Hemodynamic Relevance of Anomalous Coronary Arteries Originating From the Opposite Sinus of Valsalva-In Search of the Evidence
Copyright © 2021 Bigler, Ashraf, Seiler, Praz, Ueki, Windecker, Kadner, Räber and Gräni..
Coronary artery anomalies (CAA) represent a heterogeneous group of congenital disorders of the arterial coronary circulation, defined by an anomalous origin of the coronary ostium and/or vessel course. Of particular interest are anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS). The interarterial variants (with the anomalous vessel situated between the great arteries) are historically called "malignant," based on an anticipated higher risk for myocardial ischemia and sudden cardiac death (SCD), especially affecting young patients during strenuous physical activity. However, the interarterial course itself may not be the predominant cause of ischemia, but rather represents a surrogate for other ischemia-associated anatomical high-risk features. As the exact pathophysiology of ACAOS is not well-understood, there is a lack of evidence-based guidelines addressing optimal diagnostic work-up, downstream testing, sports counseling, and therapeutic options in patients with ACAOS. Therefore, treating physicians are often left with uncertainty regarding the clinical management of affected patients. This review focuses on the pathophysiologic consequences of ACAOS on myocardial ischemia and discusses the concept of the interplay between fixed and dynamic coronary stenosis. Further, we discuss the advantages and limitations of the different diagnostic modalities and give an outlook by highlighting the gaps of knowledge in the assessment of such anomalies.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
|---|---|
| Enthalten in: |
Frontiers in cardiovascular medicine - 7(2020) vom: 14., Seite 591326 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Bigler, Marius Reto [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Revised 19.09.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.3389/fcvm.2020.591326 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM321137728 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM321137728 | ||
| 003 | DE-627 | ||
| 005 | 20231225175155.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3389/fcvm.2020.591326 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1070.xml |
| 035 | |a (DE-627)NLM321137728 | ||
| 035 | |a (NLM)33553251 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Bigler, Marius Reto |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Hemodynamic Relevance of Anomalous Coronary Arteries Originating From the Opposite Sinus of Valsalva-In Search of the Evidence |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 19.09.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2021 Bigler, Ashraf, Seiler, Praz, Ueki, Windecker, Kadner, Räber and Gräni. | ||
| 520 | |a Coronary artery anomalies (CAA) represent a heterogeneous group of congenital disorders of the arterial coronary circulation, defined by an anomalous origin of the coronary ostium and/or vessel course. Of particular interest are anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS). The interarterial variants (with the anomalous vessel situated between the great arteries) are historically called "malignant," based on an anticipated higher risk for myocardial ischemia and sudden cardiac death (SCD), especially affecting young patients during strenuous physical activity. However, the interarterial course itself may not be the predominant cause of ischemia, but rather represents a surrogate for other ischemia-associated anatomical high-risk features. As the exact pathophysiology of ACAOS is not well-understood, there is a lack of evidence-based guidelines addressing optimal diagnostic work-up, downstream testing, sports counseling, and therapeutic options in patients with ACAOS. Therefore, treating physicians are often left with uncertainty regarding the clinical management of affected patients. This review focuses on the pathophysiologic consequences of ACAOS on myocardial ischemia and discusses the concept of the interplay between fixed and dynamic coronary stenosis. Further, we discuss the advantages and limitations of the different diagnostic modalities and give an outlook by highlighting the gaps of knowledge in the assessment of such anomalies | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a anomalous aortic origin of the coronary artery (AAOCA) | |
| 650 | 4 | |a anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS) | |
| 650 | 4 | |a dobutamine-volume challenge | |
| 650 | 4 | |a fixed vs. dynamic stenosis | |
| 650 | 4 | |a fractional flow reserve (FFR) | |
| 650 | 4 | |a hemodynamic relevance | |
| 650 | 4 | |a intravascular ultrasound (IVUS) | |
| 650 | 4 | |a multimodality imaging | |
| 700 | 1 | |a Ashraf, Afreed |e verfasserin |4 aut | |
| 700 | 1 | |a Seiler, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Praz, Fabien |e verfasserin |4 aut | |
| 700 | 1 | |a Ueki, Yasushi |e verfasserin |4 aut | |
| 700 | 1 | |a Windecker, Stephan |e verfasserin |4 aut | |
| 700 | 1 | |a Kadner, Alexander |e verfasserin |4 aut | |
| 700 | 1 | |a Räber, Lorenz |e verfasserin |4 aut | |
| 700 | 1 | |a Gräni, Christoph |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Frontiers in cardiovascular medicine |d 2014 |g 7(2020) vom: 14., Seite 591326 |w (DE-627)NLM255534736 |x 2297-055X |7 nnns |
| 773 | 1 | 8 | |g volume:7 |g year:2020 |g day:14 |g pages:591326 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.3389/fcvm.2020.591326 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 7 |j 2020 |b 14 |h 591326 | ||