Author + information
- Received December 19, 2016
- Revision received February 8, 2017
- Accepted February 15, 2017
- Published online April 3, 2017.
- Christoph Gräni, MDa,
- Ronny R. Buechel, MDb,
- Philipp A. Kaufmann, MDb and
- Raymond Y. Kwong, MD, MPHa,∗ ()
- aCardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- bDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
- ↵∗Address for correspondence:
Dr. Raymond Y. Kwong, Noninvasive Cardiovascular Imaging, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, Massachusetts 02115.
Anomalous coronary arteries (ACA) represent a congenital disorder with an anomalous location of the coronary ostium and/or vascular course. Although most individuals with ACA are asymptomatic and remain undiagnosed, some ACA variants are clinically significant leading to symptoms and even adverse cardiac events. Currently, disease prevalence, pathophysiological mechanisms, risks of sudden cardiac death, and the optimal assessment and treatment strategies among subtypes of ACA remain largely unknown. Consequently, there is a lack of guidelines regarding imaging, sport restriction, and treatment options in individuals with ACA at all ages. Cardiac imaging techniques may play a pivotal role in the assessment of individuals with ACA and may offer guidance toward an optimal treatment strategy. This state-of-the-art review highlights current challenges and future perspectives with a special focus on the role of noninvasive multimodality imaging in patients with ACA.
- anomalous coronary arteries
- competitive sports
- coronary CTA
- multimodality imaging
- sudden cardiac death
Dr. Gräni has received funding support from the Novartis Foundation for Medical-Biological Research, Bangerter-Rhyner Foundation, Swiss Sports Medicine Society, and Kreislauf Kardiologie Foundation. Dr. Kwong has received research support from the National Institutes of Health (1UH2 TR000901, 1RO1DK083424-01, and 1U01HL117006), Alnylam Pharmaceuticals, and the Society for the Cardiovascular Magnetic Resonance. The University Hospital of Zurich holds a research contract with GE Healthcare. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received December 19, 2016.
- Revision received February 8, 2017.
- Accepted February 15, 2017.
- 2017 American College of Cardiology Foundation