Abstract

Objective: This study aims to correlate coronary tortuosity with angina pectoris and the presence of ischemia in myocardial scintigraphy. Methods: This is a retrospective study in which 57 patients who underwent coronary angiography at the University Hospital Antonio Pedro in 2015 and at the National Institute of Cardiology in 2017 due to complaints of angina pectoris and had no coronary obstructions were selected. Interviews and reviews of medical records were carried out and myocardial scintigraphy examinations of stress and rest were compared to verify this hypothesis. Patients who had not yet undergone the scintigraphy examination, if they agreed to participate in the study and after signing the informed consent, were submitted to this examination. From these patients, angiographic variables were analyzed to assess the presence and degree of tortuosity and correlated with their respective irrigation territories in myocardial scintigraphy. Results: Of the 57 patients aged between 41 and 77 years studied, , 70.2% were female and hypertension was present in 89.5% of then. The tortuosity occurred in 28.1% of the patients and the ischemia in 64.9% of the cases. The most tortuous vessels were the Circumflex Artery and Anterior Descending Artery (both in 17.5%) followed by the Right Coronary or Left Posterior Ventricular Coronary (7%). In the sample of 171 territories and arteries responsible for their blood supply, a highly significant association between tortuosity and ischemia (p <0.0001) was found, and the angiographic factor studied with the greatest association with ischemia was the number of angles measured at systole (p = 0.021). Conclusion: The presence of myocardial ischemia is related to coronary tortuosity in the individualized analysis of the coronary artery and its corresponding territory. The highest number of acute angles measured at angiography in the systole is related to myocardial ischemia

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