Rodríguez-Granillo Gastón A, Rosales Miguel A, Pugliese Francesca, Fernandez-Pereira Carlos, Rodríguez Alfredo E
Department of Cardiovascular imaging, Otamendi Hospital, Azcuenaga 870 (C1115AAB), Buenos Aires, Argentina.
EuroIntervention. 2009 Mar;4(5):641-7. doi: 10.4244/eijv4i5a107.
There is conflicting data regarding the prevalence and characteristics of coronary artery anomalies (CAAs). We sought to explore the prevalence and characteristics of major and minor CAAs using computed tomography coronary angiography (CCTA).
We prospectively studied 577 patients in sinus rhythm referred for control of stents or for screening due to the presence of multiple risk factors (53%), or due to chest pain, equivalent symptoms or inconclusive stress tests (47%). 40 and 64 slice CT scanners were used. The mean age was 61 +/- 11 years and 81% were male. We identified CAAs in 121 (21.0%) patients. Anomalous origination of a coronary artery from the opposite sinus (ACAOS) were identified in 6/577 (1%) patients. Coronary ectasia or aneurysm was present in 10/577 (1.7%) patients. One-hundred and nine intramuscular segments (MB) were found in 100/577 (17.3%) patients. Coronary hypoplasia was identified in 3/577 (0.5%) patients, all involving the RCA, and 3/577 (0.5%) patients had an absent left main coronary artery. None of the segments with ACAOS (proximal segment) or MB had atherosclerotic plaque.
CAAs were highly prevalent along the coronary tree and anatomical characteristics that might help stratify the risk and guide therapy of CAAs could be easily identified with CCTA.
关于冠状动脉异常(CAA)的患病率和特征存在相互矛盾的数据。我们试图利用计算机断层扫描冠状动脉造影(CCTA)来探究主要和次要CAA的患病率及特征。
我们前瞻性研究了577例窦性心律患者,这些患者因置入支架进行对照或因存在多种危险因素(53%)、胸痛、等效症状或运动试验结果不确定(47%)而接受筛查。使用了40层和64层CT扫描仪。平均年龄为61±11岁,男性占81%。我们在121例(21.0%)患者中发现了CAA。在577例患者中的6例(1%)发现冠状动脉起源于对侧窦(ACAOS)。577例患者中的10例(1.7%)存在冠状动脉扩张或动脉瘤。在577例患者中的100例(17.3%)发现了109个肌内段(MB)。577例患者中的3例(0.5%)被诊断为冠状动脉发育不全,均累及右冠状动脉,577例患者中的3例(0.5%)左冠状动脉主干缺如。ACAOS(近端段)或MB的所有节段均无动脉粥样硬化斑块。
CAA在冠状动脉树中高度普遍,并且利用CCTA可以轻松识别可能有助于对CAA进行风险分层和指导治疗的解剖学特征。