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Czasopismo
2013 | 72 | 3 |
Tytuł artykułu

The impact of left main coronary artery morphology on the distribution of atherosclerotic lesions in its branches

Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Background: Atherosclerotic occlusion of a coronary vessel is the commonest cause of ischaemic heart disease. The distribution of atherosclerotic lesions is not random, with stenoses preferentially situated at branch ostia, bifurcation points, and the proximal segments of daughter vessels. The aim of this study was to determine the effect of the intrinsic anatomical properties of the left main coronary artery (LMCA) on the distribution of atherosclerotic lesions in its branches. Materials and methods: A retrospective review of 170 consecutive coronary angiograms obtained from the cardiac catheterisation laboratories of private hospitals in the eThekwini Municipality area of KwaZulu-Natal, South Africa was performed. The LMCA was absent in 19/170 (11.2%). The remaining angiograms (n = 151) were divided into two groups: normal 63/151 (41.7%) and those with coronary artery disease (CAD) 88/151 (58.3%). The CAD group was sub-divided into proximal 42/88 (47.7%), mixed (proximal and distal) 26/88 (29.6%) and distal 20/88 (22.7%) sub-groups based on the location of atherosclerotic lesions in the branches of the LMCA. Results and Conclusions: The mean length, diameter and angle of division of the LMCA were as follows: Total angiograms: 10.4 mm, 3.8 mm and 86.2°; normal group: 10.5 mm, 3.9 mm and 85.7°, CAD group: 10.2 mm, 3.7 mm and 86.3°; proximal sub-group: 10.9 mm, 3.7 mm and 91.6°, mixed sub-group — 9.8 mm, 3.7 mm and 85° and distal sub-group — 9.1 mm, 3.8 mm and 79.4°, respectively. The vessels with proximally located lesions were recorded to have longer lengths and wider angles of division than vessels with distal lesions. Coronary angiographic delineation of the LMCA anatomy may be predictive of a coronary arterial arrangement that may favour the progression of proximally located lesions. (Folia Morphol 2013; 72, 3: 197–201)
Wydawca
-
Czasopismo
Rocznik
Tom
72
Numer
3
Opis fizyczny
p.197-201,fig.,ref.
Twórcy
autor
  • Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
autor
  • Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
autor
  • Specialist Cardio-Thoracic Surgeon, St.Augustine’s Hospital, Chelmsford Medical Centre, Durban, KwaZulu Natal, South Africa
  • Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
Bibliografia
  • 1. Ambrose JA, Tannenbaum MA, Alexopoulos D, Hjemdahl-Monsen CE, Leavy J, Weiss M, Borrico S, Corlin R, Fuster V (1988) Angiographic progression of coronary artery disease and the development of myocardial infarction. J Am Coll Cardiol, 12: 56–62.
  • 2. Asakura T, Karino T (1990) Flow patterns and spatial distribution of atherosclerotic lesions in human coronary arteries. Circ Res, 66: 1045–1066.
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  • 4. Gazetopoulos N, Ioannidis PJ, Karydis C, Lolas C, Kiriakou K, Tountas C (1976) Short left coronary artery trunk as a risk factor in the development of coronary atherosclerosis Pathological study. Br Heart J, 38: 1160–1165.
  • 5. Gibson CM, Diaz L, Kandarpa K, Sacks FM, Pasternak RC, Sandor T, Feldman C, Stone PH (1993) Relation of vessel wall shear stress to atherosclerosis progression in human coronary arteries. Arterioscler Thromb, 13: 310–315.
  • 6. Khurana Indu (2006) Textbook of medical physiology. 1st Ed. Reed Elsevier, India, pp. 310–311.
  • 7. Malcolm AD, Roach MR (1979) Flow disturbances at the apex and lateral angles of a variety of bifurcation models and their role in development and manifestations of arterial disease. Stroke, 10: 335–343.
  • 8. Park SJ, Park DW (2009) Percutaneous coronary intervention with stent implantation versus coronary artery bypass surgery for treatment of left main coronary artery disease. Is it time to change guidelines? Circ Cardiovasc Interv, 2: 59–68.
  • 9. Reig J, Petit M (2001) Perfusion of myocardial segments of the right ventricle: role of the left coronary artery in infarction of the right ventricle. Clin Anat, 14: 142–148.
  • 10. Reig J, Petit M (2004) Main trunk of the left coronary artery: anatomic study of the parameters of clinical interest. Clin Anat, 17: 6–13.
  • 11. Saltissi S, Webb-Peploe MM, Coltar DJ (1979) Effect of variation in coronary artery anatomy on distribution of stenotic lesions. Br Heart J, 42: 186–191.
  • 12. Scher AM (2000) Absence of atherosclerosis in human intramyocardial coronary arteries: a neglected phenomenon. Atherosclerosis, 149: 1–3.
  • 13. Standring S, Ellis H, Healy JC, Johnson D, Williams A, Collins P, Wigley C (2005) Gray’s anatomy. 39th Ed. Elsevier Churchill Livingstone, New York.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
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