TORTUOSITY OF CORONARY-ARTERIES IN CHRONIC PRESSURE AND VOLUME OVERLOAD

The role of coronary tortuosity in the pathophysiology of chronic pres sure and volume overload is still unclear. A new method for measuring coronary tortuosity in patients with chronic pressure and volume overl oad was evaluated in 62 patients. Sixteen controls, 14 patients with a rterial hypertension, and 32 patients with aortic regurgitation were i ncluded in the present analysis. The left anterior descending (LAD) an d circumflex (LCX) coronary arteries were traced, and tortuosity was d etermined in the 30 degrees right (RAO) and 60 degrees left (LAO) ante rior oblique projection, Tortuosity index (TI, % was defined as the pe rcent ratio of calculated shortest distance divided by total length of the coronary artery, TI was 104.1 +/- 3.2% at end-diastole in control s, 105.7 +/- 3.8% in hypertensives (P < 0.05 vs. controls), and 102.9 +/- 2.5% in patients with aortic regurgitation (P < 0.05 vs. controls, P < 0.001 vs, hypertensives). Respective values at end-systole were 1 07.8 +/- 4.7% in controls, 109.8 +/- 7.1% in hypertensives (ns vs. con trols), and 104.3 +/- 3.3% in patients with aortic regurgitation (P < 0.001 vs. controls and vs. hypertensives), No differences were found i n tortuosity between RAO and LAO projection or between LAD and LCX art ery. Them was a significant correlation between TI and left ventricula r (LV) muscle mass, LV volume, and age. Females tended to have more to rtuous vessels than males. Coronary tortuosity is more pronounced in p atients with chronic pressure than with volume overload. Determinants of coronary tortuosity are gender, age, LY volume, and muscle mass. Th us, coronary tortuosity seems to play an important role as a physiolog ic determinant for the flow and the mechanics of the vessel wall. (C) 1996 Wiley-Liss, Inc.