Measurements of Lumen Areas and Diameters of Proximal and Middle Coronary Artery Segments in Subjects Without Coronary Atherosclerosis

摘要

There are plenty of data on morphology and lumen dimensions of diseased coronary arteries. However, information on normal coronary vessel anatomy is scarce. We provided computed tomography angiography-derived reference values of lumen dimensions in proximal and middle coronary segments in a healthy population with respect to gender and vessel dominance. Consecutive 2,849 computed tomography angiography examinations were reviewed to identify 201 subjects (77 men, patient age 50 +/- 13 years) whose coronary arteries were free from any sign of atherosclerosis (calcium score 0, no detectable plaque). For all proximal and middle coronary segments, lumen areas (LAs) and lumen diameters were measured. Coronary vessel segmentation and dominance pattern were defined using the Syntax Score. Normal values of LAs and lumen diameters were significantly smaller for women compared with men except for the proximal right coronary artery and the left main coronary artery (LMCA) (20.2 +/- 6.6 mm(2) vs 23.0 +/- 6.1 mm(2), p = 0.0003, and 5.0 +/- 0.8 mm vs 5.4 +/- 0.7 mm, p = 0.0001). The lower limit of normal for the LMCA (defined as mean LA - 2 standard deviations) equaled 7.0 and 10.8 mm(2) for women and men, respectively. Subjects with left (vs right) coronary dominance had significantly larger areas and diameters of the LMCA (26.2 +/- 9.2 mm(2) vs 20.7 +/- 6.0 mm(2), p = 0.0017, and 5.7 +/- 1.0 mm vs 5.1 +/- 0.7 mm, p = 0.0017, respectively) and proximal left circumflex (13.8 +/- 2.7 mm(2) vs 10.4 +/- 3.8 mm(2), p = 0.0001, and 4.2 +/- 0.4 mm vs 3.6 +/- 0.7 mm, p = 0.0001, respectively) and smaller areas and diameters of the proximal right coronary artery (7.1 +/- 2.0 mm(2) vs 13.3 +/- 3.6 mm(2), p 0.0001, and 3.0 +/- 0.4 mm vs 4.1 +/- 0.6 mm, p 0.0001, respectively). In conclusion, gender and coronary artery dominance pattern significantly impact normal LAs and dimensions in subjects without coronary atherosclerosis. (C) 2018 Elsevier Inc. All rights reserved.