Correlation Between Coronary Tortuosity With Coronary Atherosclerosis And Its Effect On Cardiac Function And Risk Factor Analysis

Objectives:To investigate the correlation between coronary tortuosity and coronary atherosclerosis,and to investigate the effect of coronary tortuosity on cardiac function and the risk factors of coronary tortuosity.Methods:Patients who underwent coronary angiography in the department of cardiology from December 2017 to December 2018 due to chest tightness,chest pain and other symptoms were retrospectively analyzed,and each branch of coronary was observed through corresponding different projection positions.according to the definition of coronary artery tortuosity to collected cases werestrictly.Our study has the following two parts:1.The degree of atherosclerotic between the tortuous segments and the non-tortuous segments of 389 single coronary tortuosity was compared,and statistical analysis was performed to exclude the bias caused by other factors,clarifing the correlation between coronary tortuosity and coronary atherosclerosis;2.Collecting 143 patients without obvious stenosis(stenosis degree<30%)in coronary angiography,67 patients with at least one vessel with coronary tortuosity(CT)and 76 patients with no coronary tortuosity(NCT).To compare the clinical characteristics of two groups of samples,including gender,age,height,previous history(smoking,diabetes history,hypertension history),laboratory indicators(blood cell analysis,biochemical indicators,etc.),and transthoracic echocardiography indicators will be retrospective studied,to explore the risk factors of coronary tortuosity and its possible impact on cardiac function.Results:1.There was no significant stenosis incidence in the same coronary artery with non-tortuous segment and tortuous segment(61.70%vs 88.95%,P<0.001),and the proportion of non-tortuous segment with no significant stenosis was significantly lower than tortuous segment.Indicated coronary tortuosity was negatively correlated with coronary atherosclerosis,and the stenosis decreased with the increase of tortuosity severity(P=0.047).The most frequently involved vessels in coronary tortuosity were left anterior descending branch(LAD),followed by left circumflex branch(LCX).2.Early diastolic mitral inflow velocity(E peak)(0.76±0.16 vs 0.91±0.15,P=0.000)and E/A value(0.8±0.2 vs 1.05±0.25,P=0.000)of the coronary artery tortuosity group were significantly lower than those in the non-tortuosity group.Multiple linear regression model results showed that E/A ratio was correlated with coronary artery tortuosity(P=0.000),hypertension(P=0.020)and age(P=0.002),and E peak was correlated with coronary artery tortuosity(P<0.001)and total cholesterol(P=0.032).The results indicated that the coronary tortuosity was associated with impaired left ventricular diastolic function.And the severity of coronary tortuosity was negatively correlated with E peak and E/A ratio,the more severe the tortuosity was,the more severe impaired left ventricular diastolic function was.LAD was negatively correlated with E/A ratio,LAD+LCX was positively correlated with A peak and negatively correlated with E/A ratio,LCX was positively correlated with E peak and E/A ratio,and RCA was positively correlated with A peak and E/A ratio,which were statistically significant(P<0.05).3.In the coronary tortuosity group,the gender ratio(62.69%vs 25%,P=0.013),prevalence of hypertension(76.12%vs 30.26%,P=0.000),hemoglobin concentration(140.19±16.57 vs 134.08±17.98,P=0.037),total cholesterol(4.29±0.87 vs 3.87±0.86,P=0.004),triglyceride(2.12±1.31 vs 1.62 ± 0.81),P=0.007),homocysteine(13.31 ±3.16 vs 12.15±2.42,P=0.016)were significantly higher than those in the non-pedantry group,and smoking(28.36%vs 48.68%,P=0.013)were significantly lower than those in the non-tortuosity group(161.69±6.99 vs 166.39±7.22,P=0.000).Multivariate Logistic analysis showed that women(OR 3.931,95%CI 1.021-15.138,P=0.047),hypertension(OR 6.43,95%CI 32.592-15.961,P=0.000),hemoglobin concentration(OR 1.03,95%CI 1.003-1.059,P=0.030)and smoking(OR 3.393,95%CI 1.04-11.067,P=0.043)are independent risk factors for coronary tortuosity.Conclusions:1.Coronary tortuosity is negatively correlated with coronary atherosclerosis,which can protect coronary and prevent atherosclerosis.As the severity of tortuosity increases,the severity of coronary atherosclerosis decreases.Coronary tortuosity most often involves the left anterior descending branch.2.Coronary tortuosity is associated with decreased left ventricular diastolic function,lead to left ventricular diastolic function to be impaired,and the more serious the coronary artery tortuosity is,the more obvious the left ventricular diastolic function is impaired.3.Height,hemoglobin concentration,triglycerides,total cholesterol,homocysteine,gender,smoking,and hypertension may be associated with the incidence of coronary tortuosity.female,hypertension,smoking and hemoglobin concentration were independent risk.factors for coronary tortuosity.