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

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.

Extraction of Coronary Atherosclerotic Plaques From Computed Tomography Imaging: A Review of Recent Methods

“…For example, radius gradient of the plaque, which reflects longitudinal lesion asymmetry, has been proven to be associated with the location of plaque rupture and consequent clinical events ( 95 ). The curvature and tortuosity of coronary arteries might be related to the development of atherosclerosis and plaque size ( 96 , 97 ). These secondary parameters and their clinical indication need further investigation.…”

Relationship between Coronary Arterial Geometry and the Presence and Extend of Atherosclerotic Plaque Burden: A Review Discussing Methodology and Findings in the Era of Cardiac Computed Tomography Angiography

“…In contrast to previous studies, van Zandwijk et al concluded that there was no significant association between the degree of stenosis and plaque types and the dynamic changes observed in geometrical parameters during the cardiac cycle [ 19 ]. Similar to previous study designs, this research group used CCTA with retrospective electrocardiographic gating to acquire end-systolic and end-diastolic phase reconstructions of the coronary vessels and measured curvature and tortuosity for both phases.…”

“…It was found that curvature was significantly higher in end-systole for both artery and segment level. Tortuosity, on the other hand, was significantly different only at a segment level [ 19 ]. Considering the dynamic changes of geometry throughout the cardiac cycle is expected to add to the study of atherosclerosis development but at the same time introduces more complexity and workload.…”