Tortuosity of coronary arteries: an indicator for impaired left ventricular relaxation?

To investigate the relationship between coronary tortuosity and impaired left ventricular relaxation.

One hundred and four subjects who underwent coronary angiography were included in the study. Left anterior descending, left circumflex, and right coronary arteries were traced. Tortuosity was identified by the finding of ≥3 bends (defined as ≥45° change in vessel direction) along main trunk of at least one artery. Study population were divided into tortuosity (n = 54) and no tortuosity (n = 50) groups. Subjects were all submitted to pulsed-wave Doppler and two-dimensional echocardiographic examination to assess left ventricular functions.

For subjects with tortuosity, early transmitral inflow (E) velocity was lower, late transmitral inflow (A) velocity was higher, E/A ratio was smaller compared with subjects without tortuosity (P < 0.001). Subjects with tortuosity had longer deceleration time of E velocity (DT) and isovolumic relaxation time (IVRT) than did subjects without tortuosity (P < 0.001). End-diastolic interventricular septal and left ventricular posterior wall thicknesses were greater in subjects with tortuosity than those without tortuosity (P = 0.01 and P = 0.005). There was an inverse correlation between total number of arteries with tortuosity and E/A ratio (r = −0.750, P < 0.001). Total number of arteries with tortuosity displayed correlations with DT (r = 0.723, P < 0.001) and IVRT (r = 0.703, P < 0.001).

This study depicts that coronary tortuosity is associated with impaired left ventricular relaxation.Thus, coronary tortuosity might be an indicator of impaired left ventricular relaxation.