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使用计算机断层扫描血管造影术评估冠状动脉优势与冠状动脉疾病程度之间的相关性

Correlation Between Coronary Arterial Dominance and the Degree of Coronary Artery Disease Using Computed Tomography Angiography.

作者信息

Al Ewaidat Haytham, Oglat Ammar A, Al Makhadmeh Ali, Aljarrah Tariq, Eltahir Mohamed Abdalla, Al-Masaid Khalaf Abdel Azez, E'layan Ahmad W, Alawaqla Moath Qasim, Hamarneh Ihsan I, Allouh Maisoon Mohammed, Al-Smair Ali

机构信息

Department of Allied Medical Sciences-Radiologic Technology, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan.

Department of Medical Imaging, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan.

出版信息

J Multidiscip Healthc. 2025 Mar 30;18:1827-1844. doi: 10.2147/JMDH.S514510. eCollection 2025.

Abstract

OBJECTIVE

This study used Computed Tomography Angiography to evaluate how coronary artery dominance affects CAD severity.

METHODS

We retrospectively examined 1,000 coronary CTA patients at five private outpatient radiography clinics in Amman, Jordan. Patients of both sexes aged 18 or older with no coronary CTA contraindications were enrolled. Two 10-year-experienced radiologists reviewed all coronary CT images with 64 slices or more without knowing the patients' medical histories.

RESULTS

The coronary arteries were right, left, or co-dominant. CAD: stenosis. Visual assessment of the lumen diameter rated coronary stenosis as 0%, mild (1-49%), moderate (50-69%), or severe (≥70%). Positive obstructive CAD can be identified when a coronary lesion compromises the lumen by ≥50%. A CAD patient had one, two, three, or four vascular disease. Study outcomes were assessed using descriptive statistics, -tests, and one-way ANOVA. Right, left, and co-dominant coronary arteries predominated 85.7%, 11.6%, and 2.7%. Co-dominance caused greater right coronary artery (RCA) issues than left- or right-dominance. 22.2% of co-dominance patients reported positive RCA difficulties, compared to 6.9% and 21.0% of left- and right-dominance patients (p = 0.001). In addition, 14.8% of co-dominance patients had obstructive RCA lesions, compared to 1.7% of left-dominance and 5.3% of right-dominance (p = 0.018). The coronary dominance patterns did not affect LMCA, LAD, LCX, and Ramus blockages (p = 0.846, 0.447, 0.116, and 0.867). Calcium scores averaged 44.4 for right dominance, 41.0 for left, and 86.2 for co-dominance (p = 0.136).

CONCLUSION

Coronary CTA may not provide more risk information than assessing stenosis in patients with normal arteries or non-significant CAD. However, it may aid RCA and obstructive CAD patients.

摘要

目的

本研究采用计算机断层扫描血管造影术评估冠状动脉优势类型如何影响冠心病严重程度。

方法

我们回顾性研究了约旦安曼五家私立门诊放射科诊所的1000例冠状动脉CTA患者。纳入年龄18岁及以上、无冠状动脉CTA禁忌证的男女患者。两位有10年经验的放射科医生在不知道患者病史的情况下,对所有64层及以上的冠状动脉CT图像进行了评估。

结果

冠状动脉分为右优势型、左优势型或共优势型。冠心病:狭窄。通过视觉评估管腔直径将冠状动脉狭窄分为0%、轻度(1%-49%)、中度(50%-69%)或重度(≥70%)。当冠状动脉病变使管腔狭窄≥50%时,可确定为阳性阻塞性冠心病。冠心病患者有一、二、三或四种血管疾病。使用描述性统计、t检验和单因素方差分析对研究结果进行评估。右优势型、左优势型和共优势型冠状动脉分别占85.7%、11.6%和2.7%。共优势型比左优势型或右优势型导致更多的右冠状动脉(RCA)问题。共优势型患者中有22.2%报告有RCA阳性困难,而左优势型和右优势型患者分别为6.9%和21.0%(p = 0.001)。此外,共优势型患者中有14.8%有阻塞性RCA病变,而左优势型为1.7%,右优势型为5.3%(p = 0.018)。冠状动脉优势类型不影响左主干、左前降支、左旋支和中间支的阻塞情况(p = 0.846、0.447、0.116和0.867)。右优势型的钙化积分平均为44.4,左优势型为41.0,共优势型为86.2(p = 0.136)。

结论

对于动脉正常或冠心病不严重的患者,冠状动脉CTA可能不会比评估狭窄提供更多风险信息。然而,它可能有助于RCA和阻塞性冠心病患者。

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