Ihdayhid Abdul Rahman, Fairbairn Timothy A, Gulsin Gaurav S, Tzimas Georgios, Danehy Edward, Updegrove Adam, Jensen Jesper M, Taylor Charles A, Bax Jeroen J, Sellers Stephanie L, Leipsic Jonathon A, Nørgaard Bjarne L
Department of Cardiology, Fiona Stanley Hospital, Harry Perkins Institute of Medical Research, University of Western Australia, Perth, Australia.
Department of Cardiology, University of Liverpool, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.
J Cardiovasc Comput Tomogr. 2022 May-Jun;16(3):198-206. doi: 10.1016/j.jcct.2021.10.007. Epub 2021 Oct 29.
In the absence of disease impacting the coronary arteries or myocardium, there exists a linear relationship between vessel volume and myocardial mass to ensure balanced distribution of blood supply. This balance may be disturbed in diseases of either the coronary artery tree, the myocardium, or both. However, in contemporary evaluation the coronary artery anatomy and myocardium are assessed separately. Recently the coronary lumen volume to myocardial mass ratio (V/M), measured noninvasively using coronary computed tomography angiography (CTCA), has emerged as an integrated measure of myocardial blood supply and demand in vivo. This has the potential to yield new insights into diseases where this balance is altered, thus impacting clinical diagnoses and management. In this review, we outline the scientific methodology underpinning CTCA-derived measurement of V/M. We describe recent studies describing alterations in V/M across a range of cardiovascular conditions, including coronary artery disease, cardiomyopathies and coronary microvascular dysfunction. Lastly, we highlight areas of unmet research need and future directions, where V/M may further enhance our understanding of the pathophysiology of cardiovascular disease.
在没有影响冠状动脉或心肌的疾病时，血管容积与心肌质量之间存在线性关系，以确保血液供应的平衡分布。这种平衡可能在冠状动脉树、心肌或两者的疾病中受到干扰。然而，在当代评估中，冠状动脉解剖结构和心肌是分别评估的。最近，使用冠状动脉计算机断层扫描血管造影（CTCA）无创测量的冠状动脉腔容积与心肌质量比（V/M），已成为体内心肌血液供应和需求的综合指标。这有可能为这种平衡发生改变的疾病带来新的见解，从而影响临床诊断和管理。在本综述中，我们概述了基于CTCA测量V/M的科学方法。我们描述了最近的研究，这些研究描述了一系列心血管疾病（包括冠状动脉疾病、心肌病和冠状动脉微血管功能障碍）中V/M的变化。最后，我们强调了未满足的研究需求领域和未来方向，在这些领域中，V/M可能会进一步加深我们对心血管疾病病理生理学的理解。
