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Analysis of anomalous origin of coronary arteries by coronary angiography in Chinese patients with coronary artery disease

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Abstract

With the development of coronary angiography for the diagnosis of coronary artery disease, its clinical significance in detecting coronary artery anomalies and evaluating the seriousness is attracting more attention. In the study we aimed to assess the prevalence of anomalous origin of coronary arteries in a Chinese population who underwent coronary angiography for coronary artery disease, and explore any patterns in the common variants and typical anomalies, especially the potentially serious ones. Patients who underwent coronary angiography from January 2013 to December 2016 in Fuwai Hospital were included. Baseline characteristics and angiographic data were collected, the incidence of anomalous origin of coronary arteries was calculated, and the typical patterns were analyzed. Comparisons between the present results and those of existing reports were also conducted. A total of 110,158 patients were included in the study, among which 0.76% (835 cases) had anomalous origin of coronary arteries. Among the anomalies, the incidences of anomalous origin of the right coronary artery (RCA), the left coronary artery (LCA), both the RCA and LCA, single coronary artery (SCA) and dextrocardia were 76.76% (641 cases), 14.61% (122 cases), 1.80% (15 cases), 4.67% (39 cases) and 2.16% (18 cases), respectively. Moreover, 47.54% (397 cases) of the anomalies were shown to be potentially serious, and an RCA arising from the left sinus of Valsalva (LSV) was the most common subtype (39.28%, 328 cases). Although anomalous origin of coronary arteries is not quite common, more clinical attention should be paid to this condition due to the potential risk of serious sequelae.

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References

  1. Pursnani A, Jacobs JE, Saremi F, Levisman J, Makaryus AN, Capunay C, Rogers IS, Wald C, Azmoon S, Stathopoulos IA, Srichai MB (2012) Coronary CTA assessment of coronary anomalies. J Cardiovasc Comput Tomogr 6:48–59

    Article  PubMed  Google Scholar 

  2. Tuo G, Marasini M, Brunelli C, Zannini L, Balbi M (2013) Incidence and clinical relevance of primary congenital anomalies of the coronary arteries in children and adults. Cardiol Young 23:381–386

    Article  PubMed  Google Scholar 

  3. Labombarda F, Coutance G, Pellissier A, Mery-Alexandre C, Roule V, Maragnes P, Milliez P, Saloux E (2014) Major congenital coronary artery anomalies in a paediatric and adult population: a prospective echocardiographic study. Eur Heart J Cardiovasc Imaging 15:761–768

    Article  PubMed  Google Scholar 

  4. Maron BJ, Shirani J, Poliac LC, Mathenge R, Roberts WC, Mueller FO (1996) Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles. J Am Med Assoc 276:199–204

    Article  CAS  Google Scholar 

  5. Angelini P (2014) Novel imaging of coronary artery anomalies to assess their prevalence, the causes of clinical symptoms, and the risk of sudden cardiac death. Circ Cardiovasc Imaging 7:747–754

    Article  PubMed  Google Scholar 

  6. Yurtdas M, Gulen O (2012) Anomalous origin of the right coronary artery from the left anterior descending artery: review of the literature. Cardiol J 19:122–129

    Article  PubMed  Google Scholar 

  7. Yamanaka O, Hobbs RE (1990) Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Catheter Cardiovasc Diagn 21:28–40

    Article  CAS  Google Scholar 

  8. Corrado D, Thiene G, Cocco P, Frescura C (1992) Non-atherosclerotic coronary artery disease and sudden death in the young. Br Heart J 68:601–607

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  9. Villa AD, Sammut E, Nair A, Rajani R, Bonamini R, Chiribiri A (2016) Coronary artery anomalies overview: the normal and the abnormal. World J Radiol 8:537–555

    Article  PubMed  PubMed Central  Google Scholar 

  10. Lipton MJ, Barry WH, Obrez I, Silverman JF, Wexler L (1979) Isolated single coronary artery: diagnosis, angiographic classification, and clinical significance. Radiology 130:39–47

    Article  PubMed  CAS  Google Scholar 

  11. Desmet W, Vanhaecke J, Vrolix M, Van de Werf F, Piessens J, Willems J, de Geest H (1992) Isolated single coronary artery: a review of 50,000 consecutive coronary angiographies. Eur Heart J 13:1637–1640

    Article  PubMed  CAS  Google Scholar 

  12. Engel HJ, Torres C, Page HL Jr (1975) Major variations in anatomical origin of the coronary arteries: angiographic observations in 4,250 patients without associated congenital heart disease. Catheter Cardiovasc Diagn 1:157–169

    Article  CAS  Google Scholar 

  13. Chaitman BR, Lesperance J, Saltiel J, Bourassa MG (1976) Clinical, angiographic, and hemodynamic findings in patients with anomalous origin of the coronary arteries. Circulation 53:122–131

    Article  PubMed  CAS  Google Scholar 

  14. Baltaxe HA, Wixson D (1977) The incidence of congenital anomalies of the coronary arteries in the adult population. Radiology 122:47–52

