Angiographic analysis of normal coronary artery lumen diameter in a Turkish population

Abstract

IntroductionWith its increasing incidence, coronary artery disease is one of the most common causes of morbidity and mortality especially in the industrialized countries, accounting for more than one-third of total deaths. Cardiovascular diseases are the cause of almost half of the deaths in Turkey. Amongst the European Union countries, Turkey is the fourth in the mortality caused by cardiovascular diseases in men and the first in women. [1,2] Coronary artery diameters are one of the most important factors that affect the technique and outcome of coronary by-pass operations. [3] Coronary arteries arise from the aorta as two branches, the right coronary artery (RCA) and the left main coronary artery (LMCA). After a short distance, the LMCA divides into two, and gives the left anterior descending (LAD) and circumflex artery (Cx) branches. While LAD runs along the anterior interventricular sulcus down towards the apex, Cx artery runs along the atrioventricular groove, giving rise to the left marginal branch. The circumflex then continues around the heart, terminating on its posteroinferior aspect, to supply blood to both the left and right atrium. [4] Lumen diameter of normal human coronary arteries and several factors affecting their lumen diameters have previously been studied in different countries on different populations. [5][6][7][8][9][10] To the best of our knowledge, there is no study with international recognition regarding normal AbstractObjectives: Cardiovascular diseases are the cause of nearly half of deaths in Turkey. Coronary artery diameters affect the procedure and outcome of coronary by-pass operations. The aim of this study was to measure the coronary artery diameters of the individuals with normal coronary artery on angiographic images to assess to provide data for a normal Turkish population and compare the results with studies from other countries.Methods: Seventy-seven male and female individuals between 31-79 years old were used in the study. Diameters of the two coronary arteries and their branches were measured in four segments using the Image J program. Results:The mean diameters of major coronary arteries i.e. LMCA, LAD, Cx and RCA were measured as 4.43±0.76 mm, 3.48±0.53 mm, 3.11±0.67 mm and 3.45±0.50 mm, respectively. Conclusion:This study revealed that the coronary artery lumen diameters of the Turkish population were parallel with the study conducted in the Iraqi population especially. A statistically significant correlation between certain coronary artery diameters were demonstrated also found. The findings of this study will contribute to the diagnosis and the treatment methods for the patients.

Normal coronary diameters in Turkish population

“…Our findings, thus, oppose the traditional premise which describes women with smaller coronary arteries than men. In a smaller study (n=77) conducted by Turamanlar et al [8] on the Turkish population, proximal coronary diameters were measured via quantitative coronary angiography and no significant difference was observed between two genders in terms of the proximal coronary dimensions, except for unadjusted pLAD which was found to be larger in men. However, beside relatively smaller size compared to ours, this study did not include and compare the adjusted coronary diameters to BSA in its methodology.…”

“…This quantitative angiography with the help of edge detection method is compatible with the previous studies. [7][8][9][10][11][12] Location of the pertinent proximal coronary diameters for the measurement were as follows: mid-part of the left main coronary artery (LMCA); mid-part of the proximal left anterior descending artery (pLAD) between its origin and the first diagonal branch; midpart of the proximal left circumflex artery (pLCx) between its origin and the first obtuse marginalis branch; and 1.5 to 2 mm of the proximal right coronary artery (pRCA) after it was given off from the aorta. [8,10] Right anterior oblique projections were used for the diameter calculation of LMCA, pLAD, pLCx, while left anterior oblique projection was used for pRCA.…”

“…[7][8][9][10][11][12] Location of the pertinent proximal coronary diameters for the measurement were as follows: mid-part of the left main coronary artery (LMCA); mid-part of the proximal left anterior descending artery (pLAD) between its origin and the first diagonal branch; midpart of the proximal left circumflex artery (pLCx) between its origin and the first obtuse marginalis branch; and 1.5 to 2 mm of the proximal right coronary artery (pRCA) after it was given off from the aorta. [8,10] Right anterior oblique projections were used for the diameter calculation of LMCA, pLAD, pLCx, while left anterior oblique projection was used for pRCA. [9][10][11][12] The LMCA length was also measured from its origin, until where it bifurcates into the left anterior descending (LAD) and left circumflex (LCx) arteries using right anterior oblique projections.…”

Biometric Analysis of Healthy Coronary Arteries in a Chilean Population: An Angiographic Study

“…In recent years, the biometric characteristics of coronary arteries in particular countries or ethnic groups, have been studied and compared with other populations i.e. India, Turkey or Iraq (Shukri et al, 2014;Turamanlar et al, 2016;Özdemir & Sökmen, 2020). However, to our knowledge there are no studies regarding normal anatomical characteristics of coronary arteries in the Chilean population.…”

Coronary Artery Dimensions, Anatomic Findings and Distributions of Southern Turkey

“…[3,5] However, there is limited information in the Turkish literature. [6,7] Our aim was to evaluate the LMCA and major coronary artery dimensions by QCA, and to determine angiographic findings and distributions.…”