T. Sayin et al., Exercise-induced myocardial ischemia in patients with coronary artery ectasia without obstructive coronary artery disease, INT J CARD, 78(2), 2001, pp. 143-149
Citations number
27
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background: Aetiology, clinical significance and treatment options for coro
nary artery ectasia/aneurysm is not clear. Objective: We sought to determin
e whether exercise can induce coronary ischemia in patients with coronary a
rtery ectasia/aneurysm without significant coronary stenosis. Methods: Coro
nary artery ectasia was defined as 1.5-2-fold, aneurysm as >2-fold luminal
dilatation of the adjacent normal segment. The study patients could have ir
regularities with ectatic coronaries but they did not have stenotic lesions
> 50% with visual assessment of two blinded observers. Patients having cor
onary artery ectasia or aneurysm with prior myocardial infarction, dilated
cardiomyopathy, valvular heart disease, bundle branch block, significant ST
-T changes were excluded. The control group was formed from a well matched
population of 32 patients with normal coronary arteries who have not perfor
med a treadmill test before coronary angiography. The study group underwent
a symptom limited treadmill test if they did not have one before coronary
angiogram, all control patients underwent treadmill test. Results: Thirty-t
hree patients with coronary artery ectasia/aneurysm (ranging from one to th
ree vessels) but without significant stenosis were derived from 4470 cardia
c catheterization procedures between January 1998 and July 2000. In the stu
dy group, 17 of the patients had positive treadmill tests with respect to f
ive patients in the control group (P=0.004). In subgroup analysis, diffuse
ectasia/aneurysm (involving 2-3 vessels) was found to be strongly related w
ith ischemia (P=0.005) with respect to local disease. Conclusion: Coronary
artery ectasia/aneurysm may lead to exercise induced ischemia, especially i
n the diffuse form. (C) 2001 Elsevier Science Ireland Ltd. All rights reser
ved.