Coronary distensibility index measured by computed tomography is associated with the severity of coronary artery disease

Ahmadi, Naser; Shavelle, David; Nabavi, Vahid; Hajsadeghi, Fereshteh; Moshrefi, Shahin; Flores, Ferdinand; Azmoon, Shahdad; Mao, Song S.; Ebrahimi, Ramin; Budoff, Matthew

doi:10.1016/j.jcct.2010.01.007

« Previous Next »Journal of Cardiovascular Computed Tomography
Volume 4, Issue 2 , Pages 119-126, March 2010

Coronary distensibility index measured by computed tomography is associated with the severity of coronary artery disease

Naser Ahmadi, MD
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles (UCLA) Medical Center, 1124 W Carson Street, RB2, Torrance, CA 90502, USA
- Corresponding author.
David Shavelle, MD
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles (UCLA) Medical Center, 1124 W Carson Street, RB2, Torrance, CA 90502, USA
Vahid Nabavi, MD
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles (UCLA) Medical Center, 1124 W Carson Street, RB2, Torrance, CA 90502, USA
Fereshteh Hajsadeghi, MD
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles (UCLA) Medical Center, 1124 W Carson Street, RB2, Torrance, CA 90502, USA
Shahin Moshrefi, BS
- Department of Cardiology, New York Medical Center, Valhalla, NY, USA
Ferdinand Flores, BS
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles (UCLA) Medical Center, 1124 W Carson Street, RB2, Torrance, CA 90502, USA
Shahdad Azmoon, MD
- Department of Cardiology, New York Medical Center, Valhalla, NY, USA
Song S. Mao, MD
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles (UCLA) Medical Center, 1124 W Carson Street, RB2, Torrance, CA 90502, USA
Ramin Ebrahimi, MD
- Greater Los Angeles Veterans Affairs Medical Center, UCLA, School of Medicine, Los Angeles, CA, USA
Matthew Budoff, MD
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles (UCLA) Medical Center, 1124 W Carson Street, RB2, Torrance, CA 90502, USA

Received 18 August 2009; accepted 2 January 2010. published online 14 January 2010.

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 Δlumen CSA/[lumen CSA in MD × estimated central pulse pressure (eCPP)] × 10³ {eCPP = 0.77 × 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 ≤ 30%), moderate (stenosis 31%–69%), and severe (stenosis ≥ 70%) on CTA.

Results

Excellent correlation was observed between CTA and QCA measured by CDI (r² = 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 ≥ 50%) increased significantly from 0.71 to 0.84 by addition of CDI to CAC (P < 0.05).