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Non-invasive assessment of coronary artery geometry using coronary CTA
V Tuncay1, R Vliegenthart2, M A M den Dekker2
1University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands (CMI-NEN), Department of Radiology, The Netherlands.
Insights
Coronary artery curvature and tortuosity, measured with coronary CTA, are linked to coronary artery disease (CAD) severity. Increased curvature is associated with significant stenosis and plaque presence in coronary arteries.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Diagnostics
Background:
- Coronary artery disease (CAD) poses a significant health risk.
- Assessing CAD severity often involves invasive procedures.
- Non-invasive imaging techniques are crucial for early detection and risk stratification.
Purpose of the Study:
- To investigate the relationship between coronary artery geometry (curvature and tortuosity) and the severity of coronary artery disease (CAD).
- To determine if geometric parameters can serve as indicators for the presence of plaque and significant stenosis.
Main Methods:
- Coronary computed tomography angiography (coronary CTA) was performed on 73 asymptomatic individuals at increased risk for CAD.
- Coronary artery curvature and tortuosity were quantified using semi-automated centerlines on a per-segment and per-artery basis.
- Segments and arteries were analyzed for the presence of significant stenosis (>70% luminal narrowing) and plaque.
Main Results:
- Higher coronary artery curvature was significantly associated with the presence of significant stenosis at both per-segment (p < 0.001) and per-artery (p = 0.002) levels.
- Curvature was 16.7% higher in segments and 13.8% higher in arteries with stenosis.
- Tortuosity showed an association with stenosis only at the per-segment level (p = 0.002).
- Both curvature and tortuosity were related to plaque presence at the per-segment level (p < 0.001).
Conclusions:
- Coronary artery geometry, specifically curvature, is significantly associated with the presence of significant stenosis and plaque.
- These geometric characteristics derived from coronary CTA can provide valuable insights into CAD severity.
- Non-invasive assessment of coronary artery geometry may aid in the risk stratification of patients with or at risk for CAD.
Aim:
To assess the association of coronary artery geometry with the severity of coronary artery disease (CAD).
Methods:
73 asymptomatic individuals at increased risk of CAD due to peripheral vascular disease (18 women, mean age 63.5 ± 8.2 years) underwent coronary computed tomography angiography (coronary CTA) using first generation dual-source CT. Curvature and tortuosity of the coronary arteries were quantified using semi-automatically generated centerlines. Measurements were performed for individual segments and for the entire artery. Coronary segments were labeled according to the presence of significant stenosis, defined as >70% luminal narrowing, and the presence of plaque. Comparisons were made by segment and by artery, using linear mixed models.
Results:
Overall, median curvature and tortuosity were, respectively, 0.094 [0.071; 0.120] and 1.080 [1.040; 1.120] on a per-segment level, and 0.096 [0.078; 0.118] and 1.175 [1.090; 1.420] on a per-artery level. Curvature was associated with significant stenosis at a per-segment (p < 0.001) and per-artery level (p = 0.002). Curvature was 16.7% higher for segments with stenosis, and 13.8% higher for arteries with stenosis. Tortuosity was associated with significant stenosis only at the per-segment level (p = 0.002). Curvature was related to the presence of plaque at the per-segment (p < 0.001) and per-artery level (p < 0.001), tortuosity was only related to plaque at the per-segment level (p < 0.001).
Conclusion:
Coronary artery geometry as derived from coronary CTA is related to the presence of plaque and significant stenosis.
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