Introduction. Severe Coronary Tortuosity (SCT) is two or more consecutive 180-degree turns in the epicardial artery, which is estimated by coronary angiography data and one recognizes as a risk factor for future atherosclerotic lesions in this district due to the turbulent blood flow, buildup of artery walls and changes in connection with permanent pulse strike at the tortuous artery. But, the independent clinical significance of SCT in patients with coronary artery disease (CAD) on objective signs of myocardial ischemia has not yet been studied.
Objective is to determine the dependence of clinical signs of coronary reserve limitation and angina attacks on the number of consecutive turns in the tortuous section of a coronary artery in patients with coronary artery disease with coronary syndrome X.
Methods and results. Quality of life assessment produced by Seattle Angina Questionnaire (SAQ). The presence of positive stress-test veloergometry functional class and calculated double product considered as an indicator of myocardial ischemia.
There were 217 patients with coronary X syndrome in 2008–2011. SCT syndrome was determined in 148 (68.2%) patients. The analysis of local coronary flow reserve limitations in the tortuous coronary artery has performed in 112 patients with coronary artery disease and coronary syndrome X. The most of patients had 4–6 turn of tortuous artery, the average number of turns amounted to 6.1±0.2.
Conclusions.
1. SCT is found in 148 (68.2%) from 217 cases of patients with CAD with myocardial ischemia signs and intact coronary arteries (coronary X syndrome).
2. Correlation analysis (with level of significance p=0.01) showed a strong reliable statistical interrelation between the number of consecutive turns in the coronary artery and the frequency of angina attacks by SAQ (correlation coefficient = -0.81) and average statistical relationship with objective evidences of myocardial ischemia according stress-test veloergometry (correlation coefficient=0.49).
3. The dependence of myocardial ischemia clinical signs and degree (more than 5 turns) of SCT in patients with CAD and coronary X syndrome determined by the regression equation.