Anomalous origin of the coronary artery coursing between the great vessels presenting with a cardiovascular event (J-CONOMALY Registry)

被引：20

作者：

Nagashima, Koichi ^{[1
]}

Hiro, Takafumi ^{[1
]}

Fukamachi, Daisuke ^{[1
]}

Okumura, Yasuo ^{[1
]}

Watanabe, Ichiro ^{[1
]}

Hirayama, Atsushi ^{[1
]}

Tanaka, Masashi ^{[2
]}

Tanaka, Tomofumi ^{[3
]}

Takamisawa, Itaru ^{[3
]}

Taguchi, Isao ^{[4
]}

Sato, Akira ^{[5
]}

Aonuma, Kazutaka ^{[5
]}

Fukamizu, Seiji ^{[6
]}

Nakada, Akihiro ^{[6
]}

Watanabe, Atsuyuki ^{[7
]}

Amioka, Naofumi ^{[7
]}

Suzuki, Yasuyuki ^{[8
]}

Matsumoto, Naoya ^{[8
]}

Koizumi, Junichi ^{[9
]}

Kumagai, Kazuya ^{[9
]}

Naya, Masanao ^{[10
]}

Higuchi, Yoshiharu ^{[11
]}

Naito, Yoshiro ^{[12
]}

Masuyama, Tohru ^{[12
]}

Kawamura, Mitsuharu ^{[13
]}

Tsunoda, Ryusuke ^{[14
]}

Suzuki, Susumu ^{[15
]}

Ishii, Hideki ^{[15
]}

Murohara, Toyoaki ^{[15
]}

Shimizu, Takeshi ^{[16
]}

Takeishi, Yasuchika ^{[16
]}

Shiina, Kazuki ^{[17
]}

Yamashita, Jun ^{[17
]}

Imamura, Tomohiko ^{[18
]}

Sumitomo, Naokata ^{[18
]}

Noguchi, Teruo ^{[19
]}

Aso, Toshihide ^{[20
]}

Furukawa, Kojiro ^{[21
]}

Yamauchi, Yasuteru ^{[22
]}

Okishige, Kaoru ^{[22
]}

Sakata, Kenji ^{[23
]}

Yamagishi, Masakazu ^{[23
]}

Shimizu, Shigeo ^{[24
]}

Ohno, Masakazu ^{[24
]}

Sugano, Teruyasu ^{[25
]}

Matsumura, Koichiro ^{[26
]}

Matsumoto, Kensuke ^{[27
]}

Ozaki, Kazuyuki ^{[28
]}

Hayashidani, Shunji ^{[29
]}

Meno, Hiroshi ^{[29
]}

机构：

[1] Nihon Univ, Sch Med, Dept Med, Div Cardiol,Itabashi Ku, 30-1 Ohyaguchi Kamicho, Tokyo 1738610, Japan

[2] Nihon Univ, Sch Med, Dept Cardiovasc Surg, Itabashi Ku, 30-1 Ohyaguchi Kamicho, Tokyo 1738610, Japan

[3] Sakakibara Heart Inst, Dept Cardiol, 3-16-1 Asahi Cho, Fuchu, Tokyo 1830003, Japan

[4] Dokkyo Med Univ, Saitama Med Ctr, Dept Cardiol, 2-1-50 Minamikoshigaya, Saitama 3438555, Japan

[5] Univ Tsukuba, Fac Med, Dept Cardiol, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058575, Japan

[6] Tokyo Metropolitan Hiroo Gen Hosp, Dept Cardiol, Shibuya Ku, 2-34-10 Ebisu, Tokyo 1500013, Japan

[7] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Cardiovasc Med, Kita Ku, 2-5-1 Shikatacho, Okayama 7008558, Japan

[8] Nihon Univ Hosp, Dept Cardiol, Chiyoda Ku, 1-6 Kanda Surugadai, Tokyo 1018309, Japan

[9] Iwate Med Univ, Mem Heart Ctr, Dept Cardiovasc Surg, 9-1 Uchimaru, Morioka, Iwate 0208505, Japan

[10] Hokkaido Univ, Grad Sch Med, Dept Cardiovasc Med, Kita Ku, Kita 15,Nishi 7, Sapporo, Hokkaido 0608638, Japan

[11] Osaka Police Hosp, Div Cardiovasc, Tennouji Ku, 10-31 Kitayama Cho, Osaka 5430035, Japan

[12] Hyogo Coll Med, Dept Internal Med, Cardiovasc Div, 1-1 Mukogawa Cho, Nishinomiya, Hyogo 6638501, Japan

[13] Showa Univ, Sch Med, Div Cardiol, Shinagawa Ku, 1-5-8 Hatanodai, Tokyo 1428555, Japan

[14] Japanese Red Cross Kumamoto Hosp, Dept Cardiol, Higashi Ku, 2-1-1 Nagamine Minami, Kumamoto 8618520, Japan

[15] Nagoya Univ, Grad Sch Med, Dept Cardiol, Showa Ku, 65 Tsurumai Cho, Nagoya, Aichi 4668550, Japan

[16] Fukushima Med Univ, Dept Cardiovasc Med, 1 Hikariga Oka, Fukushima 9601295, Japan

[17] Tokyo Med Univ, Dept Cardiol, Shinjuku Ku, 6-1-1 Shinjuku, Tokyo 1608402, Japan

[18] Saitama Med Univ, Int Med Ctr, Dept Pediat Cardiol, 1397-1 Yamane, Hidaka, Saitama 3501298, Japan

[19] Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Med, 5-7-1 Fujishiro Dai, Suita, Osaka 5658565, Japan

