Coronary volume to left ventricular mass ratio in patients with diabetes mellitus

Jurrien H. Kuneman, Mohammed El Mahdiui, Alexander R. van Rosendael, Inge J. van den Hoogen, Manesh R. Patel, Bjarne Linde Nørgaard, Timothy A. Fairbairn, Koen Nieman, Takashi Akasaka, Daniel S. Berman, Lynne M. Hurwitz Koweek, Gianluca Pontone, Tomohiro Kawasaki, Niels Peter Rønnow Sand, Jesper M. Jensen, Tetsuya Amano, Michael Poon, Kristian A. Øvrehus, Jeroen Sonck, Mark G. RabbatBernard De Bruyne, Campbell Rogers, Hitoshi Matsuo, Jeroen J. Bax, Jonathon A. Leipsic, Juhani Knuuti*

*Corresponding author for this work

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Abstract

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.

Original languageEnglish
JournalJournal of Cardiovascular Computed Tomography
Volume16
Issue number4
Pages (from-to)319-326
ISSN1934-5925
DOIs
Publication statusPublished - 1. Jul 2022

Bibliographical note

Publisher Copyright:
© 2022 The Authors

Keywords

  • Coronary artery disease
  • Coronary computed tomography angiography
  • Coronary volume
  • Diabetes mellitus
  • Left ventricular mass
  • Volume to mass ratio
  • Predictive Value of Tests
  • Humans
  • Middle Aged
  • Coronary Stenosis
  • Male
  • Diabetes Mellitus/diagnosis
  • Computed Tomography Angiography
  • Coronary Artery Disease/diagnostic imaging
  • Female
  • Aged
  • Coronary Angiography/methods

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