The association of coronary lumen volume to left ventricle mass ratio with myocardial blood flow and fractional flow reserve

• Published in: Journal of cardiovascular computed tomography Vol. 13; no. 4; pp. 179 - 187
• Main Authors: van Diemen, P.A., Schumacher, S.P., Bom, M.J., Driessen, R.S., Everaars, H., Stuijfzand, W.J., Raijmakers, P.G., van de Ven, P.M., Min, J.K., Leipsic, J.A., Knuuti, J., Boellaard, P.R., Taylor, C.A., van Rossum, A.C., Danad, I., Knaapen, P.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2019
• Subjects: Aged; Clinical Trials as Topic; Computed Tomography Angiography; Coronary Angiography - methods; Coronary arterial lumen volume to left ventricle mass ratio; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - physiopathology; Coronary computed tomography angiography; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Female; Fractional flow reserve; Fractional Flow Reserve, Myocardial; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Male; Middle Aged; Positron emission tomography; Predictive Value of Tests; Positron emission tomography; Fractional flow reserve; Coronary artery disease; Coronary computed tomography angiography; Coronary arterial lumen volume to left ventricle mass ratio
• ISSN: 1934-5925; 1876-861X
• DOI: 10.1016/j.jcct.2019.06.016

A diminished coronary lumen volume to left ventricle mass ratio (V/M) derived from coronary computed tomography angiography (CCTA) has been proposed as factor contributing to impaired myocardial blood flow (MBF) even in the absence of obstructive disease on invasive coronary angiography (ICA). Patients underwent CCTA, and positron emission tomography (PET) prior to ICA. Matched global V/M, global, and vessel specific hyperaemic MBF (hMBF), coronary flow reserve (CFR), and, FFR were available for 431 vessels in 152 patients. The median V/M (20.71 mm3/g) was used to divide the population into patients with either a low V/M or a high V/M. Overall, a higher percentage of vessels with an abnormal hMBF and FFR (34% vs. 19%, p = 0.009 and 20% vs. 9%, p = 0.004), as well as a lower FFR (0.93 [interquartile range: 0.85–0.97] vs. 0.95 [0.89–0.98], p = 0.016) values were observed in the low V/M group. V/M was weakly associated with vessel specific hMBF (R = 0.148, p = 0.027), and FFR (R = 0.156, p < 0.001). Among vessels with non-obstructive CAD on ICA (361 vessels), no association between V/M and vessel specific hMBF nor CFR was noted. However, in the absence of obstructive CAD, V/M was associated with (R = 0.081, p = 0.027), and independently predictive for FFR (p = 0.047). Overall, an abnormal vessel specific hMBF and FFR were more prevalent in patients with a low V/M compared to those with a high V/M. Furthermore, V/M was weakly associated with vessel specific hMBF and FFR. In the absence of obstructive CAD on ICA, V/M was weakly associated with notwithstanding independently predictive for FFR.