Taylor A J, Byers J P, Cheitlin M D, Virmani R
Department of Medicine, Walter Reed Army Medical Center, Armed Forces Institute of Pathology, Washington, DC 20307, USA.
Am Heart J. 1997 Apr;133(4):428-35. doi: 10.1016/s0002-8703(97)70184-4.
Coronary artery anomalies are associated with sudden cardiac death, although individual patient outcomes are highly variable. We performed blinded pathologic analysis of 30 consecutive cases of anomalous right (n = 21) or left (n = 9) coronary artery from the contralateral coronary sinus to determine which, if any, features might aid in risk stratification for sudden cardiac death. We found no significant differences in length of aortic intramural segment, coronary ostial size, degree of displacement of the anomalous coronary artery from the correct coronary sinus, or angle of coronary takeoff between patients with (n = 12) and without (n = 18) sudden cardiac death. All pathologic features showed considerable interpatient variability. Age > or = 30 years was the only variable associated with a decreased incidence of sudden cardiac death. Thus no simple relation exists between variations in the initial coronary artery course and clinical outcome in these anomalies.
冠状动脉异常与心源性猝死相关，尽管个体患者的预后差异很大。我们对30例连续的异常右冠状动脉（n = 21）或左冠状动脉（n = 9）从对侧冠状窦发出的病例进行了盲法病理分析，以确定哪些特征（如果有的话）可能有助于心源性猝死的风险分层。我们发现，有心源性猝死（n = 12）和无心源性猝死（n = 18）的患者在主动脉壁内段长度、冠状动脉开口大小、异常冠状动脉从正确冠状窦的移位程度或冠状动脉起始角度方面没有显著差异。所有病理特征在患者之间都表现出相当大的变异性。年龄≥30岁是与心源性猝死发生率降低相关的唯一变量。因此，在这些异常情况中，冠状动脉初始走行的变异与临床结局之间不存在简单的关系。
