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Abstract
Coronary artery ectasia (CAE) is an abnormal dilatation of the coronary artery wall . The growing number of coronary angiographies and other invasive cardiologic procedures increased the documented incidence of CAE. There is no consensus about the etiology, prognostic significance and morbidity related to this phenomenon. Atherosclerosis is most probably the main cause of primary or idiopathic ectasia.
There are, nowadays, many methods for the assessment of coronary flow velocity e.g. Doppler wire, positive emission tomography, magnetic resonance imaging and transoesophageal echocardiography.
Transoesophageal echocardiography is an application of ultrasonography which can image the proximal segments of the left coronary artery and measure the flow velocity in the left anterior descending coronary artery.
Aim of the work is to assess coronary flow in patients with coronary artery ectasia and to study the effect of intravenous nitroglycerin on coronary flow using transoesophageal echocardiography (TEE).
Forty patients were included in the study, who underwent coronary angiography at Ain Shams University Hospital, within the period between February 2006 and February 2008. Patients were divided according to the result of elective coronary angiography into two groups; group A: included 30 patients with angiographically documented ectasia in the left anterior descending coronary artery (LAD) and group B: included 10 patients with angiographically normal coronaries (It served as control group) .
All patients underwent TEE using pulsed wave Doppler to measure peak systolic and diastolic velocities (m/sec), systolic, diastolic & total velocity time integrals (cm) and the systolic, diastolic & total coronary blood flow (cm³/min) .Then reassessment of the previous parameters after intravenous injection of 0.3 mg of nitroglycerin.
patients with CAE were younger with male predominance and the incidence of diabetes mellitus was significantly low among them.
There was no statistically significant difference between both groups as regards basal peak systolic and diastolic velocities despite of higher peak diastolic velocity in normal vessels. No statistically significant difference was found between the two study groups as regards basal systolic, diastolic & total velocity time integrals. A statistically significant higher basal systolic, diastolic and total coronary blood flow was found in patients with CAE.