Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
Int J Cardiovasc Imaging. 2023 Jul;39(7):1357-1366. doi: 10.1007/s10554-023-02835-9. Epub 2023 Apr 26.
Coronary artery ectasia (CAE) in adults is often caused by atherosclerotic plaques. CAE can affect atherosclerotic plaques through hemodynamic changes. However, no study has evaluated the characteristics of CAE with atherosclerotic plaques. Therefore, we aimed to disclose the characteristics of atherosclerotic plaques in patients with CAE using optical coherence tomography (OCT). We evaluated patients with CAE, confirmed by coronary angiography, who underwent pre-intervention OCT between April 2015 and April 2021. Each millimeter of the OCT images was analyzed to assess the characteristics of CAEs, plaque phenotypes, and plaque vulnerability. A total of 286 patients (344 coronary vessels) met our criteria, 82.87% of whom were men. Right coronary artery lesions were the most common, comprising 44.48% (n = 153) of the total. We found 329 CAE vessels with plaques, accounting for 95.64% of the coronary vessels. After grouping CAEs and plaques by their relative positions, we found that the length of plaques within CAE lesions was longer than that of plaques in other sites (P < 0.001). Plaques within CAE lesions had greater maximum lipid angles and lipid indexes (P = 0.007, P = 0.004, respectively) than those on other sites. This study revealed the most common vascular and morphological characteristics of CAE. While the accompanying plaques were not affected by the location or morphology of the CAE vessels, they were affected by their position relative to the CAE lesion.
成人冠状动脉扩张症（CAE）通常由动脉粥样硬化斑块引起。CAE 可通过血流动力学变化影响动脉粥样硬化斑块。然而，尚无研究评估具有动脉粥样硬化斑块的 CAE 的特征。因此，我们旨在使用光学相干断层扫描（OCT）揭示 CAE 患者中动脉粥样硬化斑块的特征。我们评估了 2015 年 4 月至 2021 年 4 月期间通过冠状动脉造影确诊为 CAE 并接受术前 OCT 的患者。分析 OCT 图像的每一毫米，以评估 CAE、斑块表型和斑块易损性的特征。共有 286 名患者（344 支冠状动脉）符合我们的标准，其中 82.87%为男性。右冠状动脉病变最常见，占总数的 44.48%（n=153）。我们发现 329 支 CAE 血管有斑块，占冠状动脉的 95.64%。根据 CAE 和斑块的相对位置对其进行分组后，我们发现 CAE 病变内的斑块长度长于其他部位的斑块（P<0.001）。CAE 病变内的斑块具有更大的最大脂质角度和脂质指数（P=0.007，P=0.004）。本研究揭示了 CAE 最常见的血管和形态学特征。虽然伴随的斑块不受 CAE 血管位置或形态的影响，但它们受其相对于 CAE 病变位置的影响。
