LAUSR

Type of funding sources: None. Despite Coronary artery tortuosity (CAT) is a common angiographic finding, there is limited data regarding pathogenesis and aetiology of this coronary entity, one proposed hypothesis was the change in geometry of left ventricle (LV) which predispose for CAT. Very little is known about echocardiographic parameters and their significance in CAT. This study aimed to determine left ventricular mass index (LVMI) as a predictor of coronary calcium burden (represented by CT coronary calcium scoring CaCs), coronary obstructive lesions and association of LVMI with CAT in patients with chronic chest pain who were referred for coronary angiography (CA). Cross-sectional study enrolled patients with chronic chest pain whom referred for CCTA and coronary angiography (CA). Demographic characteristics and CA results were collected. LVMI was calculated for each patient. Patients were grouped into those with CAT vs without CAT. The study recruited 150 patients including 106 (70.7%) with CAT. Among total study patients; mean LVMI was higher in elderly≥ 65 years (147.5 ± 52 vs 52.5 ± 8.4, p < 0.001), hypertensive (129 ± 52.4 vs 96.6 ± 38.9, p = 0.001) and diabetics (144.2 ± 65.3 vs 102.5 ± 30.7, p = 0.001). LVMI was lower in patients with CAT (115.4 ± 46.2 vs 123.6 ± 59.8 in non-CAT group, p = 0.001), in same line, among CAT group: 49% had normal LVMI vs 45.5% in non-CAT counterparts, mild increase in LVMI seen in 18.3% vs 6.6% in non-CAT group while severe increase in LVMI seen in 33.25% vs 16.5% in non-CAT patients. Mean LVMI was higher in patients with obstructive coronary artery lesions (137.9 ± 56.3 vs 93.6 ± 27.3, p = 0.001), similarly, mean LVMI was increasing with higher grade of CT coronary calcium scoring as it was 88.5 ± 27.3 in absent CaCs while mean LVMI was 154.4 ± 62.4 in severe CaCs, p = 0.001).  left ventricular mass index increased in elderly, obese, hypertensive and diabetics. Severe grade of increase in LVMI was higher in patients with coronary artery tortuosity compared to those without coronary tortuosity. Similarly, LVMI can be useful echocardiographic predictor of coronary calcification as well as obstruction, further studies are warranted to explore pathophysiological basis and clinical impacts  of these findings. Abstract Figure.