[20] Kanagawa Childrens Med Ctr, Dept Cardiovasc Surg, Minami Ku, 2-138-4 Mutsukawa, Yokohama, Kanagawa 2328555, Japan

[21] Natl Hosp Org Kyushu Med Ctr, Dept Cardiovasc Surg, Chuo Ku, 1-8-1 Jigyohama, Fukuoka 8108563, Japan

[22] Yokohama City Bay Red Cross Hosp, Heart Ctr, Naka Ku, 3-12-1 Shinnyamashita, Yokohama, Kanagawa 2310801, Japan

[23] Kanazawa Univ, Grad Sch Med, Dept Cardiovasc & Internal Med, 13-1 Takara Machi, Kanazawa, Ishikawa 9208640, Japan

[24] Natl Hosp Org, Natl Disaster Med Ctr, Dept Cardiol, 3256 Midoricho, Tachikawa, Tokyo 1900014, Japan

[25] Yokohama City Univ, Grad Sch Med, Dept Med Sci & Cardiorenal Med, Kanazawa Ku, 3-9 Fukuura, Yokohama, Kanagawa 2360004, Japan

[26] Kansai Med Univ, Med Ctr, Dept Cardiol, 10-15 Fumizono Cho, Moriguchi, Osaka 5708507, Japan

[27] Sakakibara Heart Inst Okayama, Kita Ku, 2-5-1 Nakai Cho, Okayama 7000804, Japan

[28] Niigata Univ, Grad Sch Med & Dent Sci, Dept Cardiovasc Biol & Med, 2-5274 Gakkocho Dori, Niigata 9518514, Japan

[29] Fukuoka Red Cross Hosp, Div Cardiol, Minami Ku, 3-1-1 Okusu, Fukuoka, Fukuoka 8158555, Japan

[30] Fukuoka Univ, Sch Med, Dept Cardiol, Jonan Ku, 7-45-1 Nanakuma, Fukuoka 8140180, Japan

[31] Hirosaki Univ, Grad Sch Med, Dept Cardiol, 5 Zaifu Cho, Hirosaki, Aomori 0368562, Japan

[32] Kyorin Univ, Sch Med, Dept Internal Med 2, Div Cardiol, 6-20-2 Shinkawa, Mitaka, Tokyo 1818611, Japan

[33] Shonan Kamakura Gen Hosp, Dept Cardiol, 1370-1 Okamoto, Kamakura, Kanagawa 2478533, Japan

[34] Yokohama Municipal Citizens Hosp, Dept Cardiol, Hodogaya Ku, 56 Okasawa Cho, Yokohama, Kanagawa 2408555, Japan

[35] Shizuoka Childrens Hosp, Aoi Ku, 860 Urusiyama, Shizuoka 4208660, Japan

[36] Showa Univ, Fujigaoka Hosp, Dept Internal Med, Div Cardiol,Aoba Ku, 1-30 Fujigaoka, Yokohama, Kanagawa 2278501, Japan

[37] Fujita Hlth Univ, Dept Cardiol, 1-98 Dengakugakubo,Kutsukake Cho, Toyoake, Aichi 4701192, Japan

[38] Okinawa Prefectural Chubu Hosp, Dept Cardiovasc Med, 281 Miyazato, Uruma, Okinawa 9042293, Japan

[39] Juntendo Univ, Grad Sch Med, Dept Cardiovasc Med, Bunkyo Ku, 2-1-1 Hongo, Tokyo 1138421, Japan

[40] Tokyo Womens Med Univ, Dept Cardiol, Shinjuku Ku, 8-1 Kawada Cho, Tokyo 1628666, Japan

来源：

EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING | 2020年 / 21卷 / 02期

关键词：

anomalous origin of the coronary artery; coronary vasospasm; sudden cardiac arrest; CONGENITAL HEART-DISEASE; AORTIC ORIGIN; AMERICAN-COLLEGE; TASK-FORCE; LEFT SINUS; ASSOCIATION; MANAGEMENT; VALSALVA; OUTCOMES; ANGINA;

D O I：

10.1093/ehjci/jez076

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims Anomalous origin of the coronary artery (AOCA) with an inter-arterial course (IAC) between the great vessels poses a risk for a life-threatening cardiovascular event. We assessed, in a registry-based study, the clinical features, treatment strategies, and prognoses of life-threatening cardiovascular events ensuant to AOCA. Methods and results Included were 65 AOCA patients (48 men/17 women, aged 41 +/- 23 years) from 40 clinical centres who had experienced sudden cardiac arrest (SCA) (n = 30), acute myocardial infarction (AMI) (n = 5), angina (n = 23), or syncope (n = 7). The anomalous vessel was the right coronary artery in 72% of patients and left coronary artery in 28%; the ostium was slit-like in 42%. Coronary luminal narrowing >= 75% was absent in patients with SCA or syncope (86% and 57%, respectively), but occlusion or narrowing was seen in those with AMI (100%) or angina (52%). Age <= 40 years, male sex, sporting activity, absence of prodromal symptoms, acutely angled (<= 30 degrees) take-off from the aorta, and absence of luminal narrowing of the IAC segment were associated with SCA in this patient group. Coronary vasospasm was inducible in 12 of 17 patients without coronary narrowing. Management included surgical revascularization (n = 26) percutaneous coronary intervention (n = 9), and medical treatment (n = 26). Four SCA patients died while hospitalized; no others died during the median 5.0 (range, 1.8-7.0)-year follow-up period. Conclusions In patients with AOCA, age <= 40 years, male sex, sporting activity, and an acute take-off angle appear to be risk factors for SCA. Appropriate management can be beneficial. Confirmation in a large-scale study is warranted.

引用

页码：222 / 230

页数：9

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