Length of main left coronary artery in relation to atherosclerosis of its branches. A coronary arteriographic study.

Abstract

The relation between the length of the main left coronary artery and the presence of atherosclerosis in its branches or the presence of complete left bundle-branch block was studied by selective coronary arteriography in 43 persons.The length of the main left coronary artery wasfound to be significantly shorter in patients with coronary atherosclerosis than in subjects without angiographic evidence of coronary artery disease. In patients with electrocardiographic evidence of complete left bundle-branch block, the length of the left main coronary artery was significantly shorter than that in both previous groups.In view of these findings, it is suggested that a short main left coronary artery should be considered as a congenitalfactor predisposing to the development of coronary artery disease. The possible mechanisms leading to atherosclerosis of the left coronary arterial branches in the presence of a short main trunk are discussed.In recent studies coronary arteriographic findings of coronary artery disease. Some further data are were related to intraventricular conduction distur-also presented concerning its length in patients bances (Haft, Herman, and Gorling, 1969; Beach with complete left bundle-branch block. et Lewis et al., 1970;Hamby, Tabrah, and Gupta, 1973). A remarkable observation was made by Lewis et al. (1970), who noted that a Subjects and Methods short main left coronary artery was present in a great proportion of patients with complete left The study was based on the coronary arteriographic bundle-branch block. It was suggested that in the findings in 43 subjects. The only criterion for inclusion presence of a short main left coronary artery was the satisfactory visualization of the main left corotrunk, the initial part of the left anterior descending nary artery and its branches. artery is exposed to unusual stress from systolicThe patients studied were divided into three groups. kinking, with resulting impairment of the blood The first group included 19 patients without arteriosupply tothebundleofHis. Segmentsofar graphic evidence of coronary atherosclerosis. Twelve of supplyted toth bundleo His. Segmeknt to a e these had a form of heart disease, usually aortic and subjectea to systolc inkilg are Known to be mitral valve lesions, leading to left ventricular hyperparticularly liable to intimal changes and athero-trophy. The others presented with atypical findings sclerosis (Fulton, 1965;Glagov, 1972).suggestive of coronary artery disease. From these observations, it might be supposed The second group included 20 patients with atherothat the length of the main left coronary artery is sclerotic lesions in the left anterior descending or both one of the factors that may contribute to the de-branches of the left coronary artery. Two also had left velopment of atherosclerosis in its branches. The ventricular hypertrophy caused by valvular disease. purpose of ths investigation was to find out if Stenotic lesions in the left anterior descending artery tartery in varied from 50 per cent to complete o...

Anatomical Risk Factors Of Coronary Heart Disease

“…The mean length of the left coronary artery was variously reported by different authors. Lewis et al [15] reported a length of 12.8 mm, Fox et al [1] 9.5 mm, Kronzon et al [18] 10.4 mm, and Gazetopoulos et al [7,12] found it to be 12.4 mm. Although "short" MT and "long" MT were considered as variants in the length of the left coronary artery, [19] there is no commonly agreed upon definition of a short and long MT.…”

“…Gazetopoulos et al, [7,12] Reig and Petit [5] suggest that there is a positive correlation between the length of the trunk and the bifurcation angle, with the longest trunk has the largest angle. Although our results are similar to those of this study we did not found this relation statistically meaningful.…”

“…Lewis et al, [15] Glagov [10] and Gazetopoulos et al [7,12] also suggested that a short left coronary artery should be considered as a congenital risk factor in development of CHD. Lewis and Gotsman [11] found a relationship between a short main left coronary artery and complete left bundlebranch block in 11 out of 12 cases.…”

“…Lewis and Gotsman [11] found a relationship between a short main left coronary artery and complete left bundlebranch block in 11 out of 12 cases. Gazetopoulos et al [7,12] studied about the length of the main left coronary artery with selective coronary arteriography in 43 persons. These authors stated that the length of the main left coronary artery was found to be significantly shorter in patients with coronary atherosclerosis than in subjects without angiographic evidence of coronary artery disease.…”

“…During the past few decades, it has been shown that the vascular flow pattern has an effect on the development and progression of atherosclerosis. [8,[10][11][12][13] Friedman and Ding [3] proposed that variations in arterial geometry may have a role in some of the unexplained variations in cardiovascular risk. Considering the fact that the most of the atherosclerotic plaques localize particularly at bifurcation sites, most commonly on the ostium of the LAD [2,7,14] it can be suggested that the angulations of the coronary bifurcations might have an effect on the incidence of atherosclerosis.…”