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Imaging: Non-Invasive
Main Normal Coronary Arteries Dimensions Among Egyptian Population
Mahmoud Khalil1, Osama Shoeib1, Amr Mubarak1, Mohamed Senara1, Ahmed El Shall1, Mohamed Abouelasaad1, Ahmed Shahin1
Tanta University Hospital, Egypt1
During diagnostic coronary angiography (CA) operator¡¯s knowledge of the expected diameter of a given coronary segment is essential to be able to provide a visual estimation of the coronary artery disease severity. In the setting of percutaneous coronary intervention (PCI) the crucial first step is to determine the devices sizes either it is a stent or a balloon, correct sizing is a predictor of the outcome after PCI. The available data regarding normal coronary artery dimensions is limited, regarding the Egyptian population to our knowledge there is no available published information regarding the normal size of coronary arteries in Egyptians.
We prospectively included all Egyptian population presented to Multi slice Computed Tomography (MSCT) for coronary artery examination during the period from 1st of January2019 to the end of June 2019. We measured maximum and minimum diameter of the coronary arteries in three main locations; the mid segment of the left main (LM), the ostium of the leftanterior descending (LAD) and the ostium of the left circumflex (LCX). Synedra (synedra information technologies GmbH, Austria) software was used for reconstruction and measurements. Then we calculated the mean diameter for each segment. The expected diameter of the LM according to the Fient¡¯s law was calculated from the mean diameter of both LAD and LCX.
We included 53 patients with normal coronary arteries, 17 of them were males and 36 were females their ages range from 23-70 years old (Mean age 49.79 ¡¾ 11.39), the mean LM diameter was 4.06 ¡¾ 0.72 mm, the mean LAD diameter was 3.29 ¡¾ 0.64 mm and the mean LCX diameter was 2.75 ¡¾ 0.54 mm (All measurements are included in Table 1).We ran an independent t-test to show the differences between males and females, LM diameter was significantly larger in males in comparison to female (4.9 mm vs 4.4 mm, P value0.036), LAD also was significantly larger among males (3.55 mm vs 3.17 mm, P value 0.044)such significance was not achieved in LCX measurement .There were no differences regarding risk factors such as diabetes mellites (DM), hypertension(HTN) and dyslipidemia. Person¡¯s correlation was found to be significant between age and LM diameter (r=0.332,P value=0.015), we tested also the measured LM mean diameter and the expected LM diameter calculated by the Fient¡¯s law and showed strong correlation (r=0.444, P value 0.001) .
Table 1: Descriptive statistics including all measurements for all coronary segments measured during study
   Minimum  Maximum  Mean SD deviation
 Age  23         70  49.79  11.39 
 LM max diameter  3.5 7.2  4.6  0.8     
 LM min diameter  2.3 5.7  3.5  0.69 
 LM mean diameter  3.1 6.2  4.06  0.72 
 LAD max diameter  2.4 5.7  3.67   0.69
 LAD min diameter  1.7 4.5  2.92   0.62
 LAD mean diameter  2.2 5.1  3.29  0.64 
 LCX max diameter  1.7  4.5  3.1  0.57
 LCX min diameter  1.4  4.1  2.4  0.54
 LCX mean diameter  1.5  4.3  2.75  0.54

A general idea about the average coronary arteries diameters among Egyptian population showed by in mind of every intervention cardiologist while conducting PCI, especially in countries with limited resources and restricted reach to intra-vascular imaging as in our region.
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