38. Is there a correlation between diastolic dysfunction and coronary artery disease on coronary CT angiography?

Abstract

We investigated the relationship of coronary artery calcium score (CCS) and presence of coronary artery disease (CAD) on coronary CT angiography (CCTA) and measures of LV diastolic dysfunction (DD). We included 527 consecutive patients (39% women; mean age, 49 ± 12 years) without known CAD who underwent coronary CTA and transthoracic echocardiography within one month. CAD was evaluated on a per-vessel, and per-segment basis for intraluminal diameter stenosis by using a 16-segment model and summed over segments to obtain overall coronary plaque burden (segment involvement score [SIS]; maximum = 16). Transthoracic echocardiography evaluated mitral inflow E wave-to-A wave ratio (EAR), tissue Doppler early mitral annual tissue velocity axial excursion and stage of diastolic dysfunction. A total of 189 patients (36%) had DD with 50 patients (9.5%) had more than stage 2 DD. The presence of DD was associated with increasing CCS (p < 0.001). Similar, there was a statistically significant correlation between EAR and CCS (r = −0.152, p = 0.002) and SIS (r = 0.536, p < 0.001). The prevalence of more than stage 2 DD increased with the presence of obstructive CAD (12% versus 6%, p = 0.020) and number of obstructive vessels (p = 0.013). In multivariable analyses, the independent predictors of more than stage 1 DD included age (p < 0.001), LV ejection fraction (p < 0.001) and diabetes (p = 0.010). CCS and SIS were not independently associated with DD. Our analysis suggests that CCS as well as CAD by CCTA are not independently associated with measures of DD on echocardiography.