Syed Imamuddin1, Chamarti Venkata Arunavalli2, Parvathareddy Krishna Malakonda Reddy3, Ponnapati Venkata Anil Kumar Reddy4
BACKGROUND
Evaluation of endothelial function in isolated coronary artery ectasia (ICAE) with
flow-mediated dilation (FMD) is limited and use of flow mediated vasodilation as
a surrogate marker for the extent of coronary atherosclerosis remains unknown.
Thus, the following study was done to evaluate for endothelial dysfunction (ED) in
subjects with ICAE by assessing the FMD in the brachial artery.
METHODS
This was an observational study, conducted at a referral hospital providing tertiary
care in India between June 2017 and November 2018. Fifty patients with ICAE
and fifty control patients with normal coronary arteries (NCA) on coronary
angiogram, done by using a standard Seldinger technique via femoral route, were
the subjects of the study. Brachial artery FMD was determined by using a highresolution
ultrasound system (Samsung RS80A) using a linear transducer of a
frequency of 7.5 Mega Hertz.
RESULTS
The groups had same baseline characteristics in terms of age, sex etc. (all P values
> 0.05). However, values of serum uric acid and low-density lipoproteins were
statistically significantly higher in ICAE subjects (P < 0.0001). Whereas, dilatation
of brachial artery in response to shear stress was significantly lower in patients
with ICAE subjects than in patients with normal coronaries. (8.85 ± 0.49 vs. 12.83
± 0.45, P < 0.0001). Marki’s classification, type 1, type 2, type 3 and type 4
coronary artery ectasia (CAE) was present in 8 (16 %), 4 (8 %), 13 (26 %), and
25 (50 %), respectively.
CONCLUSIONS
Atherosclerosis may play a pivotal role in the genesis of ICAE. Hyperlipidaemia
may have a specific role in the disease process. Further research is required to
evaluate the exact molecular mechanisms involved in CAE.
