{"title":"冠状动脉CT血管造影获得的冠状动脉尺寸调整后的心肌肿块作为肥厚性心肌病患者心肌缺血的潜在生物标志物。","authors":"Jung Han Woo, Hyewon Choi, Min Jae Cha","doi":"10.3348/kjr.2024.1143","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare coronary artery dimension-adjusted subtended myocardial mass between patients with hypertrophic cardiomyopathy (HCM) and a normal population without detectable atherosclerosis, and between HCM patients with and without chest pain.</p><p><strong>Materials and methods: </strong>Twenty-five patients with HCM but no detectable atherosclerosis on coronary computed tomography angiography (CCTA) were included in the study. This group comprised 14 patients with chest pain and 11 patients without chest pain. They were matched with 25 healthy participants based on sex, age, coronary dominance pattern, and body surface area. The minimal lumen area (MLA) and subtended myocardial volume (V<sub>sub</sub>) were assessed in the left main (LM), proximal left anterior descending (pLAD), proximal left circumflex (pLCx), and proximal right coronary (pRCA) arteries. Additionally, an index of the subtended myocardial mass adjusted for the MLA, calculated as V<sub>sub</sub>/MLA², was determined.</p><p><strong>Results: </strong>MLA was significantly larger in patients with HCM compared to the control group in LM (20.93 ± 6.31 mm² vs. 15.24 ± 3.90 mm², <i>P</i> < 0.001), pLAD (14.28 ± 3.55 mm² vs. 11.36 ± 2.07 mm², <i>P</i> = 0.001), pLCx (10.94 ± 3.60 mm² vs. 9.15 ± 2.93 mm², <i>P</i> = 0.045), and pRCA (13.41 ± 4.85 mm² vs. 11.22 ± 3.20 mm², <i>P</i> = 0.018). Despite an increase in coronary luminal area, patients with HCM exhibited significantly higher V<sub>sub</sub>/MLA² compared to the control group in both the pLAD (403.56 ± 200.35 mm⁻¹ vs. 241.70 ± 85.87 mm⁻¹, <i>P</i> < 0.001) and the pRCA (186.06 ± 95.07 mm⁻¹ vs. 125.07 ± 70.18 mm⁻¹, <i>P</i> = 0.007). V<sub>sub</sub>/MLA² was significantly elevated in patients with chest pain compared to those without in the pLAD (473.75 ± 227.38 mm⁻¹ vs. 314.24 ± 110.74 mm⁻¹, <i>P</i> = 0.018) and the pLCx (417.04 ± 182.65 mm⁻¹ vs. 275.29 ± 112.97 mm⁻¹, <i>P</i> = 0.044).</p><p><strong>Conclusion: </strong>CCTA-derived V<sub>sub</sub>/MLA² may more accurately reflect the balance between myocardial blood supply and demand, offering insights into the occurrence of demand angina in patients with HCM without obstructive coronary artery disease.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"26 4","pages":"324-332"},"PeriodicalIF":4.4000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955385/pdf/","citationCount":"0","resultStr":"{\"title\":\"Coronary Artery Dimension-Adjusted Subtended Myocardial Mass Obtained With Coronary CT Angiography as a Potential Biomarker of Myocardial Ischemia in Patients With Hypertrophic Cardiomyopathy.\",\"authors\":\"Jung Han Woo, Hyewon Choi, Min Jae Cha\",\"doi\":\"10.3348/kjr.2024.1143\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare coronary artery dimension-adjusted subtended myocardial mass between patients with hypertrophic cardiomyopathy (HCM) and a normal population without detectable atherosclerosis, and between HCM patients with and without chest pain.</p><p><strong>Materials and methods: </strong>Twenty-five patients with HCM but no detectable atherosclerosis on coronary computed tomography angiography (CCTA) were included in the study. This group comprised 14 patients with chest pain and 11 patients without chest pain. They were matched with 25 healthy participants based on sex, age, coronary dominance pattern, and body surface area. The minimal lumen area (MLA) and subtended myocardial volume (V<sub>sub</sub>) were assessed in the left main (LM), proximal left anterior descending (pLAD), proximal left circumflex (pLCx), and proximal right coronary (pRCA) arteries. Additionally, an index of the subtended myocardial mass adjusted for the MLA, calculated as V<sub>sub</sub>/MLA², was determined.