Reduced Difference in Left Ventricular Mass at End Diastole and Peak Systole Is a Predictor of Major Stenosis of the Left Coronary Artery Territory

Abstract

To evaluate the feasibility of using the difference in left ventricular (LV) mass at end diastole and peak systole as determined by area-length calculation methods to detect major stenosis of the left coronary artery territory by 2-dimensional echocardiography. The LV mass at end diastole, LV mass at peak systole, and LV mass difference between end diastole and peak systole were measured and compared between 39 healthy participants and 40 patients with coronary artery disease (CAD) referred for coronary angiography. The mass difference was compared to the mean percent stenosis diameter by linear correlation analysis, and its performance in discrimination between the patients with CAD and the healthy participants was analyzed. Compared to the healthy participants, the patients with CAD had significantly higher LV mass at peak systole (mean ± SD, 101.97 ± 30.34 versus 89.87 ± 28.71 g; P< .05) and a lower mass difference between end diastole and peak systole (21.36 ± 17.55 versus 40.12 ± 14.37 g; P < .01). The mass difference correlated significantly with the mean percent stenosis diameter (r = -0.71; P < .001) in patients with CAD . With the use of the mass difference as the criterion to distinguish patients with CAD from healthy participants, the area under the receiver operating characteristic curve was 0.81 (P < .05). The sensitivity, specificity, and accuracy for the prediction of major stenosis (>70%) of the left coronary artery were 82.35%, 70.37%, and 75% respectively for a mass difference of less than 30.2 g. The LV mass difference between end diastole and peak systole can effectively reflect the diameter changes of the left coronary artery, and a reduced mass difference is a sensitive and specific predictor of major stenosis of the left coronary artery territory.