Abstract 13081: The Relationship of Left Ventricular Mass With Coronary Artery Disease and Ischemic Heart Disease: The CORE320 Study
Background & Objectives: Multidetector computed tomography (CT) allows for the simultaneous assessment of coronary atherosclerosis and cardiac structure. Left ventricular mass (LVM) is an independent predictor of cardiovascular disease. Although high LVM has been associated with myocardial ischemia, the relationship of high LVM with total coronary atheroma volume is unknown. We aimed to investigate whether myocardial ischemia and coronary atherosclerosis are associated with high LVM.
Methods: Patients underwent 320-row detector coronary CT angiography, invasive coronary angiography (ICA), and single-photon emission computed tomography (SPECT) myocardial perfusion imaging. We used a novel arterial contour detection algorithm to quantify coronary atheroma volume for the entire coronary tree using a 19-segment model. Percent atheroma volume (PAV) and normalized total atheroma volume (TAVnorm) were analyzed as a quantitative total atheroma volume. LVM was measured on myocardial CT images and indexed to height to the power of 2.7 (LVMi). Obstructive coronary artery disease (CAD) was defined as ≥ 50% diameter stenosis by ICA. Myocardial ischemia was defined as ≥ 1 abnormal myocardial segment by SPECT. Uni and multivariate analyses evaluated the association of LVMi with CAD, myocardial ischemia, PAV, and TAVnorm at the per-patient level.
Results: A total of 338 participants were included. The median LVMi, PAV, and TAVnorm were 36.7 g/m2.7, 54.0%, and 2844 mm3. The proportion of CAD and myocardial ischemia were 59.5% and 36.0%. In univariate analysis, high LVMi was associated with high TAVnorm and myocardial ischemia. High LVMi was independently associated with myocardial ischemia after adjustment for risk factors, but not with CAD, PAV, and TAVnorm (Table 1).
Conclusions: High LVMi was independently associated with myocardial ischemia, but not epicardial coronary atherosclerosis. Myocardial microvascular dysfunction may contribute to myocardial ischemia.
- © 2013 by American Heart Association, Inc.