Assessment of Dynamic Change of Coronary Artery Geometry and Its Relationship to Coronary Artery Disease, Based on Coronary CT Angiography

Jordy K Van Zandwijk,Volkan Tuncay,Matthijs Oudkerk,Rozemarijn Vliegenthart,Cornelis H Slump,Gert Jan Pelgrim,Peter M A Van Ooijen

doi:10.1007/s10278-019-00300-5

Abstract

To investigate the relationship between dynamic changes of coronary artery geometry and coronary artery disease (CAD) using computed tomography (CT). Seventy-one patients underwent coronary CT angiography with retrospective electrocardiographic gating. End-systolic (ES) and end-diastolic (ED) phases were automatically determined by dedicated software. Centerlines were extracted for the right and left coronary artery. Differences between ES and ED curvature and tortuosity were determined. Associations of change in geometrical parameters with plaque types and degree of stenosis were investigated using linear mixed models. The differences in number of inflection points were analyzed using Wilcoxon signed-rank tests. Tests were done on artery and segment level. One hundred thirty-seven arteries (64.3%) and 456 (71.4%) segments were included. Curvature was significantly higher in ES than in ED phase for arteries (p = 0.002) and segments (p < 0.001). The difference was significant only at segment level for tortuosity (p = 0.005). Number of inflection points was significantly higher in ES phase on both artery and segment level (p < 0.001). No significant relationships were found between degree of stenosis and plaque types and dynamic change in geometrical parameters. Non-invasive imaging by cardiac CT can quantify change in geometrical parameters of the coronary arteries during the cardiac cycle. Dynamic change of vessel geometry through the cardiac cycle was not found to be related to the presence of CAD.

Highlights

Jordy K. van Zandwijk and Volkan Tuncay contributed to this work.Jordy K. van Zandwijk and Volkan Tuncay were working at the affiliated institution during the presented study.Coronary artery disease (CAD) is the most common type of heart disease and the leading cause of death worldwide [1]
The current study focuses on the assessment of coronary artery geometry through the cardiac cycle based on Coronary computed tomography angiography (cCTA), and the association of dynamic change in coronary artery geometry with CAD
This study shows that the geometric parameters of coronary arteries change significantly between the ES and ED phase except for the tortuosity at the artery level, which means the first hypothesis that the coronary artery geometry changes dynamically during the cardiac cycle is accepted

Summary

Introduction

Jordy K. van Zandwijk and Volkan Tuncay contributed to this work.Jordy K. van Zandwijk and Volkan Tuncay were working (studying) at the affiliated institution during the presented study.Coronary artery disease (CAD) is the most common type of heart disease and the leading cause of death worldwide [1]. Jordy K. van Zandwijk and Volkan Tuncay contributed to this work. Jordy K. van Zandwijk and Volkan Tuncay were working (studying) at the affiliated institution during the presented study. Previous hemodynamic studies using flow simulations in static vessel models suggest an association between low wall shear stress and coronary plaque development. In studies on coronary hemodynamics in simulations incorporating cardiac motion, the importance of considering physiologically realistic flow and vessel motion was stressed [7,8,9,10,11]. This implies the need for in vivo patient studies

Methods

Results

Discussion

Conclusion