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A nomogram for predicting heterogeneous etiology of atherosclerosis in the left anterior descending coronary artery

X Yu1, Q X Gao1, L G Sun1

  • 1Department of Radiology, The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital), Suzhou 215000, China.

Clinical Radiology
|March 5, 2025
PubMed

Insights

The geometric shape of the left anterior descending artery is linked to the severity of stenosis. A new risk score combining artery shape and patient data accurately predicts moderate to severe stenosis, aiding in coronary heart disease risk assessment.

Area of Science:

  • Cardiovascular imaging and morphology
  • Biomedical engineering and biomechanics
  • Atherosclerosis research

Background:

  • Atherosclerotic plaque formation is heterogeneous, and its causes are not fully understood.
  • The geometric characteristics of coronary arteries may influence plaque development and stenosis severity.

Purpose of the Study:

  • To analyze the correlation between the geometric morphology of the left anterior descending (LAD) artery and the severity of arterial stenosis.
  • To explore potential causes of atherosclerotic heterogeneity.
  • To develop a predictive model for moderate to severe LAD stenosis (MSS-LAD).

Main Methods:

  • Coronary computed tomography angiography (CCTA) was used to derive geometric parameters (curvature, torsion, tortuosity index) and anatomical features.
  • A logistic regression model integrated clinical and serological data to predict MSS-LAD.
  • A nomogram was constructed using significant predictors and validated.

Main Results:

  • Significant differences in ramus intermedius-diagonal branch (RI-D) classification, fat volume (FV), average torsion (AT), and proximal-mid AT (AT-PM) were observed between stenosis groups.
  • Body mass index (BMI), RI-D classification, FV, and AT-PM were significant predictors of MSS-LAD.
  • The nomogram showed good predictive performance (AUC training: 0.839; AUC validation: 0.790).

Conclusions:

  • Geometric configuration of coronary arteries interacts with atherosclerotic plaque formation.
  • A risk nomogram combining anatomical features and clinical indicators effectively predicts MSS-LAD.
  • This nomogram may enhance risk assessment for coronary heart disease.
Abstract

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