CORONARY ARTERY ANATOMY AND ITS IMPACT ON ISCHEMIC HEART DISEASE: A DETAILED REVIEW
Main Article Content
Keywords
Ischemic Heart Disease, Coronary Artery Anatomy, Anatomical Variations, Advanced Imaging Techniques, Personalized Medicine.
Abstract
Coronary artery anatomy and pathoanatomy has plays a critical impact in the pathogenesis and management of ischemic heart disease (IHD), influencing diagnostic accuracy, treatment efficacy, and preventive strategies. This review article provides a detailed examination of normal coronary artery anatomy, common and rare anatomical variations, and their clinical implications in IHD. Advances in imaging techniques, including MDCT, MRI, OCT, and IVUS, have significantly improved the visualization of coronary anatomy, facilitating precise diagnoses and tailored interventions. However, the diagnostic and therapeutic challenges posed by coronary artery variations underscore the need for personalized approaches in patient care. Comparative analyses of imaging modalities reveal strengths and limitations, highlighting the importance of selecting the appropriate technique based on individual patient characteristics. Despite of the technological advances, research gaps remain, particularly in understanding the long-term implications of anatomical variations and optimizing imaging strategies for diverse patient populations. Future directions should focus on longitudinal studies and the integration of artificial intelligence to enhance the personalized management of IHD.
References
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15. Kragel AH, Roberts WC. Anomalous origin of either the right or left main coronary artery from the aortic root with subsequent coursing between aorta and pulmonary trunk: analysis of 32 necropsy cases. Am J Cardiol. 1988;62(10):771-777. doi:10.1016/0002-9149(88)91217-2
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22. Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, van den Brand M, Van Dyck N, Russell ME, Mohr FW, Serruys PW. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention. 2005;1(2):219-227.
23. Head SJ, Kieser TM, Falk V, Huysmans HA, Kappetein AP. Coronary artery bypass grafting: Part 1—the evolution over the first 50 years. Eur Heart J. 2013;34(37):2862-2872. doi:10.1093/eurheartj/eht330
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25. Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol. 2003;42(11):1959-1963. doi:10.1016/j.jacc.2003.03.002
26. Andreini D, Pontone G, Mushtaq S, Bartorelli AL, Bertella E, Trabattoni D, Montorsi P, Ballerini G, Agrifoglio M, Fiorentini C, Pepi M. Diagnostic accuracy of multidetector computed tomography coronary angiography in patients with dilated cardiomyopathy. J Am Coll Cardiol. 2007;49(18):2044-2050. doi:10.1016/j.jacc.2007.01.084
27. Pennell DJ. Cardiovascular magnetic resonance. Circulation. 2010;121(5):692-705. doi:10.1161/CIRCULATIONAHA.108.811547
28. Naya M, Murthy VL, Blankstein R, Sitek A, Hainer J, Foster C, Gaber M, Fantony JM, Dorbala S, Di Carli MF. Quantitative relationship between the extent and morphology of coronary atherosclerotic plaque and downstream myocardial perfusion. J Am Coll Cardiol. 2011;58(16):1807-1816. doi:10.1016/j.jacc.2011.07.022
29. Dewey M, Zimmermann E, Deissenrieder F, Laule M, Dubel HP, Schlattmann P, Knebel F, Rutsch W, Hamm B. Noninvasive coronary angiography by 320-row computed tomography with lower radiation exposure and maintained diagnostic accuracy: comparison of results with cardiac catheterization in a head-to-head pilot investigation. Circulation. 2009;120(10):867-875. doi:10.1161/CIRCULATIONAHA.109.854888
