Patterns of Coronary Artery Movement and the Development of Coronary Atherosclerosis

Mechanical stress in coronary arteries has been postulated to cause endothelial injury and atherosclerotic lesions, but the relationship between the pattern of coronary artery movement (CAM) and lesion severity is not known. In the present study CAM was classified into 10 patterns, which were grouped into 3 classes: (1) bend type = coronary artery flexes into a curve; (2) compression type = segmental length is shortened without vertical deviation of the artery; (3) displacement type = location of the coronary artery shifts without change of segmental length or shape. Assessment of CAM was made for 6 segments from the left anterior descending artery and 3-5 segments from the left circumflex artery, and in total 673 segments were analyzed. Coronary arterial segments with the compression type had a significantly higher percent stenosis than those without it (Compression 57.9+/-29.4 % vs Bend 7.9+/-19.0 %, Displacement 4.3+/-13.0 %; p<0.00001). The compression type was seen frequently in the proximal and mid left anterior descending artery, ostial diagonal branch, obtuse marginal branch and mid left circumflex artery. The critical CAM (eg, compression pattern) may be an important mechanical stress inducing coronary atherosclerosis.