评估冠状动脉 CT 血管造影术中左侧窦房右冠动脉异常主动脉起源与动脉间走向与心脏性猝死之间的关联。

IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiology. Cardiothoracic imaging Pub Date : 2024-08-01 DOI:10.1148/ryct.230407
Bo Mi Gil, Suyon Chang, Kyongmin Sarah Beck, Whal Lee, Hye-Jeong Lee, Ki Seok Choo, Myung Hee Chung, Tae Hoon Kim, Jung Im Jung
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After excluding patients with less than 2 years of follow-up, patients who had already undergone cardiovascular surgery or intervention, and patients with arrhythmia or heart failure before undergoing coronary CT angiography, 224 patients were analyzed. Follow-up was terminated upon the occurrence of major adverse cardiovascular events (MACE). Logistic regression was used to identify clinical and radiologic information as independent predictors of MACE. Results The period prevalence of R-AAOCA from the left sinus with IAC was 0.354%. The mean age was 62.03 years, with a male-to-female ratio of 182:134. During follow-up, 19 of 224 patients (8.5%) experienced MACE, but none had sudden cardiac death. Of these cases, only seven (3.13%) were suspected of being due to R-AAOCA from the left sinus with IAC and all of them had unstable angina. 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引用次数: 0

摘要

目的 利用来自五所大学医院的大数据集,研究冠状动脉 CT 血管造影发现的右冠状动脉主动脉起源异常(R-AAOCA)来自左冠状动脉窦并伴有动脉间路径(IAC)与心脏性猝死之间的关联。材料与方法 从回顾性收集的总共 89 314 次 CCTA 扫描(2009 年 1 月至 2016 年 12 月)中,回顾性收集了 316 例左冠状窦 R-AAOCA 伴 IAC 患者。在排除随访时间不足 2 年的患者、已接受心血管手术或介入治疗的患者以及接受冠状动脉 CT 血管造影术前患有心律失常或心力衰竭的患者后,共对 224 名患者进行了分析。一旦发生重大不良心血管事件(MACE),随访即终止。采用逻辑回归法确定临床和放射学信息作为 MACE 的独立预测因素。结果 左窦R-AAOCA合并IAC的时期发病率为0.354%。平均年龄为 62.03 岁,男女比例为 182:134。在随访期间,224 名患者中有 19 人(8.5%)发生了 MACE,但没有人发生心脏性猝死。在这些病例中,只有7例(3.13%)被怀疑是由于左窦R-AAOCA并发IAC所致,而且所有病例都有不稳定型心绞痛。冠状动脉疾病与 MACE 显著相关(P < .001),而与放射学特征无显著相关性。结论 心源性猝死与冠状动脉 CT 血管造影发现的左静脉窦 R-AAOCA 并无关联。MACE 发生率较低,冠状动脉疾病是预测患者预后的唯一重要因素。关键词右冠状动脉异常主动脉起源、左冠状动脉窦动脉间路径、冠状动脉 CT 血管造影、心脏性猝死 本文有补充材料。© RSNA, 2024.
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Evaluating the Association between Anomalous Aortic Origin of the Right Coronary Artery from the Left Sinus with Interarterial Course at Coronary CT Angiography and Sudden Cardiac Death.

Purpose To investigate the association between the anomalous aortic origin of the right coronary artery (R-AAOCA) from the left coronary sinus with interarterial course (IAC) found at coronary CT angiography and sudden cardiac death using a large data set from five university hospitals. Materials and Methods From a total of 89 314 CCTA scans (January 2009 to December 2016) that were retrospectively collected, 316 patients with R-AAOCA from the left sinus with IAC were retrospectively collected. After excluding patients with less than 2 years of follow-up, patients who had already undergone cardiovascular surgery or intervention, and patients with arrhythmia or heart failure before undergoing coronary CT angiography, 224 patients were analyzed. Follow-up was terminated upon the occurrence of major adverse cardiovascular events (MACE). Logistic regression was used to identify clinical and radiologic information as independent predictors of MACE. Results The period prevalence of R-AAOCA from the left sinus with IAC was 0.354%. The mean age was 62.03 years, with a male-to-female ratio of 182:134. During follow-up, 19 of 224 patients (8.5%) experienced MACE, but none had sudden cardiac death. Of these cases, only seven (3.13%) were suspected of being due to R-AAOCA from the left sinus with IAC and all of them had unstable angina. Coronary artery disease was significantly associated with MACE (P < .001), while no significant correlation was observed with radiologic features. Conclusion Sudden cardiac death was not associated with R-AAOCA from the left sinus with IAC found at coronary CT angiography. The occurrence of MACE was low, with coronary artery disease being the sole significant predictor of a patient's prognosis. Keywords: Anomalous Aortic Origin of the Right Coronary Artery, Left Coronary Sinus with Interarterial Course, Coronary CT Angiography, Sudden Cardiac Death Supplemental material is available for this article. © RSNA, 2024.

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