    Article  PubMed  CAS  Google Scholar 

  15. Kimbiris D, Iskandrian AS, Segal BL, Bemis CE (1978) Anomalous aortic origin of coronary arteries. Circulation 58:606–615

    Article  PubMed  CAS  Google Scholar 

  16. Donaldson RM, Raphael M, Radley-Smith R, Yacoub MH, Ross DN (1983) Angiographic identification of primary coronary anomalies causing impaired myocardial perfusion. Catheter Cardiovasc Diagn 9:237–249

    Article  CAS  Google Scholar 

  17. Wilkins CE, Betancourt B, Mathur VS, Massumi A, De Castro CM, Garcia E, Hall RJ (1988) Coronary artery anomalies: a review of more than 10,000 patients from the Clayton Cardiovascular Laboratories. Tex Heart Inst J 15:166–173

    PubMed  PubMed Central  CAS  Google Scholar 

  18. Aydinlar A, Cicek D, Senturk T, Gemici K, Serdar OA, Kazazoglu AR, Kumbay E, Cordan J (2005) Primary congenital anomalies of the coronary arteries: a coronary arteriographic study in Western Turkey. Int Heart J 46:97–103

    Article  PubMed  Google Scholar 

  19. Topaz O, DeMarchena EJ, Perin E, Sommer LS, Mallon SM, Chahine RA (1992) Anomalous coronary arteries: angiographic findings in 80 patients. Int J Cardiol 34:129–138

    Article  PubMed  CAS  Google Scholar 

  20. Wu Y, Yao M, Gao RL, Chen JL, Yang YJ, Qin XW, Qiao SB, Yao KB, Liu HB, Wu YJ, Yuan JQ, Chen J, Wu Y, Dai J, You SJ, Qian J (2004) Analysis of anomalous origin of coronary arteries by coronary angiography in adult patients. Chin J Cardiol 32:587–591

    Google Scholar 

  21. Young PM, Gerber TC, Williamson EE, Julsrud PR, Herfkens RJ (2011) Cardiac imaging: part 2, normal, variant, and anomalous configurations of the coronary vasculature. Am J Roentgenol 197:816–826

    Article  Google Scholar 

  22. Angelini P (2007) Coronary artery anomalies: an entity in search of an identity. Circulation 115:1296–1305

    Article  PubMed  Google Scholar 

  23. Li CB, Bi YW, Sun WY, Li RJ, Li GS, You BA, Chen WQ, Li DQ, Chen YG, Zhang Y (2011) Aberrant origin of circumflex coronary artery from left subclavian artery. J Am Coll Cardiol 57:e1

    Article  PubMed  Google Scholar 

  24. Yuan SM (2014) Anomalous origin of coronary artery: taxonomy and clinical implication. Rev Bras Cir Cardiovasc 29:622–629

    PubMed  PubMed Central  Google Scholar 

  25. Brothers JA, Frommelt MA, Jaquiss RDB, Myerburg RJ, Fraser CD Jr, Tweddell JS (2017) Expert consensus guidelines: anomalous aortic origin of a coronary artery. J Thorac Cardiovasc Surg 153:1440–1457

    Article  PubMed  Google Scholar 

  26. Kaikkonen KS, Kortelainen ML, Linna E, Huikuri HV (2006) Family history and the risk of sudden cardiac death as a manifestation of an acute coronary event. Circulation 114:1462–1467

    Article  PubMed  Google Scholar 

  27. Taylor AJ, Byers JP, Cheitlin MD, Virmani R (1997) Anomalous right or left coronary artery from the contralateral coronary sinus: “high-risk” abnormalities in the initial coronary artery course and heterogeneous clinical outcomes. Am Heart J 133:428–435

    Article  PubMed  CAS  Google Scholar 

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Author notes

  1. Yuan Tian and Ying Yuan are co-first authors with equal intellectual and scientific contributions.

Authors and Affiliations

  1. Urumqi Friendship Hospital, Urumqi, **njiang Uygur Autonomous Region, China

    Yuan Tian & Hang Lu

  2. National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, A 167, Beilishi Road, **cheng District, Bei**g, 100037, China

    Ying Yuan, Liang Xu, Wei **an Yang, Chao Wei Mu, Hai Bo Liu, Jue Chen, Ke Fei Dou, Yi Da Tang, ** Qing Yuan, Yong Jian Wu, Hong Bing Yan, Bo Xu, Shu Bin Qiao, Yue ** Yang, Run Lin Gao & Hong Qiu

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  1. Yuan Tian
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  3. Hang Lu
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  4. Liang Xu
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  11. ** Qing Yuan
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  16. Yue ** Yang
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  17. Run Lin Gao
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  18. Hong Qiu
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Corresponding author

Correspondence to Hong Qiu.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Tian, Y., Yuan, Y., Lu, H. et al. Analysis of anomalous origin of coronary arteries by coronary angiography in Chinese patients with coronary artery disease. Int J Cardiovasc Imaging 34, 1331–1337 (2018). https://doi.org/10.1007/s10554-018-1350-0

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  • DOI: https://doi.org/10.1007/s10554-018-1350-0

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