Triantafyllidi Helen, Rizos Ioannis, Rallidis Loukianos, Tsikrikas Spiridon, Triantafyllis Andreas, Ikonomidis Ignatios, Panou Fotis, Rigopoulos Angelos, Kremastinos Dimitrios Th
Second Department of Cardiology, Medical School, University of Athens, Attikon Hospital, 83 Agiou Ioannou Theologou, Holargos, 155 61 Athens, Greece.
Heart Vessels. 2010 May;25(3):187-94. doi: 10.1007/s00380-009-1196-4. Epub 2010 May 29.
Coronary artery ectasia is usually linked to coronary atherosclerosis. Its primary defect is a destruction of vascular media, which leads to coronary dilatation. The aim of the present study is to evaluate whether ascending aorta present anatomical and functional wall changes in patients with coronary ectasia compared with patients without ectasia. Forty patients with known coronary ectasia (group A) underwent echocardiography in order to study aortic lumen diameter and wall properties (distensibility and stiffness index). Twenty-five patients with coronary artery disease (group B) and 40 individuals with normal coronary arteries (group C) served as control groups. Both ascending aorta diameter and ascending aorta index were significantly increased in group A compared with groups B and C (P < 0.05 and P < 0.001, respectively). Furthermore, in patients with ectatic coronary arteries ascending aorta index, systolic blood pressure and diastolic dysfunction independently associate with aortic distensibility. In patients with coronary artery ectasia, ascending aortic diameter could be enlarged while aortic stiffness is related to diastolic dysfunction. We suggest that coronary ectasia is not an isolated lesion but a reflection of a generalized vascular media defect, and should not be recognized as a benign entity.
冠状动脉扩张通常与冠状动脉粥样硬化有关。其主要缺陷是血管中膜破坏，进而导致冠状动脉扩张。本研究的目的是评估与无冠状动脉扩张的患者相比，有冠状动脉扩张的患者升主动脉是否存在解剖学和功能学上的管壁变化。40例已知患有冠状动脉扩张的患者（A组）接受了超声心动图检查，以研究主动脉管腔直径和管壁特性（扩张性和僵硬度指数）。25例冠心病患者（B组）和40例冠状动脉正常的个体（C组）作为对照组。与B组和C组相比，A组的升主动脉直径和升主动脉指数均显著增加（分别为P < 0.05和P < 0.001）。此外，在冠状动脉扩张患者中，升主动脉指数、收缩压和舒张功能障碍与主动脉扩张性独立相关。在冠状动脉扩张患者中，升主动脉直径可能增大，而主动脉僵硬度与舒张功能障碍有关。我们认为冠状动脉扩张不是一个孤立的病变，而是全身性血管中膜缺陷的一种表现，不应被视为良性病变。
