Effect of the ratio of coronary arterial lumen volume to left ventricle myocardial mass derived from coronary CT angiography on fractional flow reserve

• Published in: Journal of cardiovascular computed tomography 2017-11, Vol.11 (6), p.429-436
• Main Authors: Taylor, Charles A., Gaur, Sara, Leipsic, Jonathon, Achenbach, Stephan, Berman, Daniel S., Jensen, Jesper M., Dey, Damini, Bøtker, Hans Erik, Kim, Hyun Jin, Khem, Sophie, Wilk, Alan, Zarins, Christopher K., Bezerra, Hiram, Lesser, John, Ko, Brian, Narula, Jagat, Ahmadi, Amir, Øvrehus, Kristian A., St Goar, Fred, De Bruyne, Bernard, Nørgaard, Bjarne L.
• Format: Article
• Language: English
• Subjects: Aged; Area Under Curve; Cardiac Catheterization; Chi-Square Distribution; Computed Tomography Angiography; Coronary Angiography - methods; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - pathology; Coronary Artery Disease - physiopathology; Coronary computed tomography angiography; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - pathology; Coronary Stenosis - physiopathology; Coronary Vessels - diagnostic imaging; Coronary Vessels - pathology; Coronary Vessels - physiopathology; Female; Fractional flow reserve; Fractional Flow Reserve, Myocardial; Heart Ventricles - diagnostic imaging; Heart Ventricles - pathology; Humans; Logistic Models; Male; Middle Aged; Multidetector Computed Tomography; Multivariate Analysis; Nitroglycerin - administration & dosage; Odds Ratio; Plaque, Atherosclerotic; Predictive Value of Tests; Prognosis; Radiographic Image Interpretation, Computer-Assisted; Reproducibility of Results; ROC Curve; Severity of Illness Index; Software; Vasodilator Agents - administration & dosage
• ISSN: 1934-5925; 1876-861X
• DOI: 10.1016/j.jcct.2017.08.001

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). 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. 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