Coronary Volume to Left Ventricular Mass Ratio in Patients With Hypertension
: van Rosendael Sophie E, van Rosendael Alexander R, Kuneman Jurrien H, Patel Manesh R, Nørgaard Bjarne Linde, Fairbairn Timothy A, Nieman Koen, Akasaka Takashi, Berman Daniel S, Koweek Lynne M Hurwitz, Pontone Gianluca, Kawasaki Tomohiro, Sand Niels Peter Rønnow, Jensen Jesper M, Amano Tetsuya, Poon Michael, Øvrehus Kristian A, Sonck Jeroen, Rabbat Merk G, Rogers Campbell, Matsuo Hitoshi, Leipsic Jonathon A, Marsan Nina Ajmone, Jukema J Wouter, Bax Jeroen J, Saraste Antti, Knuuti Juhani
Publisher: Elsevier
: 2023
: American Journal of Cardiology
: The American journal of cardiology
: Am J Cardiol
: 199
: 100
: 109
: 0002-9149
: 1879-1913
DOI: https://doi.org/10.1016/j.amjcard.2023.04.025
: https://doi.org/10.1016/j.amjcard.2023.04.025
: https://research.utu.fi/converis/portal/detail/Publication/179830108
The coronary vascular volume to left ventricular mass (V/M) ratio assessed by coronary computed tomography angiography (CCTA) is a promising new parameter to investigate the relation of coronary vasculature to the myocardium supplied. It is hypothesized that hypertension decreases the ratio between coronary volume and myocardial mass by way of myocardial hypertrophy, which could explain the detected abnormal myocardial perfusion reserve reported in patients with hypertension. Individuals enrolled in the multicenter ADVANCE (Assessing Diagnostic Value of Noninvasive FFRCT in Coronary Care) registry who underwent clinically indicated CCTA for analysis of suspected coronary artery disease with known hypertension status were included in current analysis. The V/M ratio was calculated from CCTA by segmenting the coronary artery luminal volume and left ventricular myocardial mass. In total, 2,378 subjects were included in this study, of whom 1,346 (56%) had hypertension. Left ventricular myocardial mass and coronary volume were higher in subjects with hypertension than normotensive patients (122.7 ± 32.8 g vs 120.0 ± 30.5 g, p = 0.039, and 3,105.0 ± 992.0 mm3 vs 2,965.6 ± 943.7 mm3, p <0.001, respectively). Subsequently, the V/M ratio was higher in patients with hypertension than those without (26.0 ± 7.6 mm3/g vs 25.3 ± 7.3 mm3/g, p = 0.024). After correcting for potential confounding factors, the coronary volume and ventricular mass remained higher in patients with hypertension (least square) mean difference estimate: 196.3 (95% confidence intervals [CI] 119.9 to 272.7) mm3, p <0.001, and 5.60 (95% CI 3.42 to 7.78) g, p <0.001, respectively), but the V/M ratio was not significantly different (least square mean difference estimate: 0.48 (95% CI -0.12 to 1.08) mm3/g, p = 0.116). In conclusion, our findings do not support the hypothesis that the abnormal perfusion reserve would be caused by reduced V/M ratio in patients with hypertension.
