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Zebic Mihic P, Arambasic J, Mlinarevic D, Saric S, Labor M, Bosnjak I, Mihaljevic I, Bilic Curcic I, Juric I. Coronary Tortuosity Index vs. Angle Measurement Method for the Quantification of the Tortuosity of Coronary Arteries in Non-Obstructive Coronary Disease. Diagnostics (Basel) 2023; 14:35. [PMID: 38201343 PMCID: PMC10795752 DOI: 10.3390/diagnostics14010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Coronary tortuosity has been recognized as a potential pathophysiological mechanism in the development of non-obstructive coronary artery disease (CAD). The aim of this study was to examine the role of two coronary tortuosity measurement methods in the detection of clinically significant coronary tortuosity. The study included 160 patients with angina symptoms and myocardial ischemia detected by cardiac stress tests in chronic settings and those diagnosed with acute coronary syndrome. After coronary angiography, tortuosity of coronary arteries was assessed by two methods, including measurement of tortuosity angles and calculating of tortuosity index. Significantly more tortuous coronary arteries were detected in the group with non-obstructive CAD (p < 0.01 for all three arteries), with significantly higher tortuosity index (TI) for all three coronary arteries in this group of patients, compared to patients with obstructive CAD. The highest TI for LCX was found in patients with lateral ischemia (p < 0.001) and for LAD in patients with anterior ischemia (p < 0.001). When measured by the angle method, the only association was found between LCX tortuosity and lateral ischemia (OR 4.9, p = 0.046). In conclusion, coronary tortuosity represents a pathophysiological mechanism for myocardial ischemia in non-obstructive CAD. The coronary tortuosity index could be a reliable and widely applicable tool for the quantification of coronary tortuosity.
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Affiliation(s)
- Petra Zebic Mihic
- Department of Cardiovascular Diseases, University Hospital Center Osijek, 31000 Osijek, Croatia; (P.Z.M.); (I.J.)
- Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Jerko Arambasic
- Department of Cardiovascular Diseases, University Hospital Center Osijek, 31000 Osijek, Croatia; (P.Z.M.); (I.J.)
- Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Drazen Mlinarevic
- Department of Cardiovascular Diseases, University Hospital Center Osijek, 31000 Osijek, Croatia; (P.Z.M.); (I.J.)
| | - Sandra Saric
- Department of Cardiovascular Diseases, University Hospital Center Osijek, 31000 Osijek, Croatia; (P.Z.M.); (I.J.)
- Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Marina Labor
- Cancer and Lung Health Care Unit, University Hospital Linköping, 58185 Linköping, Sweden
| | - Ivica Bosnjak
- Department of Cardiovascular Diseases, University Hospital Center Osijek, 31000 Osijek, Croatia; (P.Z.M.); (I.J.)
| | - Ivica Mihaljevic
- Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Nuclear Medicine, University Hospital Center Osijek, 31000 Osijek, Croatia
| | - Ines Bilic Curcic
- Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Endocrinology, University Hospital Center Osijek, 31000 Osijek, Croatia
| | - Iva Juric
- Department of Cardiovascular Diseases, University Hospital Center Osijek, 31000 Osijek, Croatia; (P.Z.M.); (I.J.)
- Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
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