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Effect of the ratio of coronary arterial lumen volume to left ventricle myocardial mass derived from coronary CT angiography on fractional flow reserve.
J Cardiovasc Comput Tomogr. 2017 Nov; 11(6):429-436.JC

Abstract

BACKGROUND

We hypothesize that in patients with suspected coronary artery disease (CAD), lower values of the ratio of total epicardial coronary arterial lumen volume to left ventricular myocardial mass (V/M) result in lower fractional flow reserve (FFR).

METHODS

V/M was computed in 238 patients from the NXT trial who underwent coronary computed tomography angiography (CTA), quantitative coronary angiography (QCA) and FFR measurement in 438 vessels. Nitroglycerin was administered prior to CT, QCA and FFR acquisition. The V/M ratio was quantified on a patient-level from CT image data by segmenting the epicardial coronary arterial lumen volume (V) and the left ventricular myocardial mass (M). Calcified and noncalcified plaque volumes were quantified using semi-automated software.

RESULTS

The median value of V/M (18.57 mm3/g) was used to define equal groups of low and high V/M patients. Patients with low V/M had greater diameter stenosis by QCA, more plaque and lower FFR (0.80 ± 0.12 vs. 0.87 ± 0.08; P < 0.0001) than those with high V/M. A total of 365 vessels in 202 patients had QCA stenosis ≤50% and measured FFR. In these patients, those with low V/M had higher percent diameter stenosis by QCA, greater total plaque volume and lower FFR (0.81 ± 0.12 vs. 0.88 ± 0.07; P < 0.0001) than those with high V/M. In multivariate logistic regression analysis, V/M was an independent predictor of FFR ≤0.80 (all p-values < 0.001).

CONCLUSIONS

Patients with a low V/M ratio have lower FFR overall and in non-obstructive CAD, independent of plaque measures.

Authors+Show Affiliations

HeartFlow, Inc., Redwood City, CA, USA; Department of Bioengineering, Stanford University, Stanford, CA, USA. Electronic address: ctaylor@heartflow.com.Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.Department of Radiology and Division of Cardiology, St. Paul's Hospital, Vancouver, British Columbia, Canada.Department of Cardiology, Erlangen, Germany.Department of Cardiology, Cedars Sinai Hospital, Los Angeles, CA, USA.Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.Department of Cardiology, Cedars Sinai Hospital, Los Angeles, CA, USA.Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.HeartFlow, Inc., Redwood City, CA, USA.HeartFlow, Inc., Redwood City, CA, USA.HeartFlow, Inc., Redwood City, CA, USA.HeartFlow, Inc., Redwood City, CA, USA.Department of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland, Ohio, USA.Minneapolis Heart Institute, Minneapolis, MN, USA.Monash Heart, Monash Medical Center and Monash University, Victoria, Australia.Department of Cardiology, Mount Sinai Hospital, New York, NY, USA.Department of Cardiology, Mount Sinai Hospital, New York, NY, USA.Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.Department of Cardiology, El Camino Hospital, Mountain View, CA, USA.Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium.Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