</p><p><strong>Results: </strong>MLA was significantly larger in patients with HCM compared to the control group in LM (20.93 ± 6.31 mm² vs. 15.24 ± 3.90 mm², <i>P</i> < 0.001), pLAD (14.28 ± 3.55 mm² vs. 11.36 ± 2.07 mm², <i>P</i> = 0.001), pLCx (10.94 ± 3.60 mm² vs. 9.15 ± 2.93 mm², <i>P</i> = 0.045), and pRCA (13.41 ± 4.85 mm² vs. 11.22 ± 3.20 mm², <i>P</i> = 0.018). Despite an increase in coronary luminal area, patients with HCM exhibited significantly higher V<sub>sub</sub>/MLA² compared to the control group in both the pLAD (403.56 ± 200.35 mm⁻¹ vs. 241.70 ± 85.87 mm⁻¹, <i>P</i> < 0.001) and the pRCA (186.06 ± 95.07 mm⁻¹ vs. 125.07 ± 70.18 mm⁻¹, <i>P</i> = 0.007). V<sub>sub</sub>/MLA² was significantly elevated in patients with chest pain compared to those without in the pLAD (473.75 ± 227.38 mm⁻¹ vs. 314.24 ± 110.74 mm⁻¹, <i>P</i> = 0.018) and the pLCx (417.04 ± 182.65 mm⁻¹ vs. 275.29 ± 112.97 mm⁻¹, <i>P</i> = 0.044).</p><p><strong>Conclusion: </strong>CCTA-derived V<sub>sub</sub>/MLA² may more accurately reflect the balance between myocardial blood supply and demand, offering insights into the occurrence of demand angina in patients with HCM without obstructive coronary artery disease.</p>\",\"PeriodicalId\":17881,\"journal\":{\"name\":\"Korean Journal of Radiology\",\"volume\":\"26 4\",\"pages\":\"324-332\"},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955385/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Korean Journal of Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3348/kjr.2024.1143\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Korean Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3348/kjr.2024.1143","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Coronary Artery Dimension-Adjusted Subtended Myocardial Mass Obtained With Coronary CT Angiography as a Potential Biomarker of Myocardial Ischemia in Patients With Hypertrophic Cardiomyopathy.
Objective: To compare coronary artery dimension-adjusted subtended myocardial mass between patients with hypertrophic cardiomyopathy (HCM) and a normal population without detectable atherosclerosis, and between HCM patients with and without chest pain.
Materials and methods: Twenty-five patients with HCM but no detectable atherosclerosis on coronary computed tomography angiography (CCTA) were included in the study. This group comprised 14 patients with chest pain and 11 patients without chest pain. They were matched with 25 healthy participants based on sex, age, coronary dominance pattern, and body surface area. The minimal lumen area (MLA) and subtended myocardial volume (Vsub) were assessed in the left main (LM), proximal left anterior descending (pLAD), proximal left circumflex (pLCx), and proximal right coronary (pRCA) arteries. Additionally, an index of the subtended myocardial mass adjusted for the MLA, calculated as Vsub/MLA², was determined.
Results: MLA was significantly larger in patients with HCM compared to the control group in LM (20.93 ± 6.31 mm² vs. 15.24 ± 3.90 mm², P < 0.001), pLAD (14.28 ± 3.55 mm² vs. 11.36 ± 2.07 mm², P = 0.001), pLCx (10.94 ± 3.60 mm² vs. 9.15 ± 2.93 mm², P = 0.045), and pRCA (13.41 ± 4.85 mm² vs. 11.22 ± 3.20 mm², P = 0.018). Despite an increase in coronary luminal area, patients with HCM exhibited significantly higher Vsub/MLA² compared to the control group in both the pLAD (403.56 ± 200.35 mm⁻¹ vs. 241.70 ± 85.87 mm⁻¹, P < 0.001) and the pRCA (186.06 ± 95.07 mm⁻¹ vs. 125.07 ± 70.18 mm⁻¹, P = 0.007). Vsub/MLA² was significantly elevated in patients with chest pain compared to those without in the pLAD (473.75 ± 227.38 mm⁻¹ vs. 314.24 ± 110.74 mm⁻¹, P = 0.018) and the pLCx (417.04 ± 182.65 mm⁻¹ vs. 275.29 ± 112.97 mm⁻¹, P = 0.044).
Conclusion: CCTA-derived Vsub/MLA² may more accurately reflect the balance between myocardial blood supply and demand, offering insights into the occurrence of demand angina in patients with HCM without obstructive coronary artery disease.
期刊介绍：
The inaugural issue of the Korean J Radiol came out in March 2000. Our journal aims to produce and propagate knowledge on radiologic imaging and related sciences.
A unique feature of the articles published in the Journal will be their reflection of global trends in radiology combined with an East-Asian perspective. Geographic differences in disease prevalence will be reflected in the contents of papers, and this will serve to enrich our body of knowledge.
World''s outstanding radiologists from many countries are serving as editorial board of our journal.
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