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Influence of left ventricular mass on coronary artery cross-sectional area
Insights
Coronary artery size increases with left ventricular hypertrophy in patients with valvular heart disease. This study found a direct relationship between left ventricular mass and coronary artery cross-sectional area in these patients.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Cardiac Physiology
Background:
- Left ventricular (LV) hypertrophy is associated with changes in coronary artery dimensions.
- Previous observations suggested a correlation between LV mass and coronary artery cross-sectional area (CSA).
Purpose of the Study:
- To quantitatively assess the relationship between LV mass and coronary artery CSA in patients with valvular heart disease and LV hypertrophy.
- To test the hypothesis that coronary artery CSA is proportional to LV mass.
Main Methods:
- Computer-based quantitative analysis of LV mass and coronary artery CSA from angiographic images.
- Inclusion of 40 patients (19 men, 21 women) with varying degrees of valvular heart disease and LV hypertrophy.
- Comparison between patients with valvular disease and normal controls.
Main Results:
- Patients with valvular heart disease and LV hypertrophy exhibited significantly larger LV mass (165 vs. 88 g/m2) and coronary CSA (46 vs. 26 mm2) compared to normal controls.
- A strong linear relationship was observed between LV mass and coronary CSA (r = 0.788, p < 0.001).
Conclusions:
- Proximal coronary artery CSA is significantly larger in patients with valvular heart disease and LV hypertrophy.
- Coronary artery cross-sectional area increases proportionally with left ventricular mass in hypertrophied ventricles.
Abstract:
Observations from cardiac catheterization suggest that coronary artery cross-sectional area (CSA) is increased in patients with left ventricular (LV) hypertrophy and is proportional to LV mass. This hypothesis was tested using computer-based quantitative analysis of LV mass and CSA from angiographic images of the left ventricle and proximal coronary arteries from 19 men and 21 women, aged 23 to 78 years (mean 56). Twenty-seven patients had valvular heart disease, 16 of whom had multivalvular involvement; diagnoses included aortic stenosis in 19, aortic regurgitation in 13 and mitral regurgitation in 12. Thirteen patients had normal valvular and ventricular function. All patients had normal coronary arteries. Significant differences between normal patients and those with valvular disease were noted in LV mass (88 +/- 7 vs 165 +/- 12 g/m2, p less than 0.001) and coronary CSA (26 +/- 2 vs 46 +/- 3 mm2, p less than 0.001). Furthermore, a linear relation between LV mass and coronary CSA was noted (r = 0.788, p less than 0.001). Thus, proximal coronary artery CSA is significantly larger in valvular heart disease patients with LV hypertrophy than in those with normal ventricles, and proximal coronary artery area increases in proportion to LV mass in hypertrophied ventricles.