Arterial bending angle and wall morphology correlate with slow coronary flow: determination with multidetector CT coronary angiography.
OBJECTIVE
The purpose of this study was to assess angulations and vessel wall morphology that could lead to bending head loss in the RCA and LMCA arteries of patients with slow coronary flow (SCF) evaluated by MDCT coronary angiography.


METHODS
The study involved 51 patients (45 males, mean age: 59.6 years) who were diagnosed with SCF by coronary angiography. Diagnosis of SCF was based on thrombolysis in myocardial infarction (TIMI) frame count. Fifty-one patients with absence of slow flow were selected as the control group. The angulations of the main coronary arteries with the aorta were measured from the axial images obtained through MDCT coronary angiography, and the findings were recorded. In addition, the coronary artery walls of these patients were evaluated. For statistical analysis, SPSS for Windows 10.0 (SPSS Inc., Chicago, IL) was used. For comparisons of the angles, either independent samples t test or the Mann-Whitney U test was used where appropriate.


RESULTS
The results of the study indicated that 38 patients had SCF in the LAD. Comparisons of patients with SCF with the controls revealed that in the patients with SCF, the mean angle of the LMCA with the aorta (40.9±20.5°) was statistically significantly smaller than the mean angle of the LMCA with the aorta in the control cases (71.8±11°). In 12 patients, slow flow was detected in the RCA. Those with slow flow in the RCA had significantly smaller angles (mean: 33.2±20.4°) than the other cases (mean: 78.9±10.7°).


CONCLUSIONS
A small angle of origin of the main coronary arteries from the aorta, measured on MDCT examinations is correlated with slow blood flow in those vessels, as calculated by the TIMI frame count in catheter coronary angiography.
Kantarci
Mecit
M
Department of Radiology, Medical Faculty, Atatürk University, Erzurum, Turkey. akkanrad@hotmail.com
Gündogdu
Fuat
F
Doganay
Selim
S
Duran
Cihan
C
Kalkan
M Emin
ME
Sagsoz
M Erdem
ME
Kucuk
Osman
O
Karakaya
Afak
A
Kucuk
Ahmet
A
Akgün
Metin
M
D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003331:Coronary Vessels / Q000503:physiopathology; D055119:Elastic Modulus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods*