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冠状动脉扩张:临床及血管造影特征

Coronary Artery Ectasia: Clinical and Angiographic Features.

作者信息

Rashid Shahid, Gul Uzma, Ali Muhammad, Sadiq Tahira, Kiyani Azhar Mehmood

机构信息

Department of Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan.

出版信息

J Coll Physicians Surg Pak. 2018 Nov;28(11):824-828. doi: 10.29271/jcpsp.2018.11.824.

Abstract

OBJECTIVE

To investigate the clinical and angiographic characteristics of coronary artery ectasia (CAE) and its relation with the inflammatory marker, HsCRP.

STUDY DESIGN

An observational study.

PLACE AND DURATION OF STUDY

Rawalpindi Institute of Cardiology, Rawalpindi, from April 2015 till November 2016.

METHODOLOGY

Eighty-one patients with CAE and 57 age matched patients with stenotic coronary artery disease (CAD), but without CAE, were included in the study. Clinical, angiographic, and laboratory data were documented. Chi-square test was used to compare coronary risk factors between two groups. T test was used to compare means between the groups. Analysis of variance was used to analyse HsCRP levels among various types of ectasia. Correlation analysis was used to study association of ectasia with different risk factors.

RESULTS

Males were predominant in both with & without CAE. Hypertension, smoking and obesity were significantly more common among CAE patients than those without (60.5% vs. 52.6%, 56.8% vs. 43.9% and 80.2% vs. 14%, respectively). Diabetes was much less in CAE group (32.1% vs. 42.1%). HsCRP was higher in patients with CAE than those without and was significantly higher in patients with more extensive ectasia. Majority (65.4%) of CAE patients had significant CAD; whereas, only 7.4% had isolated CAE. Most common artery involved was RCA (70.4% of total) and most common pattern was single ectatic vessel.

CONCLUSION

Obesity and smoking predispose to CAE, along with male sex and hypertension. While diabetes is negatively associated with CAE. HsCRP levels tend to be higher in ectasia patients, especially those with severe forms. Finally, CAE has a predilection for RCA.

摘要

目的

探讨冠状动脉扩张(CAE)的临床及血管造影特征及其与炎症标志物超敏C反应蛋白(HsCRP)的关系。

研究设计

一项观察性研究。

研究地点及时间

拉瓦尔品第心脏病研究所,拉瓦尔品第,2015年4月至2016年11月。

方法

本研究纳入81例CAE患者和57例年龄匹配的冠状动脉狭窄性疾病(CAD)患者(无CAE)。记录临床、血管造影及实验室数据。采用卡方检验比较两组间的冠状动脉危险因素。采用t检验比较两组间的均值。采用方差分析分析不同类型扩张中HsCRP水平。采用相关性分析研究扩张与不同危险因素的关联。

结果

CAE患者与非CAE患者中男性均占主导。CAE患者中高血压、吸烟和肥胖的发生率显著高于非CAE患者(分别为60.5%对52.6%、56.8%对43.9%和80.2%对14%)。CAE组糖尿病患者较少(32.1%对42.1%)。CAE患者的HsCRP高于非CAE患者,且在扩张范围更广的患者中显著更高。大多数(65.4%)CAE患者患有显著的CAD;而只有7.4%的患者为孤立性CAE。最常受累的血管是右冠状动脉(占总数的70.4%),最常见的类型是单支扩张血管。

结论

肥胖、吸烟以及男性和高血压易导致CAE。而糖尿病与CAE呈负相关。扩张患者的HsCRP水平往往较高,尤其是重症患者。最后,CAE好发于右冠状动脉。

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