Relationship Between The Anatomical Structure Of Left Coronary And Left Anterior Descending Stenosis By 640-slice Volume CT

ObjectiveTo explore the relationship between the anatomical structure of left coronary artery and left anterior descending stenosis by 640-slice volume CT.Methods116 subjects with multiple left coronary plaque formation who underwent640-slice volume CT coronary artery CTA examination in the First Affiliated Hospital of Jinzhou Medical University were collected.The anatomical structure of the left coronary artery(left trunk length,LAD-LCX angle,LM-LAD angle,proximal diameter of left trunk,distal diameter of left trunk,proximal diameter of left anterior descending branch)was measured by two deputy chief physicians and above.Patients were divided into two groups according to LAD stenosis degree with coronary artery as gold standard,LAD stenosis≥50%group and LAD stenosis<50%group.Clinical indicators such as age,sex,hypertension,hyperglycemia,hyperlipidemia,and smoking history were collected.The relationships were analyzed between LAD stenosis and anatomical structure of left coronary artery,various clinical indexes.The consistency of quantitative measurements between the two doctors was checked using interclass correlation coefficient(ICC).The continuous variables conform to the normal distribution were evaluated by t test,and the categorical variables were evaluated byc~2test.Logistic regression analysis was applied to the above statistically significant factors,and left coronary artery anatomical factors that independently predicted LAD stenosis≥50%were obtained.The ROC curve was used to obtain the critical value of anatomical factors independently predicting LAD stenosis.Results1.There were statistically significant differences in age composition,sex composition and hypertension composition between LAD stenosis≥50%group and LAD stenosis<50%group(c~2=21.144,P=0.000;c~2=12.878,P=0.000;c~2=11.755,P=0.001).2.The LM length,LAD—LCX angle and LM-LAD angle in the group with LAD stenosis≥50%were significantly larger than those in the group with LAD stenosis<50%(t=4.428,P=0.000;t=5.106,P=0.000;t=2.747,P=0.007).3.Logistic regression analysis showed that the independent predictors of LAD stenosis≥50%after excluding clinical risk factors were LM length(OR=1.167,P=0.039)and LAD-LCX angle(OR=1.066,P=0.006).4.The critical value of LM length,sensitivity,specificity,area under the ROC curve,and 95%Cl were 10.3mm,71.20%,66.00%,0.716,and 0.62~0.81,respectively.The critical value of LAD-LCX angle was 80°,sensitivity was66.10%,specificity was 88.00%,area under the curve was 0.762,and 95%Cl was 0.68~0.85.ConclusionThe LM length and LAD—LCX angle measured by CT are correlated with LAD stenosis≥50%,which still has independent predictive value after excluding clinical related risk factors.Therefore,the risk of coronary artery stenosis can be preliminarily identified by measuring the LM length and LAD-LCX angle,which can provide an effective reference for early diagnosis and treatment of coronary heart disease.