Czaja-Ziółkowska Monika, Głowacki Jan, Krysiński Mateusz, Gąsior Mariusz, Wasilewski Jarosław
3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
Department of Radiology, Silesian Medical University, Poland.
Kardiol Pol. 2023;81(1):48-53. doi: 10.33963/KP.a2022.0161. Epub 2022 Jul 1.
It has been suggested that a wider left main (LM) bifurcation angle is associated with the development of atherosclerosis. However, the relationship between LM trifurcation angulation and atherosclerosis has not been investigated.
We aimed to investigate the relationship between LM trifurcation angulation and the presence of calcifications in the left coronary artery (LCA) using coronary computed tomography angiography (CCTA). Furthermore, we assessed the relationship between LM trifurcation angulation and the age at which calcification originated.
The LM trifurcation angle and coronary artery calcium (CAC) score in the LCA were measured. Based on observational studies, we assumed that CAC progression is 25% per year on average. Then, we calculated the age at which LCA CAC scores were lower than 0.1 Agatston units.
Of 266 patients, 52 patients (mean age of [standard deviation, SD] 61 [6] years; 28 men) with LM trifurcation were included in the study. Calcified plaques occurred in the LCA in 36 patients (69.2%). The mean LM trifurcation angle in patients with a diseased LCA was wider than that in patients with a normal LCA (108° [33°] vs. 91° [28°]; P = 0.04). Pearson correlation coefficient showed that the wider the LM trifurcation angle was, the earlier the calcification in the LCA may be expected (r = -0.34; P = 0.04 with outliers; r = -0.43; P = 0.009 without outliers).
A wider LM trifurcation angle is associated with a higher LCA CAC score. Moreover, the LM trifurcation angle has a significant impact on the earlier onset of atherosclerosis.
有人提出，较宽的左主干（LM）分叉角度与动脉粥样硬化的发展有关。然而，LM三分叉角度与动脉粥样硬化之间的关系尚未得到研究。
我们旨在使用冠状动脉计算机断层扫描血管造影（CCTA）研究LM三分叉角度与左冠状动脉（LCA）钙化的存在之间的关系。此外，我们评估了LM三分叉角度与钙化起源年龄之间的关系。
测量LCA的LM三分叉角度和冠状动脉钙化（CAC）评分。基于观察性研究，我们假设CAC进展平均每年为25%。然后，我们计算LCA CAC评分低于0.1阿加斯顿单位时的年龄。
在266例患者中，52例（平均年龄[标准差，SD]为61[6]岁；28例男性）有LM三分叉的患者被纳入研究。36例患者（69.2%）的LCA出现钙化斑块。LCA病变患者的平均LM三分叉角度比LCA正常患者的更宽（108°[33°]对91°[28°]；P = 0.04）。Pearson相关系数显示，LM三分叉角度越宽，LCA钙化可能出现得越早（有异常值时r = -0.34；P = 0.04；无异常值时r = -0.43；P = 0.009）。
较宽的LM三分叉角度与较高的LCA CAC评分相关。此外，LM三分叉角度对动脉粥样硬化的早期发病有显著影响。
