Abstract
The aim of the study was to explore the differences in plaque burden at different segments of the left main bifurcation and its relationship with the bifurcation angle using high-resolution multislice CT coronary angiography (MSCT). Patients were evaluated using a 40-row MSCT scanner. One observer assessed the localization, severity and distribution of plaques within the left main (LMCA) bifurcation, whereas another observer defined the angle. Fifty patients were included. The mean heart rate was 59.8 ± 7.1. Seventeen (34%) patients presented at least wall irregularities in the LMCA and in the ostial LCx, whereas the ostial LAD was affected in 32 (64%) patients. More than 90% of plaques were located opposite to the flow divider. The median bifurcation angle was 88.5° (IQR 68.8°, 101.4°). Of the 18 patients with a normal ostial LAD, 13 (72%) had a bifurcation angle < 88.5°, whereas the 63% of the patients with any LAD disease had an angle ≥ 88.5° (P = 0.018). In conclusion, at the left main bifurcation, atherosclerotic plaques are commonly located at the ostial LAD and opposite to the flow divider. The angle of the left main bifurcation and the presence of plaques within the bifurcation are closely related.
This is a preview of subscription content, log in via an institution to check access.
References
Kimura BJ, Russo RJ, Bhargava V, McDaniel MB, Peterson KL, DeMaria AN (1996) Atheroma morphology and distribution in proximal left anterior descending coronary artery: in vivo observations. J Am Coll Cardiol 27:825–831
Kornet L, Hoeks AP, Lambregts J, Reneman RS (1999) In the femoral artery bifurcation, differences in mean wall shear stress within subjects are associated with different intima-media thicknesses. Arterioscler Thromb Vasc Biol 19:2933–2939
Kaazempur-Mofrad MR, Isasi AG, Younis HF, Chan RC, Hinton DP, Sukhova G, LaMuraglia GM, Lee RT, Kamm RD (2004) Characterization of the atherosclerotic carotid bifurcation using MRI, finite element modeling, and histology. Ann Biomed Eng 32:932–946
Berceli SA, Warty VS, Sheppeck RA, Mandarino WA, Tanksale SK, Borovetz HS (1990) Hemodynamics and low density lipoprotein metabolism. Rates of low density lipoprotein incorporation and degradation along medial and lateral walls of the rabbit aorto-iliac bifurcation. Arteriosclerosis 10:686–694
Rodriguez-Granillo GA, García-García HM, Wentzel JJ, Valgimigli M, Regar E, van der Giessen W, de Jaegere P, de Feyter P, Serruys PW (2006) Plaque composition and its relationship with acknowledged shear stress patterns in coronary arteries. J Am Coll Cardiol 47(4):884–885
Mollet NR, Cademartiri F, van Mieghem CA, Runza G, McFadden EP, Baks T, Serruys PW, Krestin GP, de Feyter PJ (2005) High resolution spiral computed tomography angiography in patients referred for diagnostic conventional coronary angiography. Circulation 112(15):2318–2323
Cademartiri F, Mollet NR, Runza G, Belgrano M, Malagutti P, Meijboom BW, Midiri M, Feyter PJ, Krestin GP (2006) Diagnostic accuracy of multislice computed tomography coronary angiography is improved at low heart rates. Int J Cardiovasc Imaging 22(1):101–105
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rodriguez-Granillo, G.A., Rosales, M.A., Degrossi, E. et al. Multislice CT coronary angiography for the detection of burden, morphology and distribution of atherosclerotic plaques in the left main bifurcation. Int J Cardiovasc Imaging 23, 389–392 (2007). https://doi.org/10.1007/s10554-006-9144-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10554-006-9144-1