Diagnosis and prognosis of abnromal origin of coronary arteries

Title : Diagnosis and prognosis of abnromal origin of coronary arteries

Abstract:

Objective: To investigate the diagnostic and prognostic value of echocardiography in patients with anomalous origin of the coronary arteries(AOCA),and to analyze its diagnostic accuracy and impact on patient outcomes.

Methods: A retrospective analysis was conducted on clinical data from patients diagnosed with AOCA in Beijing Children’s Hospital. The study included pediatric patients with a focus on anomalous left coronary artery from the pulmonary artery(ALCAPA)and anomalous aortic origin of a coronary artery(AAOCA). Echocardiographic findings, imaging results, treatment modalities, and follow-up outcomes were reviewed.

Results: Echocardiography demonstrated a high diagnostic accuracy for ALCAPA but a relatively low accuracy for AAOCA. ALCAPA patients often presented with left ventricular dysfunction, coronary artery dilation, and abnormal blood flow signals in the pulmonary artery, while AAOCA patients were frequently missed due to nonspecific symptoms. ALCAPA patients had a poor prognosis, often presenting with cardiogenic syncope or heart failure, whereas anomalous right coronary artery from the pulmonary artery(ARCAPA) patients had a relatively better prognosis. After surgical treatment, the left ventricular ejection fraction(LVEF) in ALCAPA patients significantly improved within 6 months postoperatively. In AAOCA patients, imaging revealed anatomic features associated with coronary artery compression or stenosis leading to myocardial ischemia. Symptoms such as chest pain or syncope during exercise suggested high-risk anatomic features.

Conclusion: Echocardiography is an important screening tool for AOCA, particularly for ALCAPA. However, the diagnosis of AAOCA requires additional imaging modalities to improve accuracy. Early surgical intervention significantly improves prognosis in patients with myocardial ischemia. Cardiogenic syncope or heart failure is more common in ALCAPA patients, and early surgical treatment is recommended.

Biography:

Dr. Ma Ning, Ph.D.in Medicine, Chief Physician, Professor, Director of the Department of Cardiac Ultrasound at Beijing Children's Hospital, Capital Medical University. Her research focuses primarily on the ultrasound diagnosis of pediatric cardiovascular diseases and the assessment of cardiovascular function, including the integrated prenatal and postnatal management of congenital heart diseases. She was the first in the country to initiate a pediatric coronary artery ultrasound examination program. In recent years, she has undertaken multiple research projects funded by the National Natural Science Foundation of China, the Beijing Municipal Natural Science Foundation, and the Beijing Municipal Science and Technology Commission. She has published over 50 articles, edited 2 monographs as the chief editor or co-editor, and contributed to 10 other publications.