Purpose
Coronary artery disease (CAD) is the leading cause of death in both developed and developing countries worldwide 1.
Initiation and development of plaques in the coronary arteries is related with hemodynamics and coronary geometry,
but their relationships are complex and still subject of debate 2.
Coronary arteries experience an alternating hemodynamic flow during the cardiac cycle,
which may be related to the initiation and development of atherosclerotic plaques 2.
However,
relations between coronary geometry and plaques are mainly based on studies with simulation models,
invasive...
Methods and Materials
Subjects and Data Acquisition
Patients who participated in different studies with a focus on CAD in our clinic were included in this study (n=71,
87.3% males,
mean age 62.2 ± 9.9 years).
Coronary computed tomography angiography (cCTA) was performed according to a standardized protocol using a dual-source CT scanner (SOMATOM Definition,
Siemens,
Erlangen,
Germany) with retrospective electrocardiographic (ECG) gating.
Reconstructions were made in at least every 10% of the RR-interval at 2.0 mm slice thickness.
Coronary Geometry Assessment
Reconstructed data was loaded into a dedicated...
Results
In total,
167 (78.4%) of the 213 segments could be assessed.
In 53 out of 71 patients (74.6%),
all three segments of the RCA could be assessed in systole and diastole.
On segment level,
the RCA was most frequently assessed at 40% (ES phase,
89 out of 167) and 90% (ED phase,
50 out of 167) of the RR-interval.
In 18 (10.8%) and 111 (66.5%) segments for the ES and ED phases,
respectively,
we deviated from the originally determined ES or ED phase.
Mean values...
Conclusion
In this study,
the changing geometry of the coronary arteries during the cardiac cycle was investigated and quantified on 4D dual source CT datasets.
We found that especially the tortuosity of individual segments and the entire RCA was higher in end-systolic phase than in end-diastolic phase.
In subsequent research,
this method should be applied to other coronary segments and arteries,
and the possible relationship with initiation and progression of plaque assessed.
References
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Li Y,
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