Assessment of Coronary Artery Geometry With Coronary CT Angiography: Evaluation of Atherosclerotic Plaque Burden and Composition
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Coronary Artery Disease
- Sponsor
- Aristotle University Of Thessaloniki
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Left Main Coronary Artery (LMCA) angle of take-off from the aortic root
- Last Updated
- 5 years ago
Overview
Brief Summary
The purpose of this study is to investigate the potential association of coronary artery geometry, based on coronary CT angiography (CCTA), with the complexity and the severity of coronary atherosclerosis.
Detailed Description
The angulation of the side branch take-off has been reported to influence the severity of atherosclerosis in coronary bifurcations, as larger angles have been associated with increased plaque burden. Data from computational fluid dynamics studies have confirmed this finding by demonstrating that even in the absence of alterations in the amount of branch flow, a wide angle between the side branches intensifies flow perturbations, increases the spatial endothelial shear stress (ESS) variations in the bifurcation region and the low ESS in the lateral walls, thereby augmenting the atherosclerosis-prone environment. The magnitude of reversed flow, the extension of the recirculation zone and the duration of flow separation during the pulse cycle comprise other haemodynamic parameters which are important in atherogenesis and are amplified by an increased bifurcation angle.
Investigators
Georgios P Rampidis, MD, MSc
Academic Fellow
Aristotle University Of Thessaloniki
Eligibility Criteria
Inclusion Criteria
- •Patients referred for cardiac CT angiography
- •Patients without previous history of Coronary Artery Disease (CAD)
- •Age ≥ 18 years
- •Patients giving voluntary written consent to participate in the study
Exclusion Criteria
- •Pregnancy or breast-feeding
- •Patients with serious concurrent disease and life expectancy of \< 1 year
- •Patients with a previous history of CAD
- •Patients who refuse to give written consent for participation in the study
Outcomes
Primary Outcomes
Left Main Coronary Artery (LMCA) angle of take-off from the aortic root
Time Frame: 30 days
Measurement using curved Multiplanar Reconstruction (MPR) technique in advantage workstation server
Right Coronary Artery (RCA) angle of take-off from the aortic root
Time Frame: 30 days
Measurement using curved MPR technique in advantage workstation server
Left Anterior Descending (LAD) / Left Circumflex (LCx) bifurcation angle
Time Frame: 30 days
Measurement using curved MPR technique in advantage workstation server
Indexed Coronary Volume
Time Frame: 30 days
Calculated by dividing the total coronary volume to the left ventricle mass, both derived from CCTA (mm3/gr)
Secondary Outcomes
- Extent of Coronary Atherosclerosis(30 days)
- Severity of Coronary Atherosclerosis assessed by using Leiden CTA risk score(30 days)
- Severity of Coronary Atherosclerosis assessed by using Gensini score(30 days)
- Complexity of Coronary Artery Disease [CT-SYNTAX score](30 days)
- Frequency of occurrence of high-risk plaques(30 days)
- Plaque burden assessment [Modified Duke CAD Index for coronary CTA](30 days)