Manpoong Chau Pingsaymang, Saikia Bishwajeet, Ram Mohan K, Sarma Amitav, Malviya Amit
Anatomy, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, IND.
Cardiology, North Eastern Indira Gandhi Regional Institute of Health And Medical Sciences (NEIGRIHMS), Shillong, IND.
Cureus. 2023 Sep 11;15(9):e45023. doi: 10.7759/cureus.45023. eCollection 2023 Sep.
Introduction The left ventricle, the cardiac chamber responsible for blood supply to the whole of systemic vasculature, receives most of its blood supply from the left coronary arteries (LCAs). Atherosclerosis of these vessels leading to myocardial infarction is a leading cause of death. Several invasive diagnostic or therapeutic coronary interventions are available for such patients. Just like any vascular procedure, a prior comprehensive knowledge of the dimensions of these vessels and their branching pattern is essential to perform these procedures uneventfully. No previous study in the population of North-Eastern India documents the population-specific reference for morphometric values of left coronary arteries and their anatomic variations. So, this study aims to fill up this lacuna. Methods This study was conducted in the Department of Anatomy in collaboration with the Catheterization Lab, Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. Coronary angiograms (CAG) of 100 subjects - 38 females and 62 males - were obtained from the Cardiac Catheterization Lab. Coronary angiograms were studied for the normal variant anatomy and morphometry of the LCAs - the left main coronary artery (LMCA), left anterior descending (LAD), and left circumflex (LCX). Results The mean length and luminal diameter of LMCA were found to be 9.13±3.23 mm and 4.38±0.58 mm, respectively. The mean length of LAD and LCX were 109.46±14.49 mm and 66.27±11.56 mm, respectively. Ramus intermedius was present in 32% of the subjects, whereas the remaining subjects had bifurcations of LMCA. We also found that 86% of patients had "wrap-around LAD", while in 11% of our subjects, LAD failed to reach the apex. Diagonal branches originating from LAD were single, duplicated, and multiple in 14%, 62%, and 24% respectively. The marginal branches were found to be single, double, and multiple in 20%, 51%, and 29% respectively. Conclusion This study establishes a baseline reference on morphometry of the left coronary artery specific to the population of North-East India. This study may be of assistance to radiologists and cardiologists when performing procedures on the left coronary arteries in the population of North-Eastern India, with respect to the prevalence of anatomic variations.
引言 左心室负责为整个体循环血管系统供血，其大部分血液供应来自左冠状动脉（LCA）。这些血管的动脉粥样硬化导致心肌梗死是主要的死亡原因。对于此类患者，有几种侵入性诊断或治疗性冠状动脉介入手术可供选择。与任何血管手术一样，在进行这些手术之前，全面了解这些血管的尺寸及其分支模式对于顺利进行手术至关重要。印度东北部人群中此前尚无研究记录左冠状动脉形态学值及其解剖变异的特定人群参考数据。因此，本研究旨在填补这一空白。
方法 本研究由解剖学系与位于西隆的东北英迪拉·甘地区域卫生与医学科学研究所（NEIGRIHMS）心脏病学系导管实验室合作开展。从心脏导管实验室获取了100名受试者（38名女性和62名男性）的冠状动脉造影（CAG）图像。对冠状动脉造影图像进行研究，以观察左冠状动脉（左主干冠状动脉（LMCA）、左前降支（LAD）和左旋支（LCX））的正常变异解剖结构和形态学特征。
结果 发现LMCA的平均长度和管腔直径分别为9.13±3.23毫米和4.38±0.58毫米。LAD和LCX的平均长度分别为109.46±14.49毫米和66.27±11.56毫米。32%的受试者存在中间支，其余受试者的LMCA为分叉型。我们还发现，86%的患者有“环绕型LAD”，而11%的受试者中，LAD未到达心尖。起源于LAD的对角支分别为单支、双支和多支的比例为14%、62%和24%。边缘支分别为单支、双支和多支的比例为20%、51%和29%。
结论 本研究建立了印度东北部人群特有的左冠状动脉形态学基线参考数据。在对印度东北部人群的左冠状动脉进行手术时，就解剖变异的发生率而言，本研究可能对放射科医生和心脏病专家有所帮助。
