Document Detail

Coronary distensibility index measured by computed tomography is associated with the severity of coronary artery disease.
MedLine Citation:
PMID:  20430343     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Atherosclerotic changes within the coronary artery wall can affect vessel distensibility. OBJECTIVE: This study evaluated the relationship between the coronary distensibility index (CDI) and the severity of coronary artery disease (CAD) measured by computed tomographic angiography (CTA). METHODS: One hundred thirteen subjects, age 63 +/- 10 years, 32% women, who underwent coronary artery calcium (CAC) scanning and CTA, were studied. Early diastolic and mid diastolic (MD) cross-section area (CSA) of the left anterior descending (LAD) artery were measured 5 mm distal to the left main bifurcation. CDI was defined as Deltalumen CSA/[lumen CSA in MD x estimated central pulse pressure (eCPP)] x 10(3) {eCPP = 0.77 x peripheral pulse pressure}. LAD diameter measured by CTA and quantitative coronary angiography (QCA) was compared in 19 subjects without CAD. CAD was defined as normal (no stenosis and CAC 0), mild (stenosis <or= 30%), moderate (stenosis 31%-69%), and severe (stenosis >or= 70%) on CTA. RESULTS: Excellent correlation was observed between CTA and QCA measured by CDI (r(2) = 0.96, P = 0.0001). CDI decreased from normal coronaries (6.75 +/- 1.43) to arteries with mild (5.78 +/- 1.45), moderate (3.96 +/- 1.06), and severe (3.31 +/- 1.06) disease (P = 0.004). The risk factor adjusted odds ratio of lowest versus 2 upper tertiles of CDI was 1.28 for mild, 8.47 for moderate, and 10.59 for severe CAD compared with the normal cohort. The area under the ROC curve to predict obstructive CAD (stenosis >or= 50%) increased significantly from 0.71 to 0.84 by addition of CDI to CAC (P < 0.05). CONCLUSION: CTA-measured CDI is inversely related to the severity of CAD independent of age, sex, cardiovascular risk factors, and CAC.
Naser Ahmadi; David Shavelle; Vahid Nabavi; Fereshteh Hajsadeghi; Shahin Moshrefi; Ferdinand Flores; Shahdad Azmoon; Song S Mao; Ramin Ebrahimi; Matthew Budoff
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Publication Detail:
Type:  Clinical Trial; Journal Article; Validation Studies     Date:  2010-01-14
Journal Detail:
Title:  Journal of cardiovascular computed tomography     Volume:  4     ISSN:  1876-861X     ISO Abbreviation:  J Cardiovasc Comput Tomogr     Publication Date:    2010 Mar-Apr
Date Detail:
Created Date:  2010-04-30     Completed Date:  2010-07-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101308347     Medline TA:  J Cardiovasc Comput Tomogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  119-26     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Society of Cardiovascular Computed Tomography. All rights reserved.
Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA.
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MeSH Terms
Blood Pressure
Calcinosis / epidemiology,  radiography*
Coronary Angiography / methods*,  standards
Coronary Artery Disease / epidemiology,  radiography*
Logistic Models
Middle Aged
Reproducibility of Results
Risk Factors
Severity of Illness Index*
Tomography, X-Ray Computed / methods*,  standards

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