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Validity of tortuosity severity index in chest pain patients with abnormal exercise test and normal coronary angiography()

BACKGROUND: Coronary tortuosity (CT) had different definitions and scores in literature with unclear pathophysiological impact. OBJECTIVES: To study degree of CT and it's relation to ischemic changes in patients with angina but normal coronary angiography (CA). METHODS: We conducted a prospecti...

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Autores principales: Hassan, Ayman K.M., Abd–El Rahman, Hatem, Hassan, Safaa Gomaa, Ahmed, Tarek A.N., Youssef, Amr Ahmed Aly
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Egyptian Society of Cardiology 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303525/
https://www.ncbi.nlm.nih.gov/pubmed/30591760
http://dx.doi.org/10.1016/j.ehj.2018.07.002
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author Hassan, Ayman K.M.
Abd–El Rahman, Hatem
Hassan, Safaa Gomaa
Ahmed, Tarek A.N.
Youssef, Amr Ahmed Aly
author_facet Hassan, Ayman K.M.
Abd–El Rahman, Hatem
Hassan, Safaa Gomaa
Ahmed, Tarek A.N.
Youssef, Amr Ahmed Aly
author_sort Hassan, Ayman K.M.
collection PubMed
description BACKGROUND: Coronary tortuosity (CT) had different definitions and scores in literature with unclear pathophysiological impact. OBJECTIVES: To study degree of CT and it's relation to ischemic changes in patients with angina but normal coronary angiography (CA). METHODS: We conducted a prospective study at University hospitals between May 2016 and January 2017. We included 200 consecutive patients who underwent CA due to chest pain assumed to be of cardiac origin, and their CA was normal (no diameter stenosis >30%, nor myocardial bridging). Patients were prospectively divided into 2 groups based on the presence (n = 113) or absence (n = 87) of ischemic changes during stress study and compared for clinical, echocardiographic and CA characteristics. A newly proposed Tortuosity Severity Index (TSI) was developed into significant (mild/moderate CT with more than 4 curvatures in total, or severe/extreme CT with any number of curvatures) or not significant TSI (mild CT with curvatures less than or equal to 4 curvatures in total). RESULTS: Patients with ischemic changes had the highest rate of CT (76.5 vs 18%, p = 0.004) compared to those without. CT mostly affects the left anterior descending (LAD) coronary artery in mid and distal segments. Females, elderly, and hypertensives with left ventricular hypertrophy were strongly related to CT. Multivariate logistic regression analysis identified CT with significant TSI as the only predictor of ischemic changes in these patients (OR = 6.2, CI = 2.5–15.3, P = <0.001). CONCLUSIONS: Coronary tortuosity is a strong predictor of anginal pain among patients with normal CA, despite positive stress study. This finding is more pronounced among elderly, hypertensive female patients.
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spelling pubmed-63035252018-12-27 Validity of tortuosity severity index in chest pain patients with abnormal exercise test and normal coronary angiography() Hassan, Ayman K.M. Abd–El Rahman, Hatem Hassan, Safaa Gomaa Ahmed, Tarek A.N. Youssef, Amr Ahmed Aly Egypt Heart J Coronary Artery Disease BACKGROUND: Coronary tortuosity (CT) had different definitions and scores in literature with unclear pathophysiological impact. OBJECTIVES: To study degree of CT and it's relation to ischemic changes in patients with angina but normal coronary angiography (CA). METHODS: We conducted a prospective study at University hospitals between May 2016 and January 2017. We included 200 consecutive patients who underwent CA due to chest pain assumed to be of cardiac origin, and their CA was normal (no diameter stenosis >30%, nor myocardial bridging). Patients were prospectively divided into 2 groups based on the presence (n = 113) or absence (n = 87) of ischemic changes during stress study and compared for clinical, echocardiographic and CA characteristics. A newly proposed Tortuosity Severity Index (TSI) was developed into significant (mild/moderate CT with more than 4 curvatures in total, or severe/extreme CT with any number of curvatures) or not significant TSI (mild CT with curvatures less than or equal to 4 curvatures in total). RESULTS: Patients with ischemic changes had the highest rate of CT (76.5 vs 18%, p = 0.004) compared to those without. CT mostly affects the left anterior descending (LAD) coronary artery in mid and distal segments. Females, elderly, and hypertensives with left ventricular hypertrophy were strongly related to CT. Multivariate logistic regression analysis identified CT with significant TSI as the only predictor of ischemic changes in these patients (OR = 6.2, CI = 2.5–15.3, P = <0.001). CONCLUSIONS: Coronary tortuosity is a strong predictor of anginal pain among patients with normal CA, despite positive stress study. This finding is more pronounced among elderly, hypertensive female patients. Egyptian Society of Cardiology 2018-12 2018-07-26 /pmc/articles/PMC6303525/ /pubmed/30591760 http://dx.doi.org/10.1016/j.ehj.2018.07.002 Text en © 2018 Egyptian Society of Cardiology. Production and hosting by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Coronary Artery Disease
Hassan, Ayman K.M.
Abd–El Rahman, Hatem
Hassan, Safaa Gomaa
Ahmed, Tarek A.N.
Youssef, Amr Ahmed Aly
Validity of tortuosity severity index in chest pain patients with abnormal exercise test and normal coronary angiography()
title Validity of tortuosity severity index in chest pain patients with abnormal exercise test and normal coronary angiography()
title_full Validity of tortuosity severity index in chest pain patients with abnormal exercise test and normal coronary angiography()
title_fullStr Validity of tortuosity severity index in chest pain patients with abnormal exercise test and normal coronary angiography()
title_full_unstemmed Validity of tortuosity severity index in chest pain patients with abnormal exercise test and normal coronary angiography()
title_short Validity of tortuosity severity index in chest pain patients with abnormal exercise test and normal coronary angiography()
title_sort validity of tortuosity severity index in chest pain patients with abnormal exercise test and normal coronary angiography()
topic Coronary Artery Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303525/
https://www.ncbi.nlm.nih.gov/pubmed/30591760
http://dx.doi.org/10.1016/j.ehj.2018.07.002
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