Adult Coronary Artery Morphological Analysis Based On Quantitative Coronary Angiography

BackgroundCoronary heart disease(CHD)is a chronic disease that seriously endangers human health.With the rapid development of China's economy,the prevalence and mortality of CHD in China are gradually increasing in recent years.Percutaneous coronary intervention(PCI)is an important first-line treatment for CHD.In-stent restenosis,in-stent thrombosis and coronary artery injury are common PCI-related complications that seriously endanger the life and prognosis of patients.Improper selection or operation of interventional materials may increase the incidence of complications.Therefore,it is of great significance for the design and selection of interventional stents and baloons to determine the distribution of coronary artery morphological parameters such as diameter,length and bifurcation angle in the population.ObjectivesTo identify the main morphological parameters and variation characteristics of the adult coronary artery.To explore the correlation between coronary artery morphology and the degree of stenosis.MethodsA total of 1023 adult inpatients who underwent coronary angiography(CAG)examination in the Department of Cardiology of the Affiliated Puyang Oil Field General Hospital,Xinxiang Medical University,from February 2,2019 to January 16,2020 were analyzed retrospectively.The patients who met the inclusion criteria of this study were analyzed by Stenosis Analysis 1.6 quantitative coronary angiography(QCA)software.It includes the left main coronary artery(LM),the left anterior descending branch(LAD),the first diagonal branch(D1),the left circumflex branch(LCX),the first obtuse marginal branch(OM1),the right coronary artery(RCA)and the ramus intermedius artery(RI).The morphological parameters such as coronary artery origin,dominant type,bifurcation angle,diameter,length,and stenosis of lesion were collected.And then make a statistical analysis.Results1.A total of 442 patients met the inclusion criteria,including 177 females(40.0%)and 265 males(60.0%),aged 63.6 ±10.2 years.2.Coronary artery origin: 437 cases(98.9%)were normal coronary artery origin,4 cases(0.9%)absence of LM,1 case(0.2%)abnormal LCX origin,and no other types of coronary artery origin were found.3.Coronary artery dominant type: 361 cases(81.9%)were right dominant type,47 cases(10.6%)left dominant type,and 33 cases(7.5%)balanced type.4.RI: no RI was seen in 361 cases(82.6%),1 RI in 73 cases(16.7%),2 RI in 3 cases(0.7%).5.The bifurcation angles of LM-LAD,LM-LCX,LAD-LCX and LM-RI were 149 ±17 °,103 ±27 °,81 ±28 °and 160 ±19 °,respectively.6.Diameter and length of coronary artery: The diameter and length of LM were 4.4±0.8 mm and 8.1±3.2 mm respectively.Those of the proximal segment of LAD were 3.3±0.7 mm and 16.7±7.4 mm respectively.The middle segment of LAD 2.8±0.6 mm and 23.1±11.4 mm.The distal segment of LAD 2.4±0.5 mm and 76.9±20.7 mm respectively.The average length of LAD is 116.7±21.6 mm.The diameter and length of D1 were 1.9±0.5 mm and 49.4±19.5 mm respectively.Those of the proximal segment of LCX were 3.1±0.7 mm and 20.8±9.8 mm,the distal segment of LCX 2.4±0.7 mm and 52.2±19.4 mm respectively.The average length of LCX was 73.1±20.3 mm.The diameter and length of OM1 were 1.9±0.6 mm and 48.1±20.9 mm respectively.Those of the proximal segment of RCA were 3.6±0.7 mm and 17.7±7.7 mm,the middle segment of RCA 3.1±0.7 mm and 33.3±12.3 mm,the distal segment of RCA 2.8±0.7 mm and 77.3±19.2 mm respectively.The average length of RCA was 128.5±22.3 mm.7.Coronary artery stenosis rate: The stenosis rate of LM was 15.3±13.1%.LAD proximal stenosis 32.5±22.7%,the middle segment stenosis 36.4±21.2% and the distal segment stenosis 32.0±16.5%.D1 stenosis was 36.2±20.9%.LCX proximal stenosis 29.9±17.9% and the distal segment stenosis 34.2±20.7%.OM1 stenosis was 35.5±20.0%.RCA proximal stenosis 25.2±15.6%,the middle segment stenosis 32.5±21.9% and the distal segment stenosis 30.7±19.6%.8.The correlation between the stenosis rate and morphological parameters of coronary artery: The stenosis rate of LM was positively correlated with LAD-LCX angle(R=0.150,P=0.002).The stenosis rate was negatively correlated with the diameter of proximal LAD(R=-0.189,P<0.001),proximal LCX(R=-0.150,P=0.002),distal LCX(R=-0.101,P=0.035),OM1(R=-0.160,P<0.001)and middle RCA(R=-0.133,P=0.005).The stenosis rate was positively correlated with the length of LM(R=1.660,P<0.001),proximal LAD(R=0.287,P<0.001),middle LAD(R=0.152,P=0.002),proximal LCX(R=0.168,P<0.001)and proximal RCA(R=0.172,P<0.001).ConclusionsQCA is used accurately and precisely to measure the diameter,length,bifurcation angle and stenosis rate of coronary artery.The stenosis rate of LM was positively correlated with LAD-LCX angle.The stenosis rate of proximal LAD,proximal LCX,distal LCX,OM1 and middle RCA were negatively correlated with the diameter of each of the subsegments.The stenosis rate of LM,proximal LAD,middle LAD,proximal LCX and proximal RCA were positively correlated with the length of each of the subsegments.