Kronik Total Oklüzyonu Olan Hastalarda Koroner Kollateral Dolaşım ile Koroner Arter Ektazisi Arasındaki İlişki

ÖZGİRİŞ ve AMAÇ: Bu çalışmada, kronik total tıkanıklığı (KTO) olan hastalarda koroner arter ektazisi (KAE) ile koroner koleteral dolaşım (KKD)gelişme arasındaki ilişkiyi araştırdık.YÖNTEM ve GEREÇLER: Şubat 2015 ve Haziran 2018 arasında, stabil angina pektoris ve / veya pozitif efor testi için koroner anjiyografi yapılan ardışık 403 KTO hastası çalışmaya dahil edildi. Koroner kollateral akım, Rentrop nitel sınıflaması kullanılarak bazal anjiyogramlarda derecelendirildi. Çalışma hastaları iyi KKK (Rentrop 2-3) ve kötü KKK (Rentrop 0-1) açısından 2 gruba ayrıldı. Anjiyografik olarak, epikardiyal koroner arterler; segmental veya diffüz 1.5-2 kat genişleme KAE olarak tanımlandı.BULGULAR: Çalışmaya ortanca yaş 68 (61-75) yıl olan ardışık 403 KTO hasta dahil edildi. Güçlü KKD grubunda 168 hasta, zayıf KKD grubunda 235 hasta vardı. KAE, zayıf KKD grubunda 60 (% 25.5), güçlü KKD grubunda 24 hasta (% 14.3) anjiyografik incelemede saptandı (p = 0.006). Ek olarak, diyabetes mellitus (DM) (p = 0.032) ve stabil anjina pektoris insidansı (p = 0.011) zayıf KKD olan grupta anlamlı olarak arttı. SYNTAX skoru, güçlü KKD olan grupta anlamlı olarak yüksekti (p = 0.002). Çok değişkenli lojistik regresyonda Stabil anjina pektoris [OR: 0.37 (0.22-0.62), p = 0.002], KAE [OR: 0.51 (0.26-0.98), p = 0.046] ve SYNTAX skoru [OR: 1.31 (1.11-1.56), p = 0.001], güçlü KKD 'nin varlığı ile güçlü bir şekilde ilişkili olduğu bulundu.TARTIŞMA ve SONUÇ: Çalışmamızda KTO'lu hastalarda KAE varlığı ile zayıf KKK varlığı arasında anlamlı bir ilişki bulduk.

The Relationship Between Coronary Artery Ectasia and Coronary Collateral Circulation in Patients with Chronic Total Occlusion

ABSTRACTINTRODUCTION: In this study, we investigated the relationship between coronary ectasia (CAE) and coronary colleteral (CCC) development in patients with chronic totalocclusion (CTO).METHODS: Between February 2015 and June 2018, 403 consecutive CTO patients who underwent coronary angiography for stable angina pectoris or positive efforttesting were included in the study. CCC was graded on baseline angiograms with the use of qualitative classification by Rentrop. The study patients were divided into 2 groups with respect to good CCC (Rentrop 2-3) and poor CCC ( Rentrop 0-1). Angiographically, segmental or diffuse expansion 1.5-2 fold in coronary arteries is defined as CAERESULTS: The study included consecutive 403 Patients with CTO, median age 68 (61-75) years were included in the study. There were 168 patients in the good CCC group and 235 patients in the poor CCC group. CAE was identified 60 patients (25.5%) in the poor CCC group and 24 patients (14.3%) in the good CCC group at angiographic examination (p=0.006). In addition, diabetes mellitus (DM) (p = 0.032) andthe incidence of stable angina pectoris (p = 0.011) were significantly increased in the group with poor CCC. SYNTAX score was significantly higher in the group with good CCC (p = 0.002). In multivariable logistic regression, Stable anginapectoris [OR: 0.37(0.22-0.62), p=0.002], CAE [OR: 0.51(0.26- 0.98), p=0.046] and SYNTAX score [OR: 1.31(1.11-1.56), p=0.001], were found to be associated with presence of good CCC.DISCUSSION and CONCLUSION: In our study, we found a significant relationship between the presence of CAE and poor CCC in patients with CTO.

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