Myocardial Tissue Characterization Using Electron Density Imaging: Relationship with Sex and Cardiovascular Risk Factors

pp. 117-123

Abstract

Background: Electron density (ED) imaging might be able to detect myocardial tissue differences indistinguishable for conventional non-contrast computed tomography (CT).

Objectives: To evaluate whether there are differences in myocardial ED associated with sex, and if present, their relationship with cardiovascular risk factors or coronary calcification.

Methods: Patients were participants of a prospective single center observational study comprising asymptomatic subjects between 50 and 75 years old, referred for a low-dose chest CT. All images were obtained using a dual-layer detector spectral CT, and evaluated using conventional CT (120 kVp) and ED images.

Results: A total of 171 patients were included. Myocardial attenuation was not related to sex or coronary risk factors (all p >0.05), whereas the percent electron density relative to water (%EDW) was significantly higher among males (p <0.0001), and patients with diabetes (p = 0.007), hypertension (p = 0.004), and obesity (p = 0.004). The extent of coronary artery calcification was unrelated to neither the myocardial attenuation, nor the myocardial ED. At univariate analysis, male sex was the only variable associated with a high %EDW (p = 0.011), whereas age, diabetes, obesity, smoking, hypertension, and CACSIS (coronary artery calcification segment involvement score), were not. Logistic regression analysis including sex,
obesity, diabetes, and hypertension in the model, identified male sex as the only independent predictor of a high %EDW (OR 2.51, 95%CI 1.23-5.34, p=0.016).

Conclusions: In this study, ED imaging identified myocardial tissue differences that conventional CT was unable to discriminate, with a higher %EDW in men and in patients with cardiovascular risk factors. Male sex was the only independent predictor of a high %EDW

How to cite this article:

Rodríguez Granillo GA, Rubilar B, Fontana L, Luna N, Garron-Arias S, Lylyk P, y cols. Myocardial Tissue Characterization Using Electron Density Imaging: Relationship with Sex and Cardiovascular Risk Factors. Rev Argent Cardiol 2024;92:117-23. http://dx.doi.org/10.7775/rac.v92.i2.20752