Tortuosity of the left anterior descending artery is associated with hypertension and is not independently related to physical performance: A cardiac computed tomography study

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging Pub Date : 2024-08-30 DOI:10.1111/cpf.12900

Alaa Sharfo, Malthe Faurschou Wandall-Holm, Jesper James Linde, Ida Hæsum, Graversen Peter Laursen, Klaus Fuglsang Kofoed, Jens Dahlgaard Hove

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Abstract

Background

Coronary tortuosity (CorT) is frequently observed in invasive angiography, though its aetiology and clinical significance remain ambiguous. Prior research has indicated possible links between CorT and factors such as hypertension, age, and calcium scores in the left anterior descending (LAD) artery. The aim of this study was to examine and optimize the usage of coronary computed tomography angiography (CCTA) with vessel tracking to explore these associations.

Methods

Observational sub-study of the single centre randomised controlled CATCH-trial. From the original study 600 participants, who underwent CCTA, 250 were randomly selected. Clinical data and patient risk factors were sourced from medical records and structured interviews. Tortuosity of the LAD was quantified by calculating the ratio of the actual vessel-length to the straight-line distance.

Results

The final study population comprised 194 patients (56 patients were excluded due to poor image quality or inability to perform adequate vessel tracking). After adjusting for confounding variables, tortuosity was significantly associated with hypertension (p < 0.001), female gender (p = 0.01), and increasing age (p = 0.045). No significant correlation was observed between CorT and calcium scores. Univariate analysis indicated that higher CorT levels were linked to lower metabolic equivalents of task (METs) in bicycle tests (p = 0.003); however, this relationship became nonsignificant (p = 0.97) upon adjustment for age, gender, and hypertension.

Conclusions

Our findings suggest that increased CorT is most prevalent in patients with hypertension, advancing age, and female gender. Although higher tortuosity levels did not significantly impact METs during physical activity, further research is warranted to explore the underlying mechanisms of this relationship.

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左前降支动脉迂曲与高血压有关，与体能表现无关：心脏计算机断层扫描研究。

背景：有创血管造影中经常观察到冠状动脉迂曲（CorT），但其病因和临床意义仍不明确。先前的研究表明，冠状动脉迂曲可能与高血压、年龄和左前降支（LAD）动脉钙化评分等因素有关。本研究旨在检查和优化冠状动脉计算机断层扫描血管造影（CCTA）与血管追踪的使用，以探索这些关联：方法：单中心随机对照 CATCH 试验的观察性子研究。从最初研究的 600 名接受 CCTA 的参与者中随机抽取 250 人。临床数据和患者风险因素来自病历和结构化访谈。通过计算实际血管长度与直线距离的比值，对左动脉的扭曲度进行量化：最终研究对象包括 194 名患者（56 名患者因图像质量差或无法进行充分的血管追踪而被排除）。在对混杂变量进行调整后，迂曲度与高血压显著相关（p 结论：我们的研究结果表明，迂曲度增加与高血压有关：我们的研究结果表明，迂曲度增加在高血压、高龄和女性患者中最为普遍。虽然较高的迂曲水平对体育锻炼中的 MET 并无明显影响，但仍有必要开展进一步研究，探索这种关系的内在机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.