title: The relation between coronary tortuosity and calcium score in patients with chronic stable angina and normal coronaries by CT angiography.
abstract: OBJECTIVE
  Coronary tortuosity (CorT) is a phenomenon often noticed by cardiologists and may be associated with stable angina even without significant lesion. We aim to determine the relationship between CorT and coronary artery calcium (CAC) scoring in patients with chronic stable angina and normal or near normal coronaries detected by computed tomography (CT) angiography.
  
  
  METHODS
  This is a cross sectional retrospective study included all patients with stable angina underwent CT coronary angiography and calcium scoring that reveals normal or non-significant coronary artery lesion. The presence of CorT was revised. CorT is defined as a fixed ≥ 3 bends during both systole and diastole, with each bend ≥ 45°.
  
  
  RESULTS
  The study involved 83 patients. CT angiography revealed 31 patients (37.3%) with tortuous one or more coronary arteries and 52 patients (62.7%) without any CorT. The patients were divided into 2 groups; those patients with tortuous coronary arteries (CorT group) and those without coronary tortuosity (N CorT group). There was no significant difference between both groups regarding age, presence of DM, and dyslipidemia. However, there was a highly significant difference between both groups regarding hypertension with more hypertension among the CorT group (p value < 0.001). There was a significant difference between both groups in CAC score with high CAC score in the CorT group (p value < 0.05). There was significant correlation between CorT and CAC score (unadjusted p = 0.06); if adjusted for co-variated affecting CorT (p = 0.022).
  
  
  CONCLUSIONS
  CorT is associated with subclinical atherosclerosis and increased CAC score even in the absence of significant obstructive lesion.
authors.affiliation: Cardiology Department, Zagazig University, Egypt. Electronic address: tahlawi_basha@yahoo.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: El Tahlawi
authors.affiliation: Radiology Department, Mansura University, Egypt.
authors.forename: Amal
authors.initials: A
authors.lastname: Sakrana
authors.affiliation: Radiology Department, Zagazig University, Egypt.
authors.forename: Abdelrahman
authors.initials: A
authors.lastname: Elmurr
authors.affiliation: Cardiology Department, Zagazig University, Egypt.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Gouda
authors.affiliation: Anatomy Department, Zagazig University, Egypt.
authors.forename: Marwa
authors.initials: M
authors.lastname: Tharwat
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000000981:diagnostic imaging*; D002908:Chronic Disease; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D017566:Microvascular Angina / Q000000981:diagnostic imaging*; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D061205:Vascular Calcification / Q000000981:diagnostic imaging*
keywords: Atherosclerosis; CT angiography; Cardiac; Ischemia/infarction