Coronary artery ectasia Dotaz Zobrazit nápovědu
The purpose of this angiographic study was to make a review of patients with coronary artery ectasia (CAE) and to compare the average coronary artery diameters of proximal, middle and distal segments of the following three groups of coronary arteries: Group E (ectatic segments in patients with CAE and ischaemic heart disease), Group E-n (presumably normal segments in the same group of patients) and Group N (normal coronary arteries of control patients). It was found that distal segments of all three coronary arteries and the middle segment of the circumflex artery in Group E-n were significantly narrower than the corresponding segments in Group N (p = 0.001 or less than 0.05 respectively), which suggested the arteriosclerotic origin of both, CAE and distal coronary artery involvement.
- MeSH
- dospělí MeSH
- koronární aneurysma diagnostické zobrazování MeSH
- koronární angiografie * MeSH
- koronární cirkulace fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci koronárních tepen diagnostické zobrazování MeSH
- rychlost toku krve fyziologie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
[Coronary artery ectasia and triple-vessel disease]
Coronary artery ectasia (CAE) is an entity common known from 18th century. The advance in imaging methods, especially in coronary angiography, leads to more precise data about incidence of CAE among population, which is stated from 0.2 to 4.9%. Etiology ofCAE is various. CAE can be rarely congenital in origin, can be associated with connective tissue disorders, and also CAE can be a iatrogenic lesion following percutaneous intervention. CAE is often accompanied by coronary artery disease (CAD). We report a case of woman with NSTEMI as a first manifestation of ischemic heart disease, with triple-vessel disease and CAE of LAD and RC, who was managed conservatively with a good effect. We discuss various possibilities of treatment of CAE.
BACKGROUND: Limited data are available to guide the management of coronary artery aneurysms (CAAs). OBJECTIVES: The authors sought to define the clinical characteristics, identify variables that predict outcomes, and provide long-term data on CAAs. METHODS: We describe outcomes from 1,729 consecutive patients with CAAs included in an ambispective international registry (CAAR [Coronary Artery Aneurysm Registry]; NCT02563626) involving 33 hospitals across 9 countries in America and Europe. RESULTS: Patients were predominantly male (78.6%; 1,359/1,729) with a mean age of 66 years. Classic cardiovascular risk factors were common, as well as coronary artery disease (85.8%; 1,484/1,729), peripheral vascular disease (10.9%; 188/1,729), and chronic kidney disease (8.0%; 138/1,729). The median number of aneurysms per patient was 1.0 (Q1-Q3: 1.0-1.0), with the most affected territory being the left anterior descending artery (49.6%; 857/1,729). The majority underwent any revascularization procedure (68.5%; 1,184/1,729), mainly percutaneous coronary intervention (50.7%; 877/1,729), and were discharged on dual antiplatelet therapy (65.6%; 1,134/1,729). After a median follow-up of 44.8 months (Q1-Q3: 14.9-88.1), 379 died (21.9%), and 641 (37.1%) developed a major adverse cardiovascular event (MACE) (all-cause death, heart failure, unstable angina, and reinfarction). In a multivariable analysis, age (HR: 1.03; 95% CI: 1.02-1.04; P < 0.001), diabetes mellitus (HR: 1.47; 95% CI: 1.23-1.75; P < 0.001), renal insufficiency (HR: 1.53; 95% CI: 1.19-1.96; P = 0.010), peripheral vessel disease (HR: 1.43; 95% CI: 1.13-1.82; P = 0.003), reduced left ventricular ejection fraction (HR: 0.98; 95% CI: 0.98-0.99; P < 0.001), acute indication for the index coronary angiography (HR: 1.30; 95% CI: 1.08-1.55; P = 0.005), and the number of coronary vessels presenting severe stenosis (HR: 1.11; 95% CI: 1.02-1.20; P = 0.015) were independent predictors of MACEs. Remarkably, only 37 patients presented with local aneurysm complications during follow-up. CONCLUSIONS: The long-term prognosis of CAAs is not favorable, with MACEs associated with the underlying risk factor profile for atherosclerotic heart disease.
- Klíčová slova
- acute coronary syndrome(s), aneurysm complications, coronary aneurysm, coronary artery disease, coronary ectasia,
- MeSH
- časové faktory MeSH
- hodnocení rizik MeSH
- kohortové studie MeSH
- koronární aneurysma * diagnostické zobrazování mortalita terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- registrace * MeSH
- rizikové faktory MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- Geografické názvy
- Evropa MeSH
- Severní Amerika MeSH
The term acute aortic syndrome comprises in addition to classic dissection also two recently described entities--penetrating ulcer and intramural haematoma. Forty-two necropsy cases of acute aortic syndrome were encountered during the last six years--41 dissections and one penetrating ulcer; the intramural haematoma was not seen. According to the DeBakey classification, there were 26 dissections of type I, 8 of type II, 1 of type IIIA, and 4 of type IIIB; in 2 cases the dissection was confined to the abdominal aorta. The dissection had a chronic character in four cases. Aortic rupture was found in 24 cases (59%), most frequently (19x) into the pericardial cavity. The aortic dissection continued into aortic branches in 25 patients (61%), causing stenosis/obstruction of coronary arteries in 7, of branches of the arch in 20, of abdominal arteries in 12, and of renal arteries in 17 patients, respectively. Histologically, there were degenerative lesions of the Erdheim type in the media of 10 aortas (from 21 completely examined). As possible risk factors for aortic dissection there appeared hypertension in 32 patients, anuloaortic ectasia in 11, saccular aneurysm ot the abdominal aorta in 6, family history of dissection in 2, Marfan syndrome in 2, prolaps of the mitral valve in 2, and bicuspid aortic valve in 2 patients, respectively. The aortic dissection was iatrogenic in 7 patients, presenting as a complication of a cardiosurgical or invasive cardiological procedure.
- MeSH
- akutní nemoc MeSH
- aorta patologie MeSH
- aortální aneurysma patologie MeSH
- disekce aorty patologie MeSH
- hematom patologie MeSH
- lidé MeSH
- nemoci aorty patologie MeSH
- syndrom MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
