Geerlings-Batt Jade, Sun Zhonghua
Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA, Australia.
Quant Imaging Med Surg. 2023 Mar 1;13(3):1948-1956. doi: 10.21037/qims-22-655. Epub 2023 Feb 3.
Whilst a correlation has been established between wide left main coronary artery bifurcation [left anterior descending-left circumflex (LAD-LCx)] angle (>80°) and the development of coronary artery disease (CAD), this retrospective, causal-comparative pilot study aimed to explore whether a relationship exists between right coronary artery (RCA)-aorta angle and CAD. Thirty normal cases were identified via radiology reports and selected as the control group with coronary computed tomography angiography (CCTA) scans performed on a 320-slice computed tomography (CT) scanner. Thirty CAD cases were selected with invasive coronary angiography performed to confirm the degree of stenosis, and CCTA performed on dual source and 320-slice CT scanners. An independent sample -test was used to compare the differences in coronary angles between the normal and CAD group, and analysis of variance (ANOVA) was used to assess for significant differences between coronary angles in normal and CAD subgroups. Coronary angle measurements were conducted by two independent assessors with high intraclass correlation (r=0.971-0.998, P<0.001). RCA-aorta angle measurements were significantly larger in the normal group [87.47°, 95% confidence interval (CI): 79.31° to 95.78°] compared to the CAD group (76.82°, 95% CI: 67.82° to 85.61°, P=0.05). No significant difference was found between RCA-aorta angle and degree of coronary stenosis (P=0.75). This study suggests a relationship between narrow RCA-aorta angle and CAD.
虽然已经证实左冠状动脉主干广泛分叉[左前降支-左旋支（LAD-LCx）]角度（>80°）与冠状动脉疾病（CAD）的发生之间存在关联，但这项回顾性、因果比较性的试点研究旨在探讨右冠状动脉（RCA）-主动脉角度与CAD之间是否存在关系。通过放射学报告确定了30例正常病例，并将其选为对照组，在320层计算机断层扫描（CT）扫描仪上进行冠状动脉计算机断层血管造影（CCTA）扫描。选择30例CAD病例，进行有创冠状动脉造影以确认狭窄程度，并在双源和320层CT扫描仪上进行CCTA。使用独立样本t检验比较正常组和CAD组之间冠状动脉角度的差异，并使用方差分析（ANOVA）评估正常组和CAD亚组之间冠状动脉角度的显著差异。冠状动脉角度测量由两名具有高组内相关性（r=0.971-0.998，P<0.001）的独立评估者进行。与CAD组（76.82°，95%置信区间[CI]：67.82°至85.61°，P=0.05）相比，正常组的RCA-主动脉角度测量值显著更大（87.47°，95%CI：79.31°至95.78°）。RCA-主动脉角度与冠状动脉狭窄程度之间未发现显著差异（P=0.75）。这项研究表明狭窄的RCA-主动脉角度与CAD之间存在关联。
