Abstract

BACKGROUND Evaluation of endothelial function in isolated coronary artery ectasia (ICAE) with flow-mediated dilation (FMD) is limited and use of flow mediated vasodilation as a surrogate marker for the extent of coronary atherosclerosis remains unknown. Thus, the following study was done to evaluate for endothelial dysfunction (ED) in subjects with ICAE by assessing the FMD in the brachial artery. METHODS This was an observational study, conducted at a referral hospital providing tertiary care in India between June 2017 and November 2018. Fifty patients with ICAE and fifty control patients with normal coronary arteries (NCA) on coronary angiogram, done by using a standard Seldinger technique via femoral route, were the subjects of the study. Brachial artery FMD was determined by using a highresolution ultrasound system (Samsung RS80A) using a linear transducer of a frequency of 7.5 Mega Hertz. RESULTS The groups had same baseline characteristics in terms of age, sex etc. (all P values > 0.05). However, values of serum uric acid and low-density lipoproteins were statistically significantly higher in ICAE subjects (P < 0.0001). Whereas, dilatation of brachial artery in response to shear stress was significantly lower in patients with ICAE subjects than in patients with normal coronaries. (8.85 ± 0.49 vs. 12.83 ± 0.45, P < 0.0001). Marki’s classification, type 1, type 2, type 3 and type 4 coronary artery ectasia (CAE) was present in 8 (16 %), 4 (8 %), 13 (26 %), and 25 (50 %), respectively. CONCLUSIONS Atherosclerosis may play a pivotal role in the genesis of ICAE. Hyperlipidaemia may have a specific role in the disease process. Further research is required to evaluate the exact molecular mechanisms involved in CAE. KEYWORDS Coronary Artery Disease, Ectasia, Endothelial Dysfunction, Hyperlipidaemia

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