Relationships between coronary atherosclerotic morphology and myocardial perfusion down-stream: the results of computed tomography coronary angiography and myocardial.Perfusion imaging

Relationships between coronary atherosclerotic morphology and myocardial perfusion downstream: the results of computed tomography coronary angiography and myocardial.Perfusion imaging

Maltseva A.N., Kopeva K.V., Mochula A.V., Grakova E.V., Zavadovsky K.V.

Purpose. To assess the relationships between morphological CT-characteristics of coronary atherosclerosis and myocardial perfusion downstream in patients with intermediate pretest probability of stable coronary artery disease (SCAD).

Materials and methods. The study group comprised 68 patients (42 men, 26 women, age 63 (56; 68) years) who underwent coronary computed tomography angiography (CCTA) as well as stress-rest myocardial perfusion imaging (MPI). The following atherosclerotic features were assessed: Agatston calcium score, maximal stenosis degree, positive remodeling index, total atherosclerotic plaque length, total stenosis, the presence of at least one stenosis >50%, plaque structure and geometry. The Segment Involvement Score, Segment Stenosis Score and CT-Syntax were calculated as measures of global atherosclerosis burden. The patients were divided into two groups: 1) moderate and large stress perfusion defect extent (SSS≥9); 2) small perfusion defect extent (SSS<9).

Results. The MPI parameters had moderate correlation with The Segment Involvement Score, Segment Stenosis Score and CT-Syntax. According to the univariate logistic regression, maximum stenosis, total stenosis, Segment Stenosis Score and CT-Syntax, the presence of stenosis >50%, noncalcified and circular features of the atherosclerotic plaques were the independent determinants of moderate perfusion defect. By the results to multivariable logistic analysis the combination of several CT-characteristics of coronary atherosclerosis did not improve the prognostic model.

Conclusions. Segment Stenosis Score, CT-Syntax as well as noncalcified structure and circular geometry of the atherosclerotic plaques are the most significant independent predictors of moderate and large stress perfusion defects. These CT morphological characteristics could be used for risk stratification in patients with intermediate pretest probability of SCAD.

 

Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences.

Tomsk, Russia

 

Keywords: myocardial perfusion imaging, coronary computed tomography coronary angiography, coronary artery disease, coronary atherosclerosis.


Corresponding author:  Zavadovsky K.V., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Maltseva A.N., Kopeva K.V., Mochula A.V., Grakova E.V., Zavadovsky K.V. Relationships between coronary atherosclerotic morphology and myocardial perfusion downstream: the results of computed tomography coronary angiography and myocardial.Perfusion imaging. REJR 2019; 9(2):74-89. DOI:10.21569/2222-7415-2019-9-2-74-89..

.

Received:        22.04.19 Accepted:       14.06.19