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Original Article
01 (
01
); 008-013
doi:
10.1055/s-0038-1656469

Importance of Proximal Angle in Generation of Abnormal Plaque at Coronary Bifurcation Lesions

Senior resident, Department of Cardiology, NIMS, India
Assistant Professor, Department of Cardiology, NIMS, India
Address for correspondence deepthi.kodati@gmail.com
Licence
This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Disclaimer:
This article was originally published by Thieme Medical and Scientific Publishers Private Ltd. and was migrated to Scientific Scholar after the change of Publisher; therefore Scientific Scholar has no control over the quality or content of this article.

Abstract

Abstract

BACKGROUND: Changing of linear blood flow to turbulence at branching points predisposes to development of obstructive coronary lesions. We hypothesize that in addition to bifurcation angle (BA), proximal (PA) and third angle (TA) of branching site are important in generating more vertices of blood flow.

METHODS: 65 normal and 36 significantly diseased LAD – D1, 72 normal and 27 significantly diseased LCX – OM, 73 normal and 16 significantly diseased RCA – PDA – PLV and 34 normal and 14 significantly diseased LMCA – LAD – LCX bifurcations were analyzed with QCA.

RESULTS: In LAD – D1 normal vs. significantly diseased bifurcations BA and PA were 78.2±13.2 vs. 65.1±11.3 (p <0.000) and 122.7±13.8 vs. 131.6.36±12.5 (p <0.001) respectively. In LCX – OM normal vs. significantly diseased bifurcations BA and PA were 76.8±13.6 vs. 60.7±13.8 (p=0.000) and 125.1±13.5 vs. 137.8±12.8 (p <0.000) respectively. In RCA - PDA – PLV normal vs. significantly diseased bifurcations BA, PA and TA were 91.1±13.8 vs. 71.5±15.9 (p 0.004), 113.0±14.1 vs. 128.4±20.2 (p=0.000), 118.2±21.7 vs. 133.8±12.4 (p=0.007) respectively. In LMCA –LAD – LCX normal vs. significantly diseased bifurcations BA, PA and TA were 84.0±39.1 vs. 73.0±17.6 (p >0. 32), 123.2±26.3 vs. 115.3±30.4 (p > 0.38), 130.3±27.3 vs. 137.5±33.5 (p >0.45) respectively. There was a significant difference but no correlation between the angles in normal and diseased bifurcation segment. We derived logistic regression equations for predicting the disease in different coronary bifurcations.

CONCLUSION: In LAD - D1, LCX – OM and RCA – PDA – PLV bifurcations lesser the BA, greater the PA, were more likely to develop significant lesion, which was not true in LMCA – LAD – LCX bifurcation.

Keywords

Bifurcation angle
proximal angle
Coronary artery disease

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