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Published on: August 9, 2022
Relationship of left ventricular mass to coronary atherosclerosis and myocardial ischaemia: the CORE320 multicenter
Satoru Kishi1, Tiago A Magalhaes1, Richard T George1
1Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Blalock 524, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
Insights
Left ventricular mass (LVM) is linked to coronary artery atherosclerosis and myocardial infarction (MI). Increased LVMi independently predicts coronary atherosclerosis and perfusion defects, even in patients without prior MI.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Left ventricular mass (LVM) is a key indicator of cardiac health.
- Coronary artery disease (CAD) and myocardial infarction (MI) are major cardiovascular concerns.
- Understanding the relationship between LVM and atherosclerosis is crucial for risk stratification.
Purpose of the Study:
- To investigate the association between left ventricular mass (LVM) and coronary atherosclerosis.
- To explore the link between LVM and myocardial infarction (MI).
Main Methods:
- 338 patients underwent coronary CT angiography, invasive coronary angiography (ICA), and SPECT myocardial perfusion imaging.
- Quantitative coronary atheroma volume (NormTAV) and indexed LVM (LVMi) were measured.
- Regression analyses determined associations between LVMi, atherosclerosis, and perfusion defects.
Main Results:
- 60% of patients had obstructive CAD.
- LVMi was independently associated with abnormal perfusion (SRS) and total atheroma volume (NormTAV).
- Increased LVMi predicted atherosclerosis and perfusion defects, independent of cardiovascular risk factors in patients without prior MI.
Conclusions:
- Left ventricular mass is independently associated with coronary artery atherosclerosis.
- LVM is also independently associated with the presence of myocardial infarction.
Aims:
The aim of this study was to investigate the association of left ventricular mass (LVM) with coronary atherosclerosis and myocardial infarction (MI).
Methods And Results:
Patients (n = 338) underwent 320 × 0.5 mm detector row coronary computed tomography (CT) angiography, invasive coronary angiography (ICA), and single-photon emission CT (SPECT) myocardial perfusion imaging. Quantitative coronary atheroma volume was obtained from the CT images for the entire coronary tree (19-segment model) with an arterial contour detection algorithm. Normalized total atheroma volume (NormTAV) was analysed to reflect quantitative total atheroma volume. LVM was measured on myocardial CT images and indexed to height to the power of 2.7 (LVMi). Patients with obstructive coronary artery disease (CAD) were defined as those with ≥50% diameter stenosis by quantitative ICA. Abnormal perfusion defect was defined as ≥1 abnormal myocardial segment by SPECT. The association of LVMi with coronary atherosclerosis and myocardial perfusion defect on SPECT at the patient level was determined with uni- and multivariable linear and logistic regression analyses. Obstructive CAD was present in 60.0% of enrolled patients. LVMi was independently associated with abnormal summed rest score [SRS; odds ratio (OR), 1.07; 95% confidence interval (CI), 1.03-1.09] and summed stress score (OR, 1.04; 95% CI, 1.01-1.07). An increase in LVMi was also independently associated with that in NormTAV (coefficient, 10.44; 95% CI, 1.50-19.39) and SRS ≥1 (OR, 1.05; 95% CI, 1.01-1.10), even after adjusting for cardiovascular risk factors in patients without previous MI.
Conclusions:
LVM was independently associated with the presence of coronary artery atherosclerosis and MI.
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