ArticleJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography2024
Coronary Artery Tortuosity and Spontaneous Coronary Artery Dissection: Association With Echocardiography and Global Longitudinal Strain, Fibromuscular Dysplasia, and Outcomes.
Article in Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 3 citations in OpenAlex.
- Spontaneous Coronary Artery Dissection: Advances in Understanding and Management in Women.Current atherosclerosis reports · 2026Review
- Spontaneous Coronary Artery Dissection: Sex Differences in Clinical Presentation and Outcomes From the Australian New Zealand Registry.Journal of the American Heart Association · 2026Observational
- The impact of stenting on hemodynamic environment of tortuous coronary artery: results derived from a numerical simulation model.Frontiers in bioengineering and biotechnology · 2026Article
- Percutaneous Coronary Intervention Difficulty in Tortuous Coronary Anatomy: A Case Report.Cureus · 2025Article
- The Australian-New Zealand SCAD observational cohort study: major adverse cardiovascular events are associated with ticagrelor combined with aspirin, FMD, and history of stroke.European heart journal · 2025Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe etiology and significance of coronary artery tortuosity (TCA) among patients with spontaneous coronary artery dissection (SCAD) are unknown. The aim of this prospective imaging cohort study was to report echocardiographic findings and evaluate whether TCA correlates with cardiac anatomy and function among patients with SCAD. Comorbidities including fibromuscular dysplasia (FMD) and outcomes were also assessed.
methodsTCA was determined on coronary angiography performed during the diagnosis of SCAD, and cardiac structure and function were evaluated using prospective comprehensive echocardiography.
resultsAmong 116 patients with SCAD, the mean age at echocardiography was 50.8 ± 8.8 years, a median of 10.9 months after SCAD. Sixty-two patients (53.4%) had FMD, 41 (35.3%) had histories of hypertension, and 17 (14.8%) were hypertensive during echocardiography. Most patients (n = 78 [69%]) had normal left ventricular geometry with normal median ejection fraction (61%; interquartile range, 56% to 64%) and normal global longitudinal strain (-22.2%; interquartile range, -24.0% to -19.9%). Fifteen patients (13.4%) had diastolic dysfunction that was associated with hypertension at the time of echocardiography. Patients with TCA (n = 96 [82.8%]) were older (mean age, 52.1 ± 8.0 vs 44.7 ± 9.9 years; P < .001) with a higher prevalence of FMD (59.4% vs 25%, P = .007) but a similar prevalence of hypertension (35% vs 35%, P > .99) compared with patients without TCA. Across the age range (31.5 to 66.9 years), each decade of age was associated with an approximately 0.89-unit increase in coronary tortuosity score (P < .0001). Echocardiographic parameters were not significantly different between the two groups. Median follow-up duration was 4.4 years (95% CI, 3.8 to 5.2 years). The Kaplan-Meier 3-year SCAD recurrence rate was 9.4% (95% CI, 3.7% to 14.8%). There were no deaths.
conclusionsThe majority of patients with SCAD had normal or near normal echocardiographic results, including global longitudinal strain, with no differences according to TCA. However, patients with SCAD with TCA were older, with a higher prevalence of FMD.
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