| ObjectiveThe sinus node artery is the only blood supply for the sinus node, and cardiac arrhythmia is common when the artery is involved in coronary artery diseases or in heart surgeries. Thus it's important for selective coronary angiographies and cardiac surgeries to make clear the form and course of the sinus node artery. This study was undertaken to investigate the form and origin of sinus node arteries ( SNAs ) in 511 patients with coronary angiography and to make clear the relationship between sinus node artery related lesions and sick sinus syndrome (SSS).Methods1. Objects:Patients admitted in the department of circulation of the first hospital of China Medical University between 1998 and 2004 and examined by coronary angiographies were studied. Selective coronary angiography was performed with either Judkins or Sones technique. (1) we reviewed our hospital records and coronary arteriograms of 511 patients underwent selective coronary angiograpies to observe the form and origin of sinus node arteries; (2) All the 29 patients with sinus node artery related lesions in the 511 patients were taken as study group 1, chose another 29 patients as control group 1 at the same time. The heart rate and number of sick sinus syndrome of the 2 groups were compared; (3) 34 consecutive patients underwent coronary angiography with sick sinus syndrome and (/ or) sinus bradycardia were seen as study group 2, chose another 34 patients ascontrol group 2. The sinus node artery related lesions of these two groups were compared.2. Diagnosis criteria:We adopted the sick sinus syndrome diagnosis criteria of Beijing 1977. Sinus bradycardia referred an adults quiet heart rate less than 60 beats/min. The sinus node artery related lesion referred to the stenosis or occlusion of the sinus node artery or of coronary arteries proximal to the sinus node artery.3. Statistical analysis:The origin of the sinus node artery was calculated by constituent ratio; The relationship between sinus node artery related lesion and sick sinus syndrome was analyzed with software SPSS10.0. Results were presented with x s . T test was applied to measurement data and chi square test or its continuity correction to enumeration data. We adopted 2-sides test for all significant tests, a =0. 05.Results:Among 511 patients, we found 561 sinus node arteries in 506 people. 53 patients (10. 17% ) had 2 SNAs and one patient had 3 SNAs. There were 275 (49. 02% ) right, 205 (36. 54% ) left and 81 ( 14. 44% ) posterior SNAs. We can usually see SNAs in standard projections, occasionally canl. The differences of general conditions, such as gender ( x =0. 892, P = 0. 345 > 0. 05) , age(63.76 9. 16 vs. 58. 45 11. 48,t = 1. 95 , P= 0.057 >0. 05) and the origin of sinus node artery (x2 =0. 518, P =0. 772 >0. 05) were not significant. The stenosis of sinus node arteries were significantly different (66. 03 22. 92% vs. None, t = 15. 51 ,P =0.000 <0.01). But the differences of average heart rates (71. 59 7. 45 beats/min vs. 73. 76 6. 67 beats/min, t = - 1. 170,p =0.247 >0.05) and patients of SSS (1 vs. 0, p = 1 >0.05) were not significant between the 2 groups with and without SNA related lesion. Comparing the 2 groups with and without sick sinus syndrome, the average heart rate was significantly different (58.38 9.28 beats/min vs. 71.47 8.17 beats/min, t = -6.17,P =0. 000 <0. 05) , and the general conditions, such as gender(x = 0.314, P=0.575>0.05), age (64.21 12.21 vs. 58.97 9.38,t = l.982, P=0.052 >0.05) and the origin of SNA (X2 =0.539, P=0.764 >0. 05 ) were not. And the stenosis of sinus node artery was insignificant (1.91 8. 345%vs.3.82 16.70%, t= -0.597, P =0.553 >0.05).ConclusionsWe can usually see the artery of sinus node with angiography ( occasionally cant). Right, left and posterior sinus node arteries respectively account for49. 02% ,3.6. 54% , and 14. 44% of all SNAs. There's no significant relation between the coronary artery diseases of sinus node and its disfunction, namely, ischemia of sinus node arteries are n... |
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