A Study On The Relationship Between Coronary Microcirculation And Coronary Tortuosity

Objective: To observe the effect of coronary tortuosity(CT)on coronary microvascular,and to explore the relationship between coronary tortoise and coronary microvascular disease.Methods: From March 2015 to December 2016,the patients were diagnosed with typical angina symptoms in the five subjects of the Second Hospital of Hebei Medical University.Fifty-five patients with coronary artery stenosis were not seen with coronary artery angiography.The patients were treated with coronary artery Angiography,of which 35 cases of tortuous coronary artery patients,non-coronary artery tortuous patients in 20 cases.(LVEF),wall motion integral index,heart size,wall thickness,and wall thickness were measured at the time of admission,blood pressure,blood uric acid,blood lipids,and left ventricular ejection fraction(LVEF),BNP,ECG examination,family history,history of diabetes,history of smoking,history of drinking,and whether the history of myocardial infarction or thrombosis,patients with basic medication.Selection criteria: 1.Patients with typical angina symptoms at admission 2.Coronary angiography,no obvious coronary stenosis(coronary artery stenosis <20%)Patients with typical angina symptoms at admission 3.ECT examination in line with coronary artery microvascular disease diagnostic criteria exclusion criteria : 1.Degree of coronary artery stenosis ≥20% 2.Other myocardial diseases that affect ventricular wall motion or cardiac ejection function such as stress cardiomyopathy(Takotsubo cardiomyopathy),hypertrophic cardiomyopathy,dilated cardiomyopathy,myocarditis,myocardium Dystrophic insufficiency,myocardial amyloidosis 3.severe arrhythmia such as permanent atrial fibrillation,recurrent episodes of poor ventricular arrhythmia 4.Cardiogenic shock: SBP ≤ 90 mmHg for more than 30 min,the performance of peripheral vasoconstriction such as(15 ml / h),pulse speed or need to carry out intra-aortic balloon regurgitation;5.severe heart valve disease,including heart valve-severe stenosis or a large number of reflux;6.High drug allergy;7.Need for mechanical ventilation;8.Severe liver and kidney dysfunction 9.There are autoimmune diseases,severe trauma,bleeding Sexually transmitted diseases,combined with the tumor;10,patients or patients refused to participate in this study.55 patients with the above criteria were examined by single photon emission tomography(SPECT),and 99m-technetium was used as tracer to record the segmental myocardial perfusion,perfusion and perfusion Re-distribution of signs to the inverse distribution of myocardial blood flow as a diagnostic criteria for coronary artery microvascular disease.Thirty-three patients with coronary artery microvascular disease and 22 patients with non-coronary arteriolar microvascular disease were analyzed retrospectively.The relationship between coronary artery tortuosity and coronary artery microvascular lesion was studied.The pathophysiological mechanism and pathophysiology were analyzed.Diagnosis,treatment.All data were analyzed by SPSS 21.0 software in order to compare the two groups before the application of binary logistic regression of the above data for multivariate analysis,with P <0.05 for the difference was statistically significant.Result:1 Comparison of baseline data between the two groupsThere was no significant difference in sex,age and smoking between the experimental group and the control group(P> 0.05).There was significant difference between the experimental group and the control group in hypertension,diabetes mellitus and coronary atherosclerosis(P <0.05).2 Comparison of two groups of biochemical indicators(2.20 ± 1.63 vs.4.15 ± 4.29,P = 0.000),low density lipoprotein(2.66 ±0.98 vs.2.69 ± 0.69,P = 0.092),triglyceride(1.62 ± 0.62)(P <0.05).There was no significant difference in low density lipoprotein and triglyceride(P>0.05)between the two groups(P> 0.05),total cholesterol(3.90 ± 1.41 vs.4.66± 0.80,P = 0.001)There were significant differences in hypersensitivity protein and total cholesterol between the two groups(P <0.05).3 Comparison of tortuous parameters of coronary artery in two groups of patientsThe pearson chi-square test(chi-square value 11.786 df = 1,p <0.01)was statistically significant in the experimental group and the control group.4 Multivariate logistic regression analysis resultsThe classification of Logictic regression analysis showed that gender(OR= 0.28,P = 0.029)(OR = 0.28,P = 0.029),coronary artery tortuosity(OR =62.59,P = 0.004),hypertension(OR = 11.064,P = 0.096),coronary atherosclerosis(OR = 15.405,P = 0.043)(OR = 0.202,P = 0.010),diabetes mellitus(OR = 8.320,P = 0.43),total cholesterol(OR = 0.616,P = 0.41),total cholesterol There was no significant difference between the two groups(P<0.05),but there was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups(P> 0.05),Coronary artery tortuosity,hypertension,gender,coronary atherosclerosis OR> 1,P <0.05 was statistically significant.Coronary artery tortilation is an independent risk factor for coronary artery microvascular disease.The patients were followed up for 3 months after discharge.No MACE events such as acute myocardial infarction were observed in the control group.There was no significant difference between the two groups in the acute myocardial infarction(P <0.05).There was no significant difference between the two groups(P> 0.05)Conclusion:1 Coronary tortuosity are associated with coronary microcirculation.2 Coronary tortuosity may affect the production and development of coronary microcirculation.