015;7:14-7.
• Zindrou D, Taylor KM, Bagger JP. Coronary artery size and disease in UK South Asian and Caucasian men. Eur J Cardiothorac Surg. 2006;29:492–95.
• Saikrishna C, Talwar S, Gulati G, Kumar AS. Normal coronary artery dimensions in Indians. Indian J Thorac Cardiovasc Surg. 2006;22:159–64.
• Funabashi N, Kobayashi Y, Perlroth M, Rubin GD. Coronary artery: quantitative evaluation of normal diameter determined with electron-beam CT compared with cine coronary angiography. Radiology. 2003;226:263–71.
• Kaimkhani Z, Ali M, Faruqui AM. Coronary artery diameter in a cohort of adult Pakistani population. J Pak Med Assoc. 2004;54:258–61.
• Maas AH, Appelman YE. Gender differences in coronary heart disease. Neth Heart J. 2010;18:598–603.
• Lip GY, Rathore VS, Katira R, Watson RD, Singh SP. Do Indo-Asians have smaller coronary arteries? Postgrad Med J. 1999;75:463-66.