The role of tortuous configuration of coronary arteries in the development of clinical manifestations of ischemic heart disease
Abstract
In the article we consider the role of tortuous configuration of coronary arteries (CA) in the occurrence of clinical manifestations of ischemic heart disease (IHD) in patients without any angiographic signs of atherosclerotic lesions of the vascular wall and with varying degrees of coronary stenosis. The results of general clinical, electrocardiographic and stress vector-echocardiographic examination of such patients are presented. Evidences of the importance of tortuous configuration of CA in the development of clinical manifestations of myocardial ischemia in case of absence and presence of angiographic signs of hemodynamically significant coronary atherosclerosis is presented. The role of tortuosity of CA in the coronary hemodynamics violation, reducing the functional reserves of the heart muscle and the occurrence of clinical manifestations of myocardial ischemia is demonstrated, which must be taken into account in early diagnosis of various forms of IHD.
References
2. Shaw L. J. Comparative effectiveness trials of imaging guided strategies in stable ischemic heart disease / L. J. Shaw, L. M. Philips, E. Nagel [et al.] // JACC Cardiovasc Imaging. – 2017. – Vol. 10, № 3. – P. 321–334.
3. Han H. C. Twisted Blood Vessels: Symptoms, Etiology and Biomechanical Mechanisms / Hai-Chao Han // J. Vasc. Res. – 2012. – Vol. 49. – P. 185–197.
4. Angina with «Normal» Coronary Arteries [Електронний ресурс] / R. N. Fogoros // Verywell Health. – Режим доступу : https://www.verywell.com/chest-pain-with-normal-coronary-arteries-1745819
5. Chiha J. Gender differences in the prevalence of coronary artery tortuosity and its association with coronary artery disease / J. Chiha, P. Mitchell, B. Gopinath [et al.] // IJC Heart & Vasculature. – 2017. – Vol. 14. – P. 23–27.
6. Li Y. Clinical Implication of Coronary Tortuosity in Patients with Coronary Artery Disease / Y. Li, C. Shen, Y. Ji [et al.] // PLoS ONE. – 2011. – Vol. 6, Issue 8. – P. e24232.
7. Estrada A. P. D. Coronary tortuosity and its role in myocardial ischemia in patients with no coronary obstructions /A. P. D. Estrada, R. O. Lopes, H. V. Junior // Int. J. Cardiovasc. Sci. – 2017. – Vol. 30, Issue 2. – P. 163– 170.
8. Li Y. Coronary tortuosity is associated with reversible myocardial perfusion defects in patients without coronary artery disease / Y. Li, N. F. Liu, Z. Z. Gu [et al.] // Chin. Med. J. – 2012. – Vol. 125, № 19. – P. 3581–3583.
9. Cerqueira M. D. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association / M. D. Cerqueira, J. S. Wiessman, V. V. Dilsizian [et al.] // Circulation. – 2002. – Vol. 105. – P. 539–542.
10. Mądrycorresponding W. Physiological basis in the assessment of myocardial mechanics using speckle-tracking echocardiography 2D. Part II / W. Mądrycorresponding, M. A. Karolczak // J. Ultrason. – 2016. – Vol. 16 (66). – Р. 304–316.