Correlation Between Coronary Artery Disease Severity Detected by CT Coronary Angiography and Grade of Left Ventricular Diastolic Dysfunction Detected by Echocardiography

Coronary artery disease (CAD) and left ventricular (LV) diastolic dysfunction are major contributors to cardiovascular morbidity and mortality. Understanding the relationship between anatomical coronary burden and myocardial functional impairment may improve diagnostic accuracy and risk stratification. This study aimed to investigate the correlation between CAD severity assessed by coronary computed tomography angiography (CCTA) and LV diastolic dysfunction grade evaluated by echocardiography in patients with intermediate pretest probability for CAD. A cross-sectional analytical study was conducted on 200 patients who underwent both CCTA and transthoracic echocardiography. Diastolic function was graded according to current echocardiographic guidelines, and coronary burden was assessed via CAD-RADS, Segment Involvement Score (SIS), and Coronary Artery Calcium Score (CACS) angina score. Diastolic dysfunction was detected in 80.5% of patients, with significantly higher prevalence and severity among those with obstructive CAD (P< 0.001). SIS and CACS were strongly correlated with diastolic dysfunction grades (r=0.809, P< 0.001). Obstructive CAD was also associated with higher cholesterol, HbA1c, and LDL, and lower HDL levels. Risk factors such as hypertension and diabetes were significantly more frequent in those with diastolic dysfunction. A strong positive association exists between the extent of CAD and the severity of LV diastolic dysfunction, supporting integrated imaging-based risk assessment in CAD.