Calcium Burden Is Associated With Selective Changes in Luminal Surface Topography of Cadaveric Left Anterior Descending Arteries.

BACKGROUND: Coronary artery calcification is a key feature of atherosclerosis and is routinely quantified as a marker of plaque burden. However, its relationship with luminal surface topography remains poorly defined due to the limited resolution of clinical imaging. We aimed to determine whether increasing calcium burden is associated with measurable changes in luminal surface topography. METHODS: Left anterior descending artery (LAD) specimens from 27 human cadavers were analyzed using micro-computed tomography (micro-CT) to quantify calcium burden. Luminal surfaces were exposed and scanned using high-resolution optical surface metrology (confocal microscopy), yielding quantitative topographical parameters across 366 surface scans. Associations between calcium burden and surface metrics were evaluated using linear mixed-effects models to account for within-specimen clustering (effect estimates reported as β). Sensitivity analyses were performed with adjustment for coronary segment. RESULTS: Across evaluated parameters, most global and spatial surface metrics were not associated with calcium burden. However, higher calcium burden was associated with reduced dale count (β [95% CI] = -17.22 [-33.0, -1.43]; p = 0.034). This association remained consistent after adjustment for coronary segment (β = -16.80 [-32.73, -0.87]; p = 0.039). CONCLUSION: Calcium burden in cadaveric LADs is selectively associated with reduced luminal surface dale count, suggesting subtle, localized topographic remodeling rather than global surface changes.