TCT-514 Distribution of vessel-specific myocardial mass in patients with stable coronary artery disease.

Abstract

Background: Assessing the myocardial mass at risk is crucial in evaluating patients with coronary artery disease (CAD). This study aimed to quantify the myocardial mass subtended by each epicardial vessel using coronary computed tomography angiography (CCTA). Method(s): This is a pooled analysis of studies involving stable patients with CCTA assessment. Left ventricular (LV) and vessel-specific myocardial mass were calculated using an algorithm based on the Voronoi method. Myocardial mass was assessed in vessels with a diameter greater than 1.5 mm. Result(s): A total of 948 patients were included, with a mean age of 65.6 +/- 9.2 years. The cohort was predominantly male (77%), with 66% having hypertension and 22% having diabetes. Vessel-specific myocardial mass was calculated in 2,767 main epicardial vessels (948 left anterior descending [LAD], 948 left circumflex [LCX], and 871 right coronary artery [RCA]) and 6,467 side branches (1,890 diagonals, 1,198 septals, 1,423 obtuse marginals, 247 ramus, 851 posterior descending, and 847 posterolateral branches). The median LV mass was 140.9 grams (IQR: 118.1, 166.3); females had lower LV mass values than males (105.5 [93.2, 122.5] grams vs 149.8 [131.9, 173.3] grams, P < 0.001). Patients with hypertension had larger LV mass 143.1 [118.8, 169.4] grams vs 137.9 [111.4, 158.8] grams, P < 0.001). On average, the LAD subtended 42.5% [37.9, 48.1] of LV mass, the LCX subtended 28.8% [21.9, 35.7], and the RCA subtended 26.4% [20.9, 31.9]. Left-dominant coronary circulation was observed in 11% of the patients; in these cases, the LCX subtended 47.5% [39.4, 52.6] of LV mass compared with 27.7% [21.0, 33.7] in those with right dominance (P < 0.001). The median percentages of LV mass subtended by the first septal, first diagonal, and first obtuse marginal were 8.9% [6.4, 11.1], 7.9% [4.52, 12.0], and 10.2% [4.52, 12.0], respectively. Conclusion(s): This study defines the myocardial mass subtended by each branch of the coronary circulation using CCTA. Understanding the specific vessel mass has important clinical implications and the potential to optimize revascularization strategies. Categories: IMAGING AND PHYSIOLOGY: Invasive and Non-Invasive Angiography.Copyright © 2024