Comparison of Clinical and Angiographic Findings between Stable Angina Patients with and without Coronary Tortuosity

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Resident, Department of Cardiology, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Many factors may have an important role in coronary artery disease (CAD). These factors may lead to coronary artery stenosis. Some patients do not have any plaque or stenosis in angiography but have chest pain and angina. This problem is called X syndrome. Although the causes of X syndrome are unknown, some believe that coronary tortuosity might be responsible for angina. The aim of this study was to understand the relation between coronary tortuosity and chest pain.Methods: This was a case-control study performed in Isfahan hospitals, Iran during 2010-2011. The patients candidate for coronary angiography were selected and divided into two groups based on coronary tortuosity. Demographic information, risk factors, angiographic findings and Gensini scores were collected and compared. All analyses were conducted in SPSS18.Findings: Overall, 15% of all patients had coronary tortuosity. Among clinical signs, CCS class and functional class significantly differed between the two groups. The prevalence of the mentioned symptoms was also different between the groups. The mean Gensini index was lower in the case group. Stenosis in left anterior descending artery (LAD), left circumflex artery (LCX), right ventricular apex (RVA), obtuse marginal (OM), and left main coronary artery (LM) were different between the two groups.Conclusion: There were many differences between tortuous and non-tortuous groups in demographic characteristics, risk factors and angiographic findings. Thus, tortuosity may lead to signs and symptoms due to epicardial coronary stenosis.

Keywords

References

  1. Zegers ES, Meursing BT, Zegers EB, Oude Ophuis AJ. Coronary tortuosity: a long and winding road. Neth Heart J 2007; 15(5): 191-5.
  2. Puska P. Coronary heart disease and stroke in developing countries: time to act. Int J Epidemiol 2001; 30(6): 1493-4.
  3. Sarraf-Zadegan N, Boshtam M, Malekafzali H, Bashardoost N, Sayed-Tabatabaei FA, Rafiei M, et al. Secular trends in cardiovascular mortality in Iran, with special reference to Isfahan. Acta Cardiol 1999; 54(6): 327-33.
  4. Dominguez-Rodriguez A, Abreu-Gonzalez P. Cardiac syndrome X: the pathophysiology should be expanded? Int J Cardiol 2011; 146(1): 110-1.
  5. Chauhan A. Syndrome X--angina and normal coronary angiography. Postgrad Med J 1995; 71(836): 341-5.
  6. Groves SS, Jain AC, Warden BE, Gharib W, Beto RJ. Severe coronary tortuosity and the relationship to significant coronary artery disease. W V Med J 2009; 105(4): 14-7.
  7. Saeed B, Banerjee S, Brilakis ES. Percutaneous coronary intervention in tortuous coronary arteries: associated complications and strategies to improve success. J Interv Cardiol 2008; 21(6): 504-11.
  8. Selwyn AP, Braunwald E. Ischemic Heart Disease. In: Fauci A, Braunwald E, Kasper D, Hauser S, Longo D, Jameson J, et al., editors. Harrison's Principles of Internal Medicine. 17th ed. New York: McGraw-Hill Professional; 2008. p. 1434-559.
Journal of Isfahan Medical School
Volume 29, Issue 164 - Serial Number 164
September and October 2012
Pages 2079-2086

Files

History

  • Receive Date: 09 October 2011
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics