Tortuosity of the left anterior descending artery is associated with hypertension and is not independently related to physical performance: A cardiac computed tomography study

• Published in: Clinical physiology and functional imaging Vol. 44; no. 6; pp. 463 - 470
• Main Authors: Sharfo, Alaa, Wandall‐Holm, Malthe Faurschou, Linde, Jesper James, Hæsum, Ida, Laursen, Graversen Peter, Kofoed, Klaus Fuglsang, Hove, Jens Dahlgaard
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.11.2024
• Subjects: Age; Age Factors; Aged; Angiography; Bicycles; Blood vessels; Calcium; calcium score; Computed tomography; Computed Tomography Angiography - methods; Coronary Angiography - methods; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - physiopathology; coronary artery tortuosity; coronary CT angiography; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Female; Females; Gender; Humans; Hypertension; Hypertension - physiopathology; Image quality; Male; Medical imaging; Medical records; Middle Aged; Patients; Physical activity; Physical Functional Performance; Population studies; Predictive Value of Tests; Risk Factors; Tomography; Tortuosity; Tracking; coronary CT angiography; calcium score; coronary artery tortuosity
• ISSN: 1475-0961; 1475-097X; 1475-097X
• DOI: 10.1111/cpf.12900

Background Coronary tortuosity (CorT) is frequently observed in invasive angiography, though its aetiology and clinical significance remain ambiguous. Prior research has indicated possible links between CorT and factors such as hypertension, age, and calcium scores in the left anterior descending (LAD) artery. The aim of this study was to examine and optimize the usage of coronary computed tomography angiography (CCTA) with vessel tracking to explore these associations. Methods Observational sub‐study of the single centre randomised controlled CATCH‐trial. From the original study 600 participants, who underwent CCTA, 250 were randomly selected. Clinical data and patient risk factors were sourced from medical records and structured interviews. Tortuosity of the LAD was quantified by calculating the ratio of the actual vessel‐length to the straight‐line distance. Results The final study population comprised 194 patients (56 patients were excluded due to poor image quality or inability to perform adequate vessel tracking). After adjusting for confounding variables, tortuosity was significantly associated with hypertension (p < 0.001), female gender (p = 0.01), and increasing age (p = 0.045). No significant correlation was observed between CorT and calcium scores. Univariate analysis indicated that higher CorT levels were linked to lower metabolic equivalents of task (METs) in bicycle tests (p = 0.003); however, this relationship became nonsignificant (p = 0.97) upon adjustment for age, gender, and hypertension. Conclusions Our findings suggest that increased CorT is most prevalent in patients with hypertension, advancing age, and female gender. Although higher tortuosity levels did not significantly impact METs during physical activity, further research is warranted to explore the underlying mechanisms of this relationship.