Myocardial bridging (MB) and a long recurrent wraparound left anterior descending artery(wrap-LAD) are coronary anatomic variants that have been recently suggested to beassociated with takotsubo syndrom e (TS). Until now, coronary artery tortuosity (CAT) hasnever been investigated in this setting. Our study sought to evaluate the prevalence of theaforementioned anatomic variants in a large population with TS. In this retrospectiveangiographic study, 109 patients with TS were compared with 109 age- and gender-matched subjects without coronary artery disease, va lve heart disease, or cardiomyopa-thy. CAT was identi fied by ‡3 consecutive curvatures ‡90(criteria 1) or by ‡2 consecutivecurvatures ‡180(criteria 2). Wrap-LAD was defined if any part of the vessel outreachedthe apex of the left ventricle and MB as the presence of a milking effect or a step-up andstep-down phenomenon. An anatomic variant was found in 79 patients with TS (72%) andin 48 controls (44%) (p <0.001). CAT in at least 1 vessel (criteria 1: 49% vs 20%, p <0.001;criteria 2: 38% vs 13%, p <0.001), ‡2 vessels (criteria 2: 14% vs 3%, p [ 0.005), and wrap-LAD (41% vs 27%, p [ 0.02) were signi ficantly more frequent in patients with TS than incontrols. The prevalence of MB (9% vs 5%, p [ 0.18) did not differ between groups. Inconclusion, CAT and wrap-LAD have higher prevalence in patients with TS than inmatched controls. These findings could support the hypothesis that anatomic variantsmight act as potential pathogenic substrates in TS.

Tortuosity, Recurrent Segments, and Bridging of the Epicardial Coronary Arteries in Patients With the Takotsubo Syndrome / Arcari, Luca; Limite, LUCA ROSARIO; Cacciotti, Luca; Alonzo, Alessandro; Musumeci, Maria Beatrice; Passaseo, Ilaria; Marazzi, Giuseppe; Berni, Andrea; Ansalone, Gerardo; Volpe, Massimo; Autore, Camillo. - In: THE AMERICAN JOURNAL OF CARDIOLOGY. - ISSN 0002-9149. - STAMPA. - 119:2(2017), pp. 243-248. [10.1016/j.amjcard.2016.09.055]

Tortuosity, Recurrent Segments, and Bridging of the Epicardial Coronary Arteries in Patients With the Takotsubo Syndrome

ARCARI, LUCA;LIMITE, LUCA ROSARIO;CACCIOTTI, LUCA;ALONZO, ALESSANDRO;MUSUMECI, Maria Beatrice;PASSASEO, ILARIA;BERNI, Andrea;VOLPE, Massimo;AUTORE, Camillo
2017

Abstract

Myocardial bridging (MB) and a long recurrent wraparound left anterior descending artery(wrap-LAD) are coronary anatomic variants that have been recently suggested to beassociated with takotsubo syndrom e (TS). Until now, coronary artery tortuosity (CAT) hasnever been investigated in this setting. Our study sought to evaluate the prevalence of theaforementioned anatomic variants in a large population with TS. In this retrospectiveangiographic study, 109 patients with TS were compared with 109 age- and gender-matched subjects without coronary artery disease, va lve heart disease, or cardiomyopa-thy. CAT was identi fied by ‡3 consecutive curvatures ‡90(criteria 1) or by ‡2 consecutivecurvatures ‡180(criteria 2). Wrap-LAD was defined if any part of the vessel outreachedthe apex of the left ventricle and MB as the presence of a milking effect or a step-up andstep-down phenomenon. An anatomic variant was found in 79 patients with TS (72%) andin 48 controls (44%) (p <0.001). CAT in at least 1 vessel (criteria 1: 49% vs 20%, p <0.001;criteria 2: 38% vs 13%, p <0.001), ‡2 vessels (criteria 2: 14% vs 3%, p [ 0.005), and wrap-LAD (41% vs 27%, p [ 0.02) were signi ficantly more frequent in patients with TS than incontrols. The prevalence of MB (9% vs 5%, p [ 0.18) did not differ between groups. Inconclusion, CAT and wrap-LAD have higher prevalence in patients with TS than inmatched controls. These findings could support the hypothesis that anatomic variantsmight act as potential pathogenic substrates in TS.
2017
cardiology and cardiovascular medicine; ballooning syndrome; tako-tsubo cardiomyopathy
01 Pubblicazione su rivista::01a Articolo in rivista
Tortuosity, Recurrent Segments, and Bridging of the Epicardial Coronary Arteries in Patients With the Takotsubo Syndrome / Arcari, Luca; Limite, LUCA ROSARIO; Cacciotti, Luca; Alonzo, Alessandro; Musumeci, Maria Beatrice; Passaseo, Ilaria; Marazzi, Giuseppe; Berni, Andrea; Ansalone, Gerardo; Volpe, Massimo; Autore, Camillo. - In: THE AMERICAN JOURNAL OF CARDIOLOGY. - ISSN 0002-9149. - STAMPA. - 119:2(2017), pp. 243-248. [10.1016/j.amjcard.2016.09.055]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/932450
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