Analysis of Correlation Between Coronary Tortuosity and Calcification Score

Background: Coronary artery tortuosity (CAT) is regarded as a variation of vascular anatomy, and its relationship with coronary artery calcification (CAC) score is still not well clarified. Studying the correlation between coronary artery calcification scores and CAT to determine specific prevention and intervention populations seems to have more meaningful.Methods: The study is a cross-sectional retrospective study, including 1280 patients with tortuous coronary artery. CAT is defined as the presence of at least three consecutive curvatures of more than 45°measured during systole or diastole of a major epicardial coronary artery. Multivariable regression analysis was used to adjust the clinical parameters directly affecting CAT.Results: Of these individuals, 445 (35%) were evaluated having CAT, of which females are higher than males (59.1% vs. 40.9%). Moderate CAC score (101-400) (odds ratio (OR) 1.49, 95% confidence interval [95%CI] 1.05-2.10, P=0.025) revealed significantly associated with CAT on univariable analysis. However, multivariable analysis after adjusting for confounding factors only indicated that CAT was positively correlated with female (OR 1.60, 95%CI 1.22-2.10, P=0.001), hypertension (OR 1.34, 95% CI 1.03-1.74, P=0.028), and age (OR 1.04, 95% CI 1.01-1.03, P=0.001), while was negatively associated with body mass index (BMI) > 28 (OR 0.48, 95% CI 0.32-0.70, P<0.0001). Further analysis stratified by gender showed that compared with non-CAT, CAT was significantly linked with moderate CAC score (OR 1.79, 95% CI 1.00-3.20, P=0.048), hypertension (OR 1.54, 95% CI 1.07-2.22, P=0.021), and high-density lipoprotein (HDL) (OR 1.86, 95% CI 1.07-3.24, P=0.028), while was negatively related to BMI > 28 (OR 0.51, 95% CI 0.31-0.84, P<0.008) in female patients.Conclusions: CAT is more likely to be found in females, connected with hypertension, age, and BMI. No significant correlation is found between the presence of tortuosity and calcium score or diameter stenosis on multivariable analysis. Whereas the CAT is associated with moderate CAC score in correlation analysis when women are selected as the main group.

[1]  D. Brömme,et al.  Expression of elastolytic cathepsins in human skin and their involvement in age-dependent elastin degradation. , 2020, Biochimica et biophysica acta. General subjects.

[2]  Elham Rayzan,et al.  The significant coronary tortuosity and atherosclerotic coronary artery disease; What is the relation? , 2018, Journal of cardiovascular and thoracic research.

[3]  M. Budoff,et al.  Coronary Calcium Score and Cardiovascular Risk. , 2018, Journal of the American College of Cardiology.

[4]  A. Durham,et al.  Role of smooth muscle cells in vascular calcification: implications in atherosclerosis and arterial stiffness , 2018, Cardiovascular research.

[5]  P. Mitchell,et al.  Gender differences in the prevalence of coronary artery tortuosity and its association with coronary artery disease , 2016, International journal of cardiology. Heart & vasculature.

[6]  M. Tharwat,et al.  The relation between coronary tortuosity and calcium score in patients with chronic stable angina and normal coronaries by CT angiography. , 2016, Atherosclerosis.

[7]  N. Žarković,et al.  Elastin aging and lipid oxidation products in human aorta , 2014, Redox biology.

[8]  R. Nicoll,et al.  The predictive value of arterial and valvular calcification for mortality and cardiovascular events , 2014, International journal of cardiology. Heart & vessels.

[9]  R. Kronmal,et al.  Progression of coronary calcium and incident coronary heart disease events: MESA (Multi-Ethnic Study of Atherosclerosis). , 2013, Journal of the American College of Cardiology.

[10]  G. Ma,et al.  Impact of Coronary Tortuosity on Coronary Pressure: Numerical Simulation Study , 2012, PloS one.

[11]  Hai-Chao Han Twisted Blood Vessels: Symptoms, Etiology and Biomechanical Mechanisms , 2012, Journal of Vascular Research.

[12]  Avione Y. Lee,et al.  Effects of elastin degradation and surrounding matrix support on artery stability. , 2012, American journal of physiology. Heart and circulatory physiology.

[13]  G. Ma,et al.  Clinical Implication of Coronary Tortuosity in Patients with Coronary Artery Disease , 2011, PloS one.

[14]  Edward Proctor,et al.  The Chronic Vascular and Haemodynamic Response after Permanent Bilateral Common Carotid Occlusion in Newborn and Adult Rats , 2006, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[15]  T. Callister,et al.  Progression of Coronary Artery Calcium and Risk of First Myocardial Infarction in Patients Receiving Cholesterol-Lowering Therapy , 2004, Arteriosclerosis, thrombosis, and vascular biology.

[16]  O. Hess,et al.  Tortuosity of coronary arteries in chronic pressure and volume overload. , 1996, Catheterization and cardiovascular diagnosis.

[17]  Y C Fung,et al.  Longitudinal strain of canine and porcine aortas. , 1995, Journal of biomechanics.

[18]  G. Hutchins,et al.  Correlation of age and heart weight with tortuosity and caliber of normal human coronary arteries. , 1977, American heart journal.

[19]  M. G. Taylor,et al.  Alterations with Age in the Viscoelastic Properties of Human Arterial Walls , 1966, Circulation research.