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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 2, March/April 2019
AFRICA
77
CorT is a common coronary angiographic finding. It is
generally attributed to age-dependent pathological changes of
the elastic material in the vessel, and elongation and dilatation of
the arteries, with left ventricular hypertrophy due to HT.
9
The aetiology and clinical importance of CorT are unclear.
Arteries may become tortuous due to reduced axial strain and
hypertensive pressure in an elastic cylindrical arterial model.
Therefore CorT might be one of the forms of artery remodelling
induced by hypertension due to increased coronary pressure and
blood flow.
CorT was positively correlated with essential HT,
11-14
female
gender and advanced age.
10
Our results are consistent with
previous studies where HT was independently associated with
CorT. Chiha
et al
.
15
reported that women had more severe CorT,
and only age was associated with the presence of tortuosity.
Similar to a previous study,
11,12
we found that advanced age was
independently associated with CorT.
Women with suspected ischaemic chest pain undergoing
invasive coronary angiography were found to have less extensive
CAD. Women displayed a greater symptom burden and a higher
rate of functional disability compared to men, but presented with
a lower prevalence of obstructive CAD and more microvascular
dysfunction.
16
Furthermore, despite the lower prevalence of
obstructive disease, women displayed evidence of ischaemia on
functional assessments such as pressure wire studies, myocardial
perfusion imaging and magnetic resonance imaging.
13,14
These
findings suggest that different pathophysiological mechanismmay
be responsible for chest pain in females compared to males, and
that traditional risk factors and standard diagnostic techniques
may play an alternative role. Consistent with a previous study,
12
we found that female gender was a major predictor of CorT.
MAC has been related to the severity of calcium deposition
in the coronary vasculature.
17-19
It has been associated with
atherosclerosis in the coronary and carotid arteries and the
aorta.
20-22
HT is a major cardiovascular (CV) risk factor and has
been independently associated with MAC.
16-23
Qasim
et al.
24
reported that the association between HT and
MAC on univariate analysis may be confounded by other CV
risk factors. Female gender has been associated with the presence
of MAC.
20,25
Bhatt
et al
.
26
reported that female gender was an
independent predictor of MAC. MAC has been consistently
linked with age and is considered a marker of senile degenerative
changes in the heart.
24,26,27-29
The present study was the first to evaluate the relationship
between CorT and MAC. In our study, there was a significant
association between MAC and CorT. Higher incidence of
co-existence of MAC and CorT may be associated with both
having the same predisposing factors, including HT, HL, female
gender and advanced age. Further prospective and randomised
studies with a larger number of patients are needed on this subject.
Our study has some limitations, first, the retrospective study
design and second, the small sample size.
Conclusion
To the best or our knowledge, this study is the first to evaluate
the relationship between CorT and MAC. We found a strong
association between CorT and MAC. Further prospective,
randomised studies with a larger number of patients are required
to confirm the results obtained in this small study.
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