Why the study?
LVM predicts adverse cardiovascular outcomes and shares endothelial dysfunction pathophysiology with coronary atherosclerosis, prompting evaluation of the potential association between coronary atherosclerosis and LVM.
Is left ventricular mass independently associated with coronary artery atherosclerotic burden in patients without known structural heart disease?
Is left ventricular mass independently associated with coronary artery atherosclerotic burden in patients without known structural heart disease?
Left ventricular mass index and concentricity are independently associated with the burden of coronary atherosclerosis in patients without known structural heart disease.
LV mass and concentricity may indicate coronary plaque burden on CT; leaves open causality and prognostic utility.
BACKGROUND: Left ventricular mass (LVM) is a predictor for adverse cardiovascular outcomes. Coronary atherosclerosis (coronary artery disease [CAD]) and concentric left ventricular (LV) remodeling are linked pathophysiologically by endothelial dysfunction. AIM: This study sought to determine the potential association between coronary atherosclerosis and LVM. METHODS: A total of 2384 consecutive patients, without structural heart disease or a medical history of CAD, undergoing prospective mid-diastolic electrocardiogram-gated computed tomography coronary angiography were enrolled in the study. LVM and LV mid-diastolic volume were measured using semiautomated software and indexed to body surface area. The average LV mid-diastolic wall thickness and concentricity index (LVM/LV mid-diastolic volume) were calculated. According to the Agatston Score, the patients were divided into 3 groups (Agatston=0, 0.1 to 399.9, ≥400). Similarly, patients were also divided into 4 groups on the basis of the Total Plaque Score (TPS) (0, 1 to 4, 5 to 8, and ≥9). In addition, patients were categorized according to CAD (normal coronaries, nonobstructive CAD, and obstructive stenosis [obstruction >50%]). The association between the different categories of CAD and LV measures was assessed. RESULTS: Both left ventricular mass index (LVMi) and the LV concentricity index increased with TPS categories from 55.3±12.1, 57.4±11.7, 60.9±13.6, and 63.7±15.3 g/m2 (P<0.05), and 0.935±0.424, 0.975±0.3273, 1.046±0.431, and 1.138±0.443 mL/g (P<0.01), respectively. A similar trend of increasing LVMi was observed with increasing Agatston Score (P<0.001) and CAD category (P<0.05). CONCLUSION: In patients without known structural heart disease, LVMi is independently associated with measures of CAD.
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Walpot et al. (2020) studied this question.
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