30. Kim RJ, Wu E, Rafael A, Chen EL, Parker MA, Simonetti O, Klocke FJ, Bonow RO, Judd RM. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med. 2000;343(20):1445-1453. doi:10.1056/NEJM200011163432003
31. Tearney GJ, Regar E, Akasaka T, Adriaenssens T, Barlis P, Bezerra HG, Bouma B, Bruining N, Cho JM, Chowdhary S, Costa MA, de Silva R, Dijkstra J, Di Mario C, Dudeck D, Falk E, Feldman MD, Fitzgerald P, Garcia-Garcia HM, Gonzalo N, Granada JF, Guagliumi G, Holm NR, Honda Y, Ikeno F, Kawasaki M, Kochman J, Koltowski L, Kubo T, Kume T, Kyono H, Lam CC, Lamouche G, Lee DP, Leon MB, Maehara A, Manfrini O, Mintz GS, Mizuno K, Morel MA, Nadkarni S, Okura H, Otake H, PietrasikA, Prati F, Räber L, Radu MD, Rieber J, Riga M, Rollins A, Rosenberg M, Sirbu V, Serruys PW, Shimada K, Shinke T, Shite J, Siegel E, Sonoda S, Suter M, Takarada S, Tanaka A, Terashima M, Thim T, Uemura S, Ughi GJ, van Beusekom HM, van der Steen AF, van Es GA, van Soest G, Virmani R, Waxman S, Weissman NJ, Weisz G. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. J Am Coll Cardiol. 2012;59(12):1058-1072. doi:10.1016/j.jacc.2011.09.079
32. Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, Bugiardini R, Crea F, Cuisset T, Di Mario C, Ferreira JR, Gersh BJ, Gitt AK, Hulot JS, Marx N, Opie LH, Pfisterer M, Prescott E, Ruschitzka F, Sabaté M, Senior R, Taggart DP, van der Wall EE, Vrints CJ; ESC Committee for Practice Guidelines. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the Management of Stable Coronary Artery Disease of the European Society of Cardiology. Eur Heart J. 2013;34(38):2949-3003. doi:10.1093/eurheartj/eht296
33. Taylor CA, Hughes TJ, Zarins CK. Finite element modeling of blood flow in arteries. Comput Methods Appl Mech Eng. 1998;158(1-2):155-196. doi:10.1016/S0045-7825(98)80008-2
34. Krittanawong C, Zhang H, Wang Z, Aydar M, Kitai T. Artificial Intelligence in Precision Cardiovascular Medicine. J Am Coll Cardiol. 2017;69(21):2657-2664. doi:10.1016/j.jacc.2017.03.571
2. Libby P, Theroux P. Pathophysiology of coronary artery disease. Circulation. 2005;111(25):3481-3488. doi:10.1161/CIRCULATIONAHA.105.537878
3. Budoff MJ, Achenbach S, Blumenthal RS, et al. Assessment of coronary artery disease by cardiac computed tomography: A scientific statement from the American Heart Association. Circulation. 2006;114(16):1761-1791. doi:10.1161/CIRCULATIONAHA.106.178458
4. Angelini P, Velasco JA, Flamm S. Coronary anomalies: Incidence, pathophysiology, and clinical relevance. Circulation. 2002;105(20):2449-2454. doi:10.1161/01.CIR.0000016175.49835.57
5. Standring S. Gray's Anatomy: The Anatomical Basis of Clinical Practice. 41st ed. London: Elsevier Health Sciences; 2016.
6. Thomas T, Kostis JB. The Role of the Left Anterior Descending Coronary Artery in the Pathogenesis of Myocardial Infarction. Am J Cardiol. 2020;125(6):831-839. doi:10.1016/j.amjcard.2019.12.021
7. Angelini P. Coronary artery anomalies: an entity in search of an identity. Circulation. 2007;115(10):1296-1305. doi:10.1161/CIRCULATIONAHA.106.618082
8. Schaper W, Gorge G, Winkler B, Schaper J. The Collateral Circulation of the Heart. Prog Cardiovasc Dis. 1988;31(1):57-77. doi:10.1016/0033-0620(88)90008-4
9. Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn. 1990;21(1):28-40. doi:10.1002/ccd.1810210110
10. Möhlenkamp S, Hort W, Ge J, Erbel R. Update on myocardial bridging. Circulation. 2002;106(20):2616-2622. doi:10.1161/01.CIR.0000038493.95602.5D
11. Kimura K, Isobe M. Coronary Artery Anomalies and Anomalies of Coronary Artery Origin and Course: What Have We Learned? Circ J. 2019;83(3):499-505. doi:10.1253/circj.CJ-19-0058
