Coronary volume to left ventricular mass ratio in patients with diabetes mellitus
Kuneman Jurrien H; Mahdiui Mohammed El; Rosendael Alexander R Van; van den Hoogen Inje J; Patel Manesh R; Nørgaard Bjarne Linde; Fairbairn Timothy A; Koen Nieman; Takashi Akasaka; Berman Daniel S; Hurwitz Lynne M. Koweek; Pontone Gianluca; Kawasaki Tomohiro; Rønnow Niels Peter; Sand Jesper M; Jensen; Amano; Tetsuya Poon Michael; Øvrehus Kristian A; Sonck Jeroen; Rabbat Mark G; De Bruyne Bernand; Campbell Rogers; Matsuo Hitoshi; Bax Jeroen J; Leipsic Jonathon A.; Knuuti Juhani
https://urn.fi/URN:NBN:fi-fe2022081154670
Tiivistelmä
Background
Diabetes 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.
Methods
Patients 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.
Results
Of 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).
Conclusion
The 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.
Kokoelmat
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