Lumen diameter of normal human coronary arteries. Influence of age, sex, anatomic variation, and left ventricular hypertrophy or dilation.

Abstract

BACKGROUND Precise knowledge of the expected "normal" lumen diameter at a given coronary anatomic location is a first step toward developing a quantitative estimate of coronary disease severity that could be more useful than the traditional "percent stenosis." METHODS AND RESULTS Eighty-three arteriograms were carefully selected from among 9,160 consecutive studies for their smooth lumen borders indicating freedom from atherosclerotic disease. Of these, 60 men and 10 women had no abnormalities of cardiac function, seven men had idiopathic dilated cardiomyopathy, and six men had left ventricular hypertrophy associated with significant aortic stenosis. Lumen diameter was measured at 96 points in 32 defined coronary segments or major branches. Measurements were scaled to the catheter, corrected for imaging distortion, and had a mean repeat measurement error of 0.12 mm. When sex, anatomic dominance, and branch length were accounted for, normal lumen diameter at each of the standard anatomic points could usually be specified with a population variance of +/- 0.6 mm or less (SD) and coefficient of variation of less than 0.25 (SD/mean). For example, the left main artery measured 4.5 +/- 0.5 mm, the proximal left anterior descending coronary artery (LAD) 3.7 +/- 0.4 mm, and the distal LAD 1.9 +/- 0.4 mm. For the LAD, lumen diameter was not affected by anatomic dominance (right versus left), but for the right coronary artery, proximal diameter varied between 3.9 +/- 0.6 and 2.8 +/- 0.5 mm (p less than 0.01) and for the left circumflex, between 3.4 +/- 0.5 and 4.2 +/- 0.6 mm (p less than 0.01). Women had smaller epicardial arterial diameter than men (-9%; p less than 0.001), even after normalization for body surface area (p less than 0.01). Branch artery caliber was unaffected by the anatomic dominance but increased with branch length, expressed as a fraction of the origin-to-apex distance (p less than 0.001). Lumen diameter was not affected by age or by vessel tortuosity but was significantly increased among men with left ventricular hypertrophy (+ 17%; p less than 0.001) or dilated cardiomyopathy (+ 12%; p less than 0.001). CONCLUSIONS This is a reference normal data set against which to compare lumen dimensions in various pathological states. It should be of particular value in the investigation of diffuse atherosclerotic disease.

Right coronary artery anatomy: anatomical and morphometric analysis

“…Curiously, Lip et al [23] found in indoasian people a narrower caliber of 2.98 mm. Equally with our results, Dodge et al [21] and Kaimkhani et al [24], found a correlation between coronary dominance and caliber, being higher in hearts with right dominance. We found larger calibers in LCA than RCA.…”

“…We found larger calibers in LCA than RCA. These findings are consistent with angiographic and post-morten measurements [19][20][21][22][23][24] .…”

“…RCA proximal caliber found in our results (3.42 mm) is smaller than anterior reports (3.5-4.1 mm) [19][20][21][22]. Curiously, Lip et al [23] found in indoasian people a narrower caliber of 2.98 mm.…”

18F-NaF Uptake by Atherosclerotic Plaque on PET/CT Imaging: Inverse Correlation Between Calcification Density and Mineral Metabolic Activity

“…Our findings may thus explain the high variability in the prevalence of hot spots in different vascular districts, as plaque growing in smaller-diameter vessels, such as the carotid and coronary arteries, are more likely to be identified even at an initial stage (23)(24)(25). Conversely, plaque developing in larger vessels can be relatively asymptomatic; such segments may thus house clinically undetected initial-, intermediate-, and end-stage cold plaque.…”

Inter-observer variation in delineating the coronary arteries as organs at risk

“…The conclusion of their study was that a margin of 2 mm in the A-P and L-R plane and of 4 mm in the inferior-superior plane should be added on the contour delineated by the physician [23]. In a study by Dodge et al, using arteriograms, the diameter of LAD is estimated to 3,7±0,4 mm in the proximal and to 1,9±0,4 mm in the distal parts [24]. In terms of cardiac and respiratory motion, a diameter of 6 mm when delineating the LAD should be considered as sufficient based on the results of the present study and the study by White et al [23].…”