12. Dodge JT, Brown BG, Bolson EL, Dodge HT. Lumen diameter of normal human coronary arteries. Influence of age, sex, anatomic variation, and left ventricular hypertrophy or dilation. Circulation. 1992;86(1):232-246. doi:10.1161/01.CIR.86.1.232
13. Angelini P. Coronary artery anomalies: an entity in search of an identity. Circulation. 2007;115(10):1296-1305. doi:10.1161/CIRCULATIONAHA.106.618082
14. Basso C, Maron BJ, Corrado D, Thiene G. Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes. J Am Coll Cardiol. 2000;35(6):1493-1501. doi:10.1016/S0735-1097(00)00566-0
15. Kragel AH, Roberts WC. Anomalous origin of either the right or left main coronary artery from the aortic root with subsequent coursing between aorta and pulmonary trunk: analysis of 32 necropsy cases. Am J Cardiol. 1988;62(10):771-777. doi:10.1016/0002-9149(88)91217-2
16. Chatzizisis YS, Coskun AU, Jonas M, Edelman ER, Feldman CL, Stone PH. Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior. J Am Coll Cardiol. 2007;49(25):2379-2393. doi:10.1016/j.jacc.2007.02.059
17. Friedman MH, Hutchins GM, Bargeron CB, Deters OJ, Mark FF. Correlation between intimal thickness and fluid shear in human arteries. Atherosclerosis. 1981;39(3):425-436. doi:10.1016/0021-9150(81)90027-7
18. Wilson RF, White CW. Intracoronary papaverine: An ideal coronary vasodilator for studies of the coronary circulation in conscious humans. Circulation. 1986;73(3):444-451. doi:10.1161/01.CIR.73.3.444
19. Leschka S, Alkadhi H, Plass A, Desbiolles L, Grunenfelder J, Marincek B, Wildermuth S. Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur Heart J. 2005;26(15):1482-1487. doi:10.1093/eurheartj/ehi261
20. Kim WY, Danias PG, Stuber M, Flamm SD, Plein S, Nagel E, Langerak SE, Weber OM, Pedersen EM, Schmidt M, Botnar RM, Manning WJ. Coronary magnetic resonance angiography for the detection of coronary stenoses. N Engl J Med. 2001;345(26):1863-1869. doi:10.1056/NEJMoa010866
21. Yacoub MH, Gehle P, Chandrasekaran V, Birks EJ, Child A, Radley-Smith R. Late results of a valve-preserving operation in patients with aneurysms of the ascending aorta and root. J Thorac Cardiovasc Surg. 1998;115(5):1080-1090. doi:10.1016/S0022-5223(98)70411-4
22. Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, van den Brand M, Van Dyck N, Russell ME, Mohr FW, Serruys PW. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention. 2005;1(2):219-227.
23. Head SJ, Kieser TM, Falk V, Huysmans HA, Kappetein AP. Coronary artery bypass grafting: Part 1—the evolution over the first 50 years. Eur Heart J. 2013;34(37):2862-2872. doi:10.1093/eurheartj/eht330
24. Risgaard B, Waagstein K, Haunsø S, Dorte T, Bundgaard H, Winkel BG, Ottesen GL, Jørgensen E, Pehrson S, Køber L, Lynge TH. Sudden cardiac death: a nationwide cohort study among the young. Br J Sports Med. 2014;48(17):1177-1183. doi:10.1136/bjsports-2014-093731
25. Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol. 2003;42(11):1959-1963. doi:10.1016/j.jacc.2003.03.002
26. Andreini D, Pontone G, Mushtaq S, Bartorelli AL, Bertella E, Trabattoni D, Montorsi P, Ballerini G, Agrifoglio M, Fiorentini C, Pepi M. Diagnostic accuracy of multidetector computed tomography coronary angiography in patients with dilated cardiomyopathy. J Am Coll Cardiol. 2007;49(18):2044-2050. doi:10.1016/j.jacc.2007.01.084
27. Pennell DJ. Cardiovascular magnetic resonance. Circulation. 2010;121(5):692-705. doi:10.1161/CIRCULATIONAHA.108.811547
28. Naya M, Murthy VL, Blankstein R, Sitek A, Hainer J, Foster C, Gaber M, Fantony JM, Dorbala S, Di Carli MF. Quantitative relationship between the extent and morphology of coronary atherosclerotic plaque and downstream myocardial perfusion. J Am Coll Cardiol. 2011;58(16):1807-1816. doi:10.1016/j.jacc.2011.07.022
