Ikenaga Hiroki, Kurisu Satoshi, Watanabe Noriaki, Shimonaga Takashi, Higaki Tadanao, Iwasaki Toshitaka, Utsunomiya Hiroto, Mitsuba Naoya, Ishibashi Ken, Dohi Yoshihiro, Imai Katsuhiko, Sueda Taijiro, Kihara Yasuki
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Department of Cardiovascular Surgery, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Heart Vessels. 2015 Nov;30(6):712-8. doi: 10.1007/s00380-014-0540-5. Epub 2014 Jul 3.
Aortic aneurysms are associated with coronary artery ectasia (CAE). However, the relation between the extent of CAE and coronary blood flow in patients with aortic aneurysms is not fully understood. This study was undertaken to assess the angiographic characteristics and effects of the topographical extent of CAE on coronary blood flow in patients with aortic aneurysms. This study consisted of 93 consecutive patients with aortic aneurysms (AA group) and 79 patients without aortic aneurysms who had angiographically normal coronary arteries as the control group (Control group). Coronary flow velocity was determined using the thrombolysis in myocardial infarction frame count (TFC) and the topographical extent of CAE was assessed. In the AA group, 43 patients (46.2 %) had significant coronary artery stenosis and 37 patients (40.2 %) had diffuse CAE. TFC was significantly higher in the AA group than in the control group in all 3 coronary arteries. Furthermore, mean corrected TFC (CTFC) was significantly higher in the AA group than in the control group (40.1 ± 10.7 vs. 25.8 ± 6.5, p < 0.001). In the AA group, mean CTFC in patients with diffuse CAE was significantly higher than that in patients with segmental CAE (50.2 ± 8.7 vs. 33.6 ± 5.2, p < 0.001). The mean CTFC correlated positively with the topographical extent of CAE. Many patients with aortic aneurysms were accompanied with angiographic coronary artery stenosis and CAE. Furthermore, patients with aortic aneurysms had higher CTFC than those without aortic aneurysms and it was primarily driven by more frequent prevalence of diffuse CAE.
主动脉瘤与冠状动脉扩张（CAE）相关。然而，主动脉瘤患者中CAE的程度与冠状动脉血流之间的关系尚未完全明确。本研究旨在评估主动脉瘤患者CAE的血管造影特征及其局部范围对冠状动脉血流的影响。本研究纳入了93例连续的主动脉瘤患者（AA组）和79例冠状动脉造影正常且无主动脉瘤的患者作为对照组（对照组）。使用心肌梗死溶栓帧数（TFC）测定冠状动脉血流速度，并评估CAE的局部范围。在AA组中，43例患者（46.2%）存在显著冠状动脉狭窄，37例患者（40.2%）存在弥漫性CAE。AA组所有3支冠状动脉的TFC均显著高于对照组。此外，AA组的平均校正TFC（CTFC）显著高于对照组（40.1±10.7对25.8±6.5，p<0.001）。在AA组中，弥漫性CAE患者的平均CTFC显著高于节段性CAE患者（50.2±8.7对33.6±5.2，p<0.001）。平均CTFC与CAE的局部范围呈正相关。许多主动脉瘤患者伴有血管造影显示的冠状动脉狭窄和CAE。此外，主动脉瘤患者的CTFC高于无主动脉瘤患者，这主要是由于弥漫性CAE的发生率更高所致。
