Relationship between coronary tortuosity and plateletcrit coronary tortuosity and plateletcrit

Platelets count and platelets indices; mean platelet volume and plateletcrit in pediatric chronic lung disease

Background

The lungs contribute in the final maturation of the circulating platelets, and some studies suggested that chronic lung disease (CLD) could impair circulating platelets maturation or count. Our aim was to study the validity of platelet count (PLT), mean platelet volume (MPV), and plateletcrit (PCT) as simple tools to assess chronic lung disease severity or predict its course.

Results

In 39 pediatric patients with CLD, we showed a significant rise in PLTs and PCT and a significant lower MPV when compared to normal controls (P values 0.003, 0.010, 0.004, respectively). Also, a significant positive correlation was detected between the C reactive protein (CRP) level and both the PLTs and PCT (r 0.327, 0.363 respectively) in addition to a significant reduction in MPV level in relation to the age of disease onset (P value 0.031).

Conclusion

This study disagrees with the postulation that chronic lung disease could lead to the reduction of circulating platelets and emphasizes the role of increased platelets count and decreased MPV in reflecting the inflammatory condition underlying the chronic lung disease in the pediatric age group.

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 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.