الفهرس 
CoronaryArteryAnatomyOnly 14 pages are availabe for public view
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Abstract
CAD is an alarming health concern worldwide. An increase in the prevalence of various CAD risk factors at rapid pace has also been noted across different regions in the world. Hence, emphasis on preventive screening strategies, early diagnosis, and appropriate and timely management are strongly recommended. CAE has been defined as localized or diffuse non-obstructive lesions of the epicardial coronary arteries, with a luminal dilation ≥ 1.5 times of the adjacent normal segments or vessel diameter. Isolated CAE has been defined as CAE without significant coronary artery stenosis. This abnormal dilatation of coronary arteries can cause angina pectoris and even myocardial infarction due to vasospasm, dissection or thrombus in patients without CAD. Coronary angiography and new diagnostic tools have enabled clinicians to discover more cases of ectasia. However, not all patients with ectasia are symptomatic and receive coronary angiography examination; hence, the real incidence is unknown. The reported incidence is between 0.3% and 4.9% at autopsy and during coronary angiography. Farbia et al stated that of 2524 patients referred for coronary angiography, 166 (6.5%) atherosclerotic patients had CAE and 243 (9.6%) patients had normal coronary. The incidence as high as 12% in Indian population, which may have different demographic characteristics. There is a male preponderance, with a male-to female ratio of 3:1. Previous studies have demonstrated that inflammation, neuro-hormonal process and cardiovascular risk factors are associated with development of CAE. Although it has been suggested that CAE is a variant of O-CAD, a definitive link between atherosclerosis and ectasia has not been confirmed. However, it is unclear why similar risk factors lead to dilatation in the arterial lumen in some patients but to obstruction in others. Postmortem histopathologic studies showed that extensive vascular inflammatory infiltration involving all layers of the vascular wall in the coronary circulation was usually observed in patients with CAE. Qin et al found that sex, BMI, diastolic blood pressure, d-dimer, triglyceride, and LDL/HDL ratio are all risk factors for CAE. Hyperlipidemia has a good predictive value for CAE. The proximal and middle parts of the RCA are most commonly affected by ectasia, although the reasons for this are not clear. Involvement of the left anterior descending artery and left circumflex artery is variable. The left main coronary artery is less commonly involved. Most cases of CAE involve only a single vessel. Disturbance in blood flow filling and washout are major characteristics of CAE. Delayed antegrade filling, a segmental back flow phenomenon, and local deposition of dye (stasis) in the dilated coronary segment have been observed during imaging. This study aimed to assess the prevalence and predictors of CAE among population in Delta area. This cross-sectional study was conducted on 2850 adult (age > 18 years old) came for coronary angiography for positive noninvasive diagnostic tests, acute coronary syndrome or stable CAD. Patients were classified into two groups: CAE patients (n =108) and non-ectasia patients (n =2742). All patients were subjected to history taking, clinical examination, laboratory investigations, standard 12-leads ECG, resting transthoracic echocardiography (TTE) and coronary angiography.