Nesrin ÇANDIR, Hasan OZAN, Necdet KOCABIYIK, Hürkan KUŞAKLIGİL

Koroner Kalp Hastalığının Anatomik Risk Faktörleri

Amaç: Çalışmanın amacı koroner anjiografi kullanarak sol koroner arterin vasküler geometrik özellikleri gibi konjenital kalp hastalıklarının muhtemel anatomik risk faktörlerini açıklamaktı. Hastalar ve Yöntemler: Sol koroner arterin trunk uzunluğu (T), arteria interventricularis anterior (LAD)’un dönüş açısı, LAD ve arteria circumflexa (Cx) arasındaki bifurkasyon açısı 77 hastada (yaş aralığı 20-83, ort. 58.9±11.68) ölçüldü. Bulgular: Arteria interventricularis anterior (LAD) ve Cx’de aterosklerotik plak varlığı araştırıldı. Sol koroner arterin trunk uzunluğu, LAD dönüş açısı ve LAD-Cx bifurkasyon açıları değerleri sırasıyla ortalama 12.86 mm, 140.99° ve 94.07° idi. Arteria interventricularis anterior’de aterosklerotik plağı olan hastalarda ortalama T değerleri LAD’leri intakt olan hastalarınkinden 2.5 mm daha kısa bulundu (p=0.020). Diğer taraftan LAD dönüş açısı ile bifurkasyon açısı arasında negatif korelasyon bulundu (p < 0.001). Sonuç: Sonuçlarımıza göre LAD ve dallarının geometrik özellikleri, başka risk faktörü olmayan CHD’li hastaların gelişiminde bir risk faktörü olabilir

Anahtar Kelimeler:

Koroner kalp hastalığı, koroner anjiografi, arteria interventricularis anterior, arteria circumflexa, aterosklerosis

Anatomical Risk Factors of Coronary Heart Disease

Objectives: The aim of this study was to explore the possible anatomical risk factors of coronary heart disease (CHD) such as vascular geometry of the left coronary artery and its branches using coronary angiography. Patients and Methods: The trunk length (T) of the left coronary artery, the curve angle of the left anterior descending artery (LAD) and the bifurcation angle between the LAD and the circumflex artery (Cx) were measured in 77 patients (age range 20-83, mean 58.9&plusmn;11.68). Results: The atherosclerotic plaque existence was investigated in LAD and Cx. The mean values of the T length, LAD curve angle and the LAD-Cx bifurcation angle were respectively 12.86 mm, 140.99&deg; and 94.07&deg;. In patients who have atherosclerotic plaques in LAD, the mean value of the T lengths was found 2.5 mm shorter than those of the patients whose LADs are intact (p=0.020). On the other hand a significant negative correlation between the LAD curve angle and the bifurcation angle was found (p&lt;0.001). Conclusion: In view of our results it can be suggested that geometrical pattern of LAD and its branches may be a congenital risk factor in development of CHD in patients who have no other risk factors. Amaç: Çalışmanın amacı koroner anjiografi kullanarak sol koroner arterin vasküler geometrik özellikleri gibi konjenital kalp hastalıklarının muhtemel anatomik risk faktörlerini açıklamaktı. Hastalar ve Yöntemler: Sol koroner arterin trunk uzunluğu (T), arteria interventricularis anterior (LAD)&#39;un dönüş açısı, LAD ve arteria circumflexa (Cx) arasındaki bifurkasyon açısı 77 hastada (yaş aralığı 20-83, ort. 58.9&plusmn;11.68) ölçüldü. Bulgular: Arteria interventricularis anterior (LAD) ve Cx&#39;de aterosklerotik plak varlığı araştırıldı. Sol koroner arterin trunk uzunluğu, LAD dönüş açısı ve LAD-Cx bifurkasyon açıları değerleri sırasıyla ortalama 12.86 mm, 140.99&deg; ve 94.07&deg; idi. Arteria interventricularis anterior&#39;de aterosklerotik plağı olan hastalarda ortalama T değerleri LAD&#39;leri intakt olan hastalarınkinden 2.5 mm daha kısa bulundu (p=0.020). Diğer taraftan LAD dönüş açısı ile bifurkasyon açısı arasında negatif korelasyon bulundu (p&lt;0.001). Sonuç: Sonuçlarımıza göre LAD ve dallarının geometrik özellikleri, başka risk faktörü olmayan CHD&#39;li hastaların gelişiminde bir risk faktörü olabilir.

Keywords:

Coronary heart disease; coronary angiography; left coronary artery; circumflex artery; atherosclerosis,

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