Coronary volume to left ventricular mass ratio in patients with diabetes mellitus |
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| Institution: | 1. Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands;2. Division of Cardiology, Department of Medicine, Duke University Medical Center, Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA;3. Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark;4. Department of Cardiology, University of Liverpool, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom;5. Departments of Cardiovascular Medicine and Radiology, Stanford University, Stanford, CA, USA;6. Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan;7. Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart Institute, Los Angeles, CA, USA;8. Centro Cardiologico Monzino, Milan, Italy;9. Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan;10. Department of Cardiology, Odense University Hospital, Odense, Esbjerg, Denmark;11. Department of Cardiology, Aichi Medical University, Aichi, Japan;12. Department of Noninvasive Cardiac Imaging, Northwell Health, New York, USA;13. Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium;14. Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy;15. Division of Cardiology, Loyola University Chicago, Chicago, IL, USA;p. HeartFlow Inc., Redwood City, CA, USA;q. Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan;r. Department of Radiology, St Paul''s Hospital, Vancouver, British Columbia, Canada;s. Turku PET Center, Turku University Hospital and University of Turku, Turku, Finland |
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| Abstract: | BackgroundDiabetes mellitus is a major risk factor for coronary artery disease (CAD) and may provoke structural and functional changes in coronary vasculature. The coronary volume to left ventricular mass (V/M) ratio is a new anatomical parameter capable of revealing a potential physiological imbalance between coronary vasculature and myocardial mass. The aim of this study was to examine the V/M derived from coronary computed tomography angiography (CCTA) in patients with diabetes.MethodsPatients with clinically suspected CAD enrolled in the ADVANCE (Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care) registry and known diabetic status were included. Coronary artery volume and left ventricular myocardial mass were analyzed from CCTA and the V/M ratio was calculated and compared between patients with and without diabetes.ResultsOf the 3053 patients (age 66 ?± ?10 years; 66% male) with known diabetic status, diabetes was present in 21.9%. Coronary volume was lower in patients with diabetes compared to those without diabetes (2850 ?± ?940 ?mm3 vs. 3040 ?± ?970 ?mm3, p ?< ?0.0001), whereas the myocardial mass was comparable between the 2 groups (122 ?± ?33 ?g vs. 122 ?± ?32 ?g, p ?= ?0.70). The V/M ratio was significantly lower in patients with diabetes (23.9 ?± ?6.8 ?mm3/g vs. 25.7 ?± ?7.5 ?mm3/g, p ?< ?0.0001). Among subjects with obstructive CAD (n ?= ?2191, 24.0% diabetics) and non-obstructive CAD (16.7% diabetics), the V/M ratio was significantly lower in patients with diabetes compared to those without (23.4 ?± ?6.7 ?mm3/g vs. 25.0 ?± ?7.3 ?mm3/g, p ?< ?0.0001 and 25.6 ?± ?6.9 ?mm3/g vs. 27.3 ?± ?7.6 ?mm3/g, respectively, p ?= ?0.006).ConclusionThe V/M ratio was significantly lower in patients with diabetes compared to non-diabetics, even after correcting for obstructive coronary stenosis. The clinical value of the reduced V/M ratio in diabetic patients needs further investigation. |
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| Keywords: | Coronary volume Left ventricular mass Volume to mass ratio Coronary computed tomography angiography Coronary artery disease Diabetes mellitus |
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