29. Dewey M, Zimmermann E, Deissenrieder F, Laule M, Dubel HP, Schlattmann P, Knebel F, Rutsch W, Hamm B. Noninvasive coronary angiography by 320-row computed tomography with lower radiation exposure and maintained diagnostic accuracy: comparison of results with cardiac catheterization in a head-to-head pilot investigation. Circulation. 2009;120(10):867-875. doi:10.1161/CIRCULATIONAHA.109.854888
30. Kim RJ, Wu E, Rafael A, Chen EL, Parker MA, Simonetti O, Klocke FJ, Bonow RO, Judd RM. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med. 2000;343(20):1445-1453. doi:10.1056/NEJM200011163432003
31. Tearney GJ, Regar E, Akasaka T, Adriaenssens T, Barlis P, Bezerra HG, Bouma B, Bruining N, Cho JM, Chowdhary S, Costa MA, de Silva R, Dijkstra J, Di Mario C, Dudeck D, Falk E, Feldman MD, Fitzgerald P, Garcia-Garcia HM, Gonzalo N, Granada JF, Guagliumi G, Holm NR, Honda Y, Ikeno F, Kawasaki M, Kochman J, Koltowski L, Kubo T, Kume T, Kyono H, Lam CC, Lamouche G, Lee DP, Leon MB, Maehara A, Manfrini O, Mintz GS, Mizuno K, Morel MA, Nadkarni S, Okura H, Otake H, PietrasikA, Prati F, Räber L, Radu MD, Rieber J, Riga M, Rollins A, Rosenberg M, Sirbu V, Serruys PW, Shimada K, Shinke T, Shite J, Siegel E, Sonoda S, Suter M, Takarada S, Tanaka A, Terashima M, Thim T, Uemura S, Ughi GJ, van Beusekom HM, van der Steen AF, van Es GA, van Soest G, Virmani R, Waxman S, Weissman NJ, Weisz G. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. J Am Coll Cardiol. 2012;59(12):1058-1072. doi:10.1016/j.jacc.2011.09.079
32. Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, Bugiardini R, Crea F, Cuisset T, Di Mario C, Ferreira JR, Gersh BJ, Gitt AK, Hulot JS, Marx N, Opie LH, Pfisterer M, Prescott E, Ruschitzka F, Sabaté M, Senior R, Taggart DP, van der Wall EE, Vrints CJ; ESC Committee for Practice Guidelines. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the Management of Stable Coronary Artery Disease of the European Society of Cardiology. Eur Heart J. 2013;34(38):2949-3003. doi:10.1093/eurheartj/eht296
33. Taylor CA, Hughes TJ, Zarins CK. Finite element modeling of blood flow in arteries. Comput Methods Appl Mech Eng. 1998;158(1-2):155-196. doi:10.1016/S0045-7825(98)80008-2
34. Krittanawong C, Zhang H, Wang Z, Aydar M, Kitai T. Artificial Intelligence in Precision Cardiovascular Medicine. J Am Coll Cardiol. 2017;69(21):2657-2664. doi:10.1016/j.jacc.2017.03.571
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Apr 13, 2024
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Dr. Ramdas Gopalrao Surwase, Dr. Smita Balsurkar (Mali), & Dr. Mahesh Shamrao Ugale. (2024). CORONARY ARTERY ANATOMY AND ITS IMPACT ON ISCHEMIC HEART DISEASE: A DETAILED REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 31(4), 924-932. https://doi.org/10.53555/jptcp.v31i4.5578
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Author Biographies
Dr. Ramdas Gopalrao Surwase
Associate professor, Department of Anatomy, Maharashtra Institute of Medical Science and Research Medical College, LATUR, Maharashtra, India.
Dr. Smita Balsurkar (Mali)
Associate professor, Department of anatomy, Maharashtra Institute of Medical Science and Research Medical College, LATUR, Maharashtra, India.
Dr. Mahesh Shamrao Ugale
Professor, Department of anatomy, Maharashtra Institute of Medical Science and Research Medical College, LATUR, Maharashtra, India.
How to Cite
Dr. Ramdas Gopalrao Surwase, Dr. Smita Balsurkar (Mali), & Dr. Mahesh Shamrao Ugale. (2024). CORONARY ARTERY ANATOMY AND ITS IMPACT ON ISCHEMIC HEART DISEASE: A DETAILED REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 31(4), 924-932. https://doi.org/10.53555/jptcp.v31i4.5578