Gender-related differences in coronary artery dimensions: a volumetric analysis.
Gender-related differences in coronary artery dimensions: a volumetric analysis.
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DOI：
10.1002/clc.20509
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发表时间：
2010-02-01
影响因子：
2.7
通讯作者：
Raman, Subha V
中科院分区：
文献类型：
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作者：
Dickerson, Jennifer A;Nagaraja, Haikady N;Raman, Subha V
背景：与男性相比，女性的血运重建结果一直较差，冠状动脉血管并发症更多。这被归因于较小的冠状动脉，虽然有限的数据存在，以支持这一假设。假说：通过使用体积数据获得的多探测器心血管计算机断层扫描（CCT），我们试图确定在何种程度上性别影响冠状动脉的尺寸和测试的假设，即女性将有较小的冠状动脉尺寸，即使在身体表面积和心脏质量标准化。在64层扫描仪上完成的CCT检查是从大学心血管数据库中识别的。选择了50名女性和44名男性无冠状动脉疾病的数据集进行分析。测量左前降支（LAD）、回旋支（LCx）和右冠状动脉（RCA）近端和远端节段的横截面积，对患者性别不知情。测量结果采用双样本t检验和线性回归分析技术进行比较，考虑体表面积（BSA）和左心室（LV）质量。对冠状动脉横截面面积的分析（未校正BSA和LV质量）显示，与男性相比，女性左前降支近端部分的冠状动脉尺寸较小（P = 0.01）和RCA（P = 0.002），但其余冠状动脉节段无显著差异。结论：性别显著影响近端LAD和RCA大小。冠状动脉直径的差异可以解释冠状动脉血运重建术的部分但不是全部的性别相关风险，强调了考虑多种影响因素的重要性。
BACKGROUND: Women consistently have poorer revascularization outcomes and more coronary vascular complications compared to men. This has been attributed to smaller coronary arteries, though limited data exist to support this assumption.HYPOTHESIS: By using volumetric data obtained from multidetector cardiovascular computed tomography (CCT), we sought to determine to what extent gender influences coronary artery dimensions and test the hypothesis that women would have smaller coronary dimensions even after normalizing for body surface area and cardiac mass.METHODS: CCT examinations completed on a 64-slice scanner were identified from a university cardiovascular database. Data sets from 50 women and 44 men without coronary artery disease were selected for analysis. Cross-sectional areas of proximal and distal segments of the left anterior descending (LAD), circumflex (LCx), and right coronary artery (RCA) were measured, blinded to patient gender. Measurements were compared using 2-sample t tests and linear regression analysis techniques accounting for body surface area (BSA) and left ventricular (LV) mass.RESULTS: Analysis of cross-sectional coronary artery areas, unadjusted for BSA and LV mass showed smaller coronary artery size in women compared to men in the proximal portion of both the LAD (P = .01) and RCA (P = .002), but no significant difference in the remaining coronary segments.CONCLUSION: Gender significantly impacts proximal LAD and RCA size. Differences in coronary artery dimensions may explain some, but not all excess gender-related risk with coronary artery revascularization, underscoring the importance of considering multiple contributing factors.