Exercise-induced myocardial ischemia in isolated coronary artery ectasias and aneurysms (“dilated coronaropathy”)

Krüger, Dietmar; Stierle, Ulrich; Herrmann, G.; Simon, R.; Sheikhzadeh, Abdolhamid

doi:10.1016/s0735-1097(99)00375-7

Cited by 227 publications

(248 citation statements)

References 38 publications

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“…This finding agrees with the results published in several previous studies, in which it has been widely shown that CAE co-exists with CAD approximately in 85% of cases [3,[13][14][15][16][17]. The right coronary artery was the most involved artery in the coronary artery ectasia followed by the anterior descending artery and the circumflex artery [2,13,18,19].…”

Section: Discussion:-supporting

confidence: 91%

Matrix Metalloproteinases and Coronary Artery Ectasia.

Levantino¹,

Raspanti²,

Evola³

et al. 2017

IJAR

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Background: Coronary artery ectasia is the abnormal dilatation of one or more coronary segments. Although the pathogenetic mechanisms underlying CAE are largely unknown, it seems that some of the extracellular matrix degrading enzymes such as matrix metalloproteinases (mmps) can play an important role in the development of this condition. The aim of our study was to evaluate the relationship between MMP-9 and the development of CAE as well as the role played by the inflammatory process in this condition. Materials And Methods: In our retrospective study we have enrolled a series of 79 patients: 47 presented, on coronary angiography, focal or diffuse ectasia of coronary arteries (cases), 32 had a free coronary tree or without hemodynamically significant stenosis (controls). All patients were subjected to blood sampling for the dosage of MMP-9 and Creactive protein (CRP). Results: In our study we found that the most involved coronary artery in CAE was the right coronary artery. Serum levels of MMP-9 were higher in the patients with CAE (5.011 mcg / ml vs. 3.93 mcg / ml, p = 0,07) although not statistically significant, in direct proportion to the number of involved vessels (p = 0.025). Serum CRP levels were higher in patients with CAE (5.12 mg / dl vs. 2.18 mg / dl, p = 0.4) although not statistically significant, in direct proportion to the number of involved vessels (p = 0.001). Conclusions: We found a possible relationship between elevated levels of MMP-9 and CAE, as well as the relationship between levels of MMP-9 and severity of the CAE. Furthermore we found a possible relationship between elevated CRP levels and CAE and there was a directly proportional relationship between the increase of CRP and extension of the CAE.

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Section: Discussion:-supporting

confidence: 91%

Matrix Metalloproteinases and Coronary Artery Ectasia.

Levantino¹,

Raspanti²,

Evola³

et al. 2017

IJAR

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“…In the literature, the phenomenon of SCF is well known for coronary artery ectasia (Kruger et al 1999;Senen et al 2004). Coronary artery ectasia is defined by segmental or diffuse dilation of the coronary arteries to more than 1.5 the diameter of the adjacent segments of the same artery or of different arteries (Swaye et al 1983).…”

Section: Discussionmentioning

confidence: 99%

Slow Coronary Flow is Associated with Carotid Artery Dilatation

Yiğit

Sezgin

Demircan

et al. 2006

Tohoku J. Exp. Med.

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Slow coronary flow (SCF) in a normal coronary angiogram is a wellrecognized clinical entity, but its etiopathogenesis remains unclear. Carotid intima-media thickness (CIMT) is a noninvasive marker of atherosclerosis. The aim of this study was to investigate the CIMT and diameter of carotid and coronary artery in relation to SCF. Twenty-four patients with angiographically diagnosed SCF (51 ± 7 years), and 26 agematched subjects with normal coronary flow (NCF) (52 ± 8 years) in the coronary angiography were enrolled. Coronary flow rates were documented by thrombolysis in myocardial infarction (TIMI) frame count (TFC), a simple method for evaluating coronary blood flow. Carotid and coronary artery diameters and CIMT were measured. Mean TFC was significantly higher in patients with SCF than in patients with NCF ( p < 0.001). There were no significant differences regarding maximum ( p = 0.84) and mean CIMT ( p = 0.61). On the other hand, carotid lumen ( p = 0.03) and coronary artery diameters ( p = 0.001) were significantly greater in patients with SCF than in subjects with NCF. There was a significant relation between mean coronary artery diameter and TFC ( p = 0.004, 95% CI for OR: 1.61-11.87). In conclusion, these findings suggest that CIMT is not altered in patients with SCF as compared with those with NCF. However, carotid and coronary artery diameters are increased in patients with SCF as compared to those with NCF. Because the common carotid artery can be assessed in nearly every patient, carotid artery dilatation may be used as an early indicator for SCF. slow coronary flow; carotid intima-media thickness; carotid artery diameter; coronary artery diameter

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“…Nitrates theoretically seem to be appropriate in patients with CAE due to their ability to cause coronary dilatation, however on the contrary they have been shown to exacerbate myocardial ischemia. 5 Stent implantation is recommended only when significant stenosis accompanies the CAE and medical therapy has not been successful. This is because these lesions have heterogeneous morphologies, large caliber making it difficult to determine stent type, size and complete expansion.…”

Section: Discussionmentioning

confidence: 99%