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Abstract：
Purpose To investigate the association between the anomalous aortic origin of the right coronary artery (R-AAOCA) from the left coronary sinus with interarterial course (IAC) found at coronary CT angiography and sudden cardiac death using a large data set from five university hospitals. Materials and Methods From a total of 89 314 CCTA scans (January 2009 to December 2016) that were retrospectively collected, 316 patients with R-AAOCA from the left sinus with IAC were retrospectively collected. After excluding patients with less than 2 years of follow-up, patients who had already undergone cardiovascular surgery or intervention, and patients with arrhythmia or heart failure before undergoing coronary CT angiography, 224 patients were analyzed. Follow-up was terminated upon the occurrence of major adverse cardiovascular events (MACE). Logistic regression was used to identify clinical and radiologic information as independent predictors of MACE. Results The period prevalence of R-AAOCA from the left sinus with IAC was 0.354%. The mean age was 62.03 years, with a male-to-female ratio of 182:134. During follow-up, 19 of 224 patients (8.5%) experienced MACE, but none had sudden cardiac death. Of these cases, only seven (3.13%) were suspected of being due to R-AAOCA from the left sinus with IAC and all of them had unstable angina. Coronary artery disease was significantly associated with MACE (P < .001), while no significant correlation was observed with radiologic features. Conclusion Sudden cardiac death was not associated with R-AAOCA from the left sinus with IAC found at coronary CT angiography. The occurrence of MACE was low, with coronary artery disease being the sole significant predictor of a patient\'s prognosis. Keywords: Anomalous Aortic Origin of the Right Coronary Artery, Left Coronary Sinus with Interarterial Course, Coronary CT Angiography, Sudden Cardiac Death Supplemental material is available for this article. © RSNA, 2024.
摘要：
目的使用五所大学医院的大量数据集，研究左冠状静脉窦的右冠状动脉异常主动脉起源（R-AAOCA）与冠状动脉CT血管造影发现的动脉间通道（IAC）与心脏性猝死之间的关系。材料与方法回顾性收集的89314项CCTA扫描（2009年1月至2016年12月），回顾性收集了316例来自IAC左窦的R-AAOCA患者。排除随访少于2年的患者后，已经接受过心血管手术或干预的患者，以及在接受冠状动脉CT血管造影之前有心律失常或心力衰竭的患者，对224例患者进行了分析。在发生主要不良心血管事件（MACE）后终止随访。使用Logistic回归确定临床和放射学信息作为MACE的独立预测因子。结果R-AAOCA从IAC左窦的经期患病率为0.354%。平均年龄为62.03岁,男女比例为182:134。随访期间,224例患者中有19例（8.5%）经历了MACE，但没有人心源性猝死.在这些案件中,只有7例(3.13%)被怀疑是由于IAC左窦的R-AAOCA所致,且均有不稳定型心绞痛.冠状动脉疾病与MACE显著相关(P<.001),而与放射学特征无显著相关性。结论心源性猝死与冠状动脉CT血管造影发现的IAC左窦R-AAOCA无关。MACE发生率较低,冠状动脉疾病是患者预后的唯一重要预测指标。关键词：右冠状动脉异常主动脉起源，左冠状窦伴动脉间,冠状动脉CT血管造影,本文提供心源性猝死补充材料。©RSNA,2024.
