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Anomalous origin of left circumflex artery from the right sinus of Valsalva: Clinical outcomes in a consecutive series of master athletes

BACKGROUND: Aim of the study was to collect and describe a case series of consecutive master athletes in whom an anomalous origin of left circumflex artery (LCx) from the right sinus of Valsalva (ALCx) was detected at a clinically indicated coronary computed tomography angiography CCTA) to establish...

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Autores principales: Ratti, Angelo, Prestini, Blanca, Conte, Edoardo, Marchetti, Davide, Schillaci, Matteo, Melotti, Eleonora, Belmonte, Marta, Mushtaq, Saima, Dessani, Maria Antonietta, Pizzamiglio, Francesca, Tundo, Fabrizio, Zeppilli, Paolo, Bartorelli, Antonio, Andreini, Daniele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540012/
https://www.ncbi.nlm.nih.gov/pubmed/37735845
http://dx.doi.org/10.1002/clc.24120
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author Ratti, Angelo
Prestini, Blanca
Conte, Edoardo
Marchetti, Davide
Schillaci, Matteo
Melotti, Eleonora
Belmonte, Marta
Mushtaq, Saima
Dessani, Maria Antonietta
Pizzamiglio, Francesca
Tundo, Fabrizio
Zeppilli, Paolo
Bartorelli, Antonio
Andreini, Daniele
author_facet Ratti, Angelo
Prestini, Blanca
Conte, Edoardo
Marchetti, Davide
Schillaci, Matteo
Melotti, Eleonora
Belmonte, Marta
Mushtaq, Saima
Dessani, Maria Antonietta
Pizzamiglio, Francesca
Tundo, Fabrizio
Zeppilli, Paolo
Bartorelli, Antonio
Andreini, Daniele
author_sort Ratti, Angelo
collection PubMed
description BACKGROUND: Aim of the study was to collect and describe a case series of consecutive master athletes in whom an anomalous origin of left circumflex artery (LCx) from the right sinus of Valsalva (ALCx) was detected at a clinically indicated coronary computed tomography angiography CCTA) to establish a focused clinical management and counseling about sport activity in those subjects. METHODS: We analyzed a prospective registry of subjects referred to a clinically indicated CCTA. Information about the clinical status was obtained by previous clinical records and clinical evaluation at time of image acquisition; follow‐up allowed to record symptoms, outcomes and downstream testing. RESULTS: The study population consisted in 14 subjects, of which one competitive athlete and 13 recreational master athletes. Mean age was of 67.2 ± 10.6 years (71% of male); follow‐up lasted 6.4 ± 2.6 years. The major high‐risk anatomy features (inter‐arterial course, intramural segment, high take‐off and slit‐like ostium) were absent. None had abnormal ostial morphology and all had full retroaortic course; three subjects (21%) presented an acute take‐off angle. Coronary artery disease (CAD) was present in 10 patients (71%). Major outcomes (cardiac hospitalization, death for all causes) recorded were not related to the anomalous LCx. Symptoms were most related to atherosclerotic CAD in different vessels whereas two subjects without CAD exhibited cardiac symptoms, without hospitalization. CONCLUSIONS: Our study suggests that the diagnosis of ALCx, being usually associated to low‐risk anatomical characteristics, could be considered a benign finding, with scarce or no implications for physically active individuals neither for recreational athletes.
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spelling pubmed-105400122023-09-30 Anomalous origin of left circumflex artery from the right sinus of Valsalva: Clinical outcomes in a consecutive series of master athletes Ratti, Angelo Prestini, Blanca Conte, Edoardo Marchetti, Davide Schillaci, Matteo Melotti, Eleonora Belmonte, Marta Mushtaq, Saima Dessani, Maria Antonietta Pizzamiglio, Francesca Tundo, Fabrizio Zeppilli, Paolo Bartorelli, Antonio Andreini, Daniele Clin Cardiol Clinical Investigations BACKGROUND: Aim of the study was to collect and describe a case series of consecutive master athletes in whom an anomalous origin of left circumflex artery (LCx) from the right sinus of Valsalva (ALCx) was detected at a clinically indicated coronary computed tomography angiography CCTA) to establish a focused clinical management and counseling about sport activity in those subjects. METHODS: We analyzed a prospective registry of subjects referred to a clinically indicated CCTA. Information about the clinical status was obtained by previous clinical records and clinical evaluation at time of image acquisition; follow‐up allowed to record symptoms, outcomes and downstream testing. RESULTS: The study population consisted in 14 subjects, of which one competitive athlete and 13 recreational master athletes. Mean age was of 67.2 ± 10.6 years (71% of male); follow‐up lasted 6.4 ± 2.6 years. The major high‐risk anatomy features (inter‐arterial course, intramural segment, high take‐off and slit‐like ostium) were absent. None had abnormal ostial morphology and all had full retroaortic course; three subjects (21%) presented an acute take‐off angle. Coronary artery disease (CAD) was present in 10 patients (71%). Major outcomes (cardiac hospitalization, death for all causes) recorded were not related to the anomalous LCx. Symptoms were most related to atherosclerotic CAD in different vessels whereas two subjects without CAD exhibited cardiac symptoms, without hospitalization. CONCLUSIONS: Our study suggests that the diagnosis of ALCx, being usually associated to low‐risk anatomical characteristics, could be considered a benign finding, with scarce or no implications for physically active individuals neither for recreational athletes. John Wiley and Sons Inc. 2023-09-21 /pmc/articles/PMC10540012/ /pubmed/37735845 http://dx.doi.org/10.1002/clc.24120 Text en © 2023 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigations
Ratti, Angelo
Prestini, Blanca
Conte, Edoardo
Marchetti, Davide
Schillaci, Matteo
Melotti, Eleonora
Belmonte, Marta
Mushtaq, Saima
Dessani, Maria Antonietta
Pizzamiglio, Francesca
Tundo, Fabrizio
Zeppilli, Paolo
Bartorelli, Antonio
Andreini, Daniele
Anomalous origin of left circumflex artery from the right sinus of Valsalva: Clinical outcomes in a consecutive series of master athletes
title Anomalous origin of left circumflex artery from the right sinus of Valsalva: Clinical outcomes in a consecutive series of master athletes
title_full Anomalous origin of left circumflex artery from the right sinus of Valsalva: Clinical outcomes in a consecutive series of master athletes
title_fullStr Anomalous origin of left circumflex artery from the right sinus of Valsalva: Clinical outcomes in a consecutive series of master athletes
title_full_unstemmed Anomalous origin of left circumflex artery from the right sinus of Valsalva: Clinical outcomes in a consecutive series of master athletes
title_short Anomalous origin of left circumflex artery from the right sinus of Valsalva: Clinical outcomes in a consecutive series of master athletes
title_sort anomalous origin of left circumflex artery from the right sinus of valsalva: clinical outcomes in a consecutive series of master athletes
topic Clinical Investigations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540012/
https://www.ncbi.nlm.nih.gov/pubmed/37735845
http://dx.doi.org/10.1002/clc.24120
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