Prevalence of Severe Coronary Tortuosity Syndrome in Patients with Coronary Artery Disease and Cor- onary X Syndrome

Sebov D., Penina O.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Introduction. Severe Coronary Tortuosity (SCT) is two or more consecutive 180-degree turns in the epicardial artery, which estimates by coronary angiography data. This is a risk factor for future atherosclerotic lesions in this district due to the turbulent blood flow, buildup of artery walls and changes in connection with permanent pulse strike to the tortuosity. But, the prevalence of SCT syndrome in patients with coronary artery disease (CAD) and intact coronary arteries with objective criteria of the myocardial ischemia (coronary X syndrome) has not yet been studied. Objective is to determine the prevalence of SCT syndrome by angiographic data in patients with CAD with CXS, habitants of Odessa city. Methods and results. The following criteria of SCT syndrome were established: - absence of the atherosclerotic lesion in coronary arteries, - presence of more than 2 consecutive turns of major coronary artery by visual estimation in angiographic data, - maximal quantity of consecutive turns is limited to 9, because the subsequent tortuosity with distal localization is very difficult for the unification. Coronary angiographic data of 3234 patients (2008-2011) were studied. There were 217 patients with intact major coronary arteries (CXS), which consist of 14,7 % cases with stable angina. The mean age of patients was (52,26 ± 0,45) years, including men was (52,31 ± 0,65) years, women was (52,01 ± 0,60) years (p = 0,73). So, the most of patients with CXS has an employable age, that proves again the importance of study of this one. SCT syndrome was determined in 148 from 217 patients with CXS (68,2 %). So, the identified prevalence of SCT syndrome in Odessa region is 14,55 in 100. 000 habitants. But the real prevalence of the SCT syndrome expects much more, as a planned coronary interventions didn’t often perform in stable coronary artery disease (with the aim of verification or in high functional class angina). Thus, expected statistics of SCT syndrome can be calculated on the frequence of CXS from this study (14,7 %) and the level of stable angina’s prevalence in Ukraine (1300-2800 in 100,000 habitants). So, the expected prevalence of SCT syndrome is 130 – 280 in 100,000 habitants. Conclusions. The Severe Coronary Tortuosity (SCT) syndrome is a leading factor of clinical signs of myocardial ischemia in patients with coronary X syndrome (non-atherosclerotic coronary artery disease) and the one of most actual problem of the interventional cardiology. The identified prevalence of SCT syndrome in Odessa city was 14.5 cases for every 100.000 habitants. The minimal data of SCT syndrome revealed in cause of the insufficient performing of coronary angiographies in patients with low functional class of angina, therefore the expected prevalence of SCT syndrome (based on the statistic proportion in population with clinical CAD) is 130-280 cases for every 100.000 habitants. However, this extrapolation is approximate, because there is not studied the prevalence of stable CAD without angiographic verification, so the future study of SCT syndrome, treatment strategy and tactics of treatment are required.

coronary artery disease, coronary X syndrome, severe coronary tortuosity

• Горбась І. М. Ішемічна хвороба серця: епідеміологія і статистика / І. М. Горбась // Здоров`я України. – 2009. – № 3. – С. 34-35.
• Кнышов Г. В. Извитость венечных артерий и ее роль в развитии ишемии миокарда / Г. В. Кнышов, Е. О. Лебедева, Е. А. Настенко // Український кардіологічний журнал. – 2012. – № 5. – С. 34-38.
• Чумакова Г. А. Клиническое значение патологической извитости корнарных артерий / Г. А. Чумакова, В. Н. Подковыркин // Сердце : журнал для практикующих врачей. – 2010. – № 2 (52). – С. 102-105.
• Baim D. Coronary angiography. In: Grossman`s Cardiac Catheterization, angiography and Intervention, Seventh edition, edited by Baim D. Lippicont / D. Baim. – Philadelphia : Williams & Wilkins, 2006. – Р. 24-57.
• Crea F. Angina pectoris and normal coronary arteries: cardiac syndrome X / F. Crea, G. A. Lanza // Heart. – 2004. – Vol. 90. – P. 457-463.
• Groves S. S. Severe coronary tortuosity and the relationship to significant coronary artery disease / S. S. Groves, A. C. Jain, B. E. Warden [et al.] // W. V. Med. J. – 2009. – Vol. 105(4). – С. 14-17.
• Kemp H. G. Left ventricalar function in patients with anginal syndrome and normal coronary arteriograms / H. G. Kemp // Am. J. Cardiol. – 1973. – Vol. 32. – Р. 375–376.

«Bulletin of problems biology and medicine» Issue 4 part 1 (113), 2014 year, 186-189 pages, index UDK 616. 12. 008. 331+616. 12-009. 72(043. 3)