28789941

Citation

Taylor, Charles A., et al. "Effect of the Ratio of Coronary Arterial Lumen Volume to Left Ventricle Myocardial Mass Derived From Coronary CT Angiography On Fractional Flow Reserve." Journal of Cardiovascular Computed Tomography, vol. 11, no. 6, 2017, pp. 429-436.
Taylor CA, Gaur S, Leipsic J, et al. Effect of the ratio of coronary arterial lumen volume to left ventricle myocardial mass derived from coronary CT angiography on fractional flow reserve. J Cardiovasc Comput Tomogr. 2017;11(6):429-436.
Taylor, C. A., Gaur, S., Leipsic, J., Achenbach, S., Berman, D. S., Jensen, J. M., Dey, D., Bøtker, H. E., Kim, H. J., Khem, S., Wilk, A., Zarins, C. K., Bezerra, H., Lesser, J., Ko, B., Narula, J., Ahmadi, A., Øvrehus, K. A., St Goar, F., ... Nørgaard, B. L. (2017). Effect of the ratio of coronary arterial lumen volume to left ventricle myocardial mass derived from coronary CT angiography on fractional flow reserve. Journal of Cardiovascular Computed Tomography, 11(6), 429-436. https://doi.org/10.1016/j.jcct.2017.08.001
Taylor CA, et al. Effect of the Ratio of Coronary Arterial Lumen Volume to Left Ventricle Myocardial Mass Derived From Coronary CT Angiography On Fractional Flow Reserve. J Cardiovasc Comput Tomogr. 2017;11(6):429-436. PubMed PMID: 28789941.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of the ratio of coronary arterial lumen volume to left ventricle myocardial mass derived from coronary CT angiography on fractional flow reserve. AU - Taylor,Charles A, AU - Gaur,Sara, AU - Leipsic,Jonathon, AU - Achenbach,Stephan, AU - Berman,Daniel S, AU - Jensen,Jesper M, AU - Dey,Damini, AU - Bøtker,Hans Erik, AU - Kim,Hyun Jin, AU - Khem,Sophie, AU - Wilk,Alan, AU - Zarins,Christopher K, AU - Bezerra,Hiram, AU - Lesser,John, AU - Ko,Brian, AU - Narula,Jagat, AU - Ahmadi,Amir, AU - Øvrehus,Kristian A, AU - St Goar,Fred, AU - De Bruyne,Bernard, AU - Nørgaard,Bjarne L, Y1 - 2017/08/03/ PY - 2017/02/05/received PY - 2017/06/14/revised PY - 2017/08/01/accepted PY - 2017/8/10/pubmed PY - 2018/7/17/medline PY - 2017/8/10/entrez KW - Coronary artery disease KW - Coronary computed tomography angiography KW - Fractional flow reserve SP - 429 EP - 436 JF - Journal of cardiovascular computed tomography JO - J Cardiovasc Comput Tomogr VL - 11 IS - 6 N2 - BACKGROUND: We hypothesize that in patients with suspected coronary artery disease (CAD), lower values of the ratio of total epicardial coronary arterial lumen volume to left ventricular myocardial mass (V/M) result in lower fractional flow reserve (FFR). METHODS: V/M was computed in 238 patients from the NXT trial who underwent coronary computed tomography angiography (CTA), quantitative coronary angiography (QCA) and FFR measurement in 438 vessels. Nitroglycerin was administered prior to CT, QCA and FFR acquisition. The V/M ratio was quantified on a patient-level from CT image data by segmenting the epicardial coronary arterial lumen volume (V) and the left ventricular myocardial mass (M). Calcified and noncalcified plaque volumes were quantified using semi-automated software. RESULTS: The median value of V/M (18.57 mm3/g) was used to define equal groups of low and high V/M patients. Patients with low V/M had greater diameter stenosis by QCA, more plaque and lower FFR (0.80 ± 0.12 vs. 0.87 ± 0.08; P < 0.0001) than those with high V/M. A total of 365 vessels in 202 patients had QCA stenosis ≤50% and measured FFR. In these patients, those with low V/M had higher percent diameter stenosis by QCA, greater total plaque volume and lower FFR (0.81 ± 0.12 vs. 0.88 ± 0.07; P < 0.0001) than those with high V/M. In multivariate logistic regression analysis, V/M was an independent predictor of FFR ≤0.80 (all p-values < 0.001). CONCLUSIONS: Patients with a low V/M ratio have lower FFR overall and in non-obstructive CAD, independent of plaque measures. SN - 1876-861X UR - https://www.unboundmedicine.com/medline/citation/28789941/Effect_of_the_ratio_of_coronary_arterial_lumen_volume_to_left_ventricle_myocardial_mass_derived_from_coronary_CT_angiography_on_fractional_flow_reserve_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1934-5925(17)30169-7 DB - PRIME DP - Unbound Medicine ER -