Abstract P321: Coronary Artery Remodeling and Subclinical Atherosclerosis: the CARDIA study

Atherosclerosis related inflammation and plaque result in expansive remodeling of the coronary artery, a finding associated with plaque rupture and clinical events. The extent of expansive coronary remodeling in adults prior to the development of clinical disease is largely unknown. We tested the hypothesis that middle-aged adults who have subclinical coronary artery disease also have larger coronary artery diameters. Methods: Submillimeter thin slice, non-contrast cardiac CT images were obtained in 1197 black and white men and women in the Coronary Artery Risk Development in Young Adults (CARDIA) Study during the year 25 examination (2010-2011, mean age 50 years). Average coronary artery diameter(mm) and cross sectional area (mm2) were measured sequentially along the length of each vessel and averaged for the left main (LM) and proximal circumflex (LCX), left anterior descending (LAD), and right coronary (RCA) arteries. Presence/absence of coronary artery calcifications [CAC (0 versus >0 AU)] was measured independently. Multivariable linear regression models were used to examine the association of CAC with artery size. Results: Coronary diameter was larger in blacks compared to whites (p<0.05) and in men compared to women (p<.0001) following adjustment for age and study center. Presence of CAC was associated with larger diameter coronary arteries after adjustment for age, race, sex, education, height, and study center (Table, model 1). These associations remained following additional adjustment for established cardiovascular risk factors, with the exception of the left main segment (Table, model 2), and were similar for vessel area as for vessel diameter (not shown). Conclusion: Coronary arteries are larger in middle-age individuals with vs without CAC, supporting the hypothesis that atherosclerosis leads to expansive coronary remodeling. Coronary remodeling by non-contrast CT is a measure that may provide new information on cardiovascular risk and prediction of clinical cardiovascular events.

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Congenital Left Main Coronary Artery to Coronary Sinus Fistula

The Heart Surgery Forum ◽

10.1532/hsf98.20101085 ◽

2011 ◽

Vol 14 (4) ◽

pp. 255 ◽

Cited By ~ 4

Author(s):

Fotios A. Mitropoulos ◽

Meletios A. Kanakis ◽

Periklis A. Davlouros ◽

George Triantis

Keyword(s):

Coronary Artery ◽

Coronary Arteries ◽

Coronary Sinus ◽

Left Main Coronary Artery ◽

Coronary Artery Fistula ◽

Left Main ◽

Coronary Fistula ◽

Excellent Outcome ◽

Surgical Ligation ◽

Congenital Coronary Artery Fistula

Congenital coronary artery fistula is an extremely rare anomaly that may involve any of the coronary arteries and any of the cardiac chambers. We report the case of a 14-year-old female patient with a symptomatic congenital coronary fistula starting from the left main coronary artery and draining to the coronary sinus. The patient underwent surgical ligation of the fistula and had an excellent outcome.

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Association between the Severity of Nonalcoholic Fatty Liver Disease and the Risk of Coronary Artery Calcification

Medicina ◽

10.3390/medicina57080807 ◽

2021 ◽

Vol 57 (8) ◽

pp. 807

Author(s):

Chien-Chih Chen ◽

Wei-Chien Hsu ◽

Han-Ming Wu ◽

Jiun-Yi Wang ◽

Pei-Yu Yang ◽

...

Keyword(s):

Computed Tomography ◽

Cardiovascular Risk ◽

Liver Disease ◽

Coronary Artery ◽

Fatty Liver ◽

Multidetector Computed Tomography ◽

Coronary Artery Calcification ◽

Fatty Liver Disease ◽

Calcium Score ◽

Left Main

Background and Objectives: There are limited data on the association between severity of non-alcoholic fatty liver disease (NAFLD) and coronary artery calcification. This study investigated sonographic diagnosed NAFLD and coronary artery calcium score (CAC) as detected by cardiac multidetector computed tomography in general populations. Materials and Methods: A total of 545 patients were enrolled in this study. NAFLD was diagnosed by ultrasonography examination and CAC score were evaluated by cardiac multidetector computed tomography. The association between NAFLD and artery calcium score stage was determined by logistic regression analysis and Spearman correlation coefficient analysis. Results: Of all the participants, 437 (80.2%) had ultrasonography-diagnosed NAFLD and 242 (44%) had coronary artery calcification (CAC > 0). After adjustment for cardiovascular risk factors, the risk of developing coronary artery calcification was 1.36-fold greater in the patients with different severity of NAFLD compared to those without NAFLD (OR = 1.36, 95% CI = 1.07–1.77, p = 0.016). The highest OR for separate coronary artery calcification was 1.98 (OR = 1.98, 95% CI = 1.37–2.87, p < 0.001) in the left main artery, and the risk was still 1.71-fold greater after adjustments (OR = 1.71, 95% CI = 1.16–2.54, p = 0.007). Conclusions: This cross-sectional study demonstrated that the severity of NAFLD was associated with the presence of significant coronary artery calcification, especially in the left main coronary artery, suggesting increasing the cardiovascular risk.

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Coronary artery z score values in adolescent elite male soccer players

Cardiology in the Young ◽

10.1017/s1047951120004011 ◽

2020 ◽

pp. 1-5

Author(s):

Stephan Gerling ◽

Tobias Pollinger ◽

Markus Johann Dechant ◽

Michael Melter ◽

Werner Krutsch ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Arteries ◽

High Intensity ◽

Left Main Coronary Artery ◽

Left Ventricular ◽

Soccer Players ◽

Z Score ◽

Left Main ◽

Luminal Diameter ◽

The Mean

Abstract Background: With the increased training loads at very early ages in European elite youth soccer, there is an interest to analyse coronary artery remodelling due to high-intensity exercise. Design and methods: Prospective echocardiographic study in 259 adolescent elite male soccer players and 48 matched controls. Results: The mean age was 12.7 ± 0.63 years in soccer players and 12.6 ± 0.7 years in controls (p > 0.05). Soccer players had significant greater indexed left ventricular mass (93 ± 13 g/m2 versus 79 ± 12 g/m2, p = 0.001). Both coronary arteries origin could be identified in every participant. In soccer players, the mean diameter of the left main coronary artery was 3.67 mm (SD ± 0.59) and 2.61 mm (SD ± 0.48) for right main coronary artery. Controls showed smaller mean luminal diameter (left main coronary artery, p = 0.01; right main coronary artery, p = 0.025). In soccer players, a total of 91% (n = 196) and in controls a total of 94% (n = 45) showed left main coronary artery z scores within the normal range: −2.0 to 2.0. In right main coronary artery, a pattern of z score values distribution was comparable (soccer players 94%, n = 202 vs. controls 84%, n = 40). A subgroup of soccer players had supernormal z score values (>2.0 to 2.5) for left main coronary artery (9%, n = 19, p = 0.01) and right main coronary artery (6%, n = 10, p = 0.025), respectively. Conclusion: Elite soccer training in early adolescence may be a stimulus strong enough to develop increased coronary arteries diameters. In soccer players, a coronary artery z score >2.0–2.5 might reflect a physiologic response induced by multiannual high-intensity training.

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Obstruction of 2 Coronary Arteries from Different Causes Immediately after Transapical Transcatheter Aortic Valve Replacement

Texas Heart Institute Journal ◽

10.14503/thij-17-6497 ◽

2020 ◽

Vol 47 (1) ◽

pp. 30-34

Author(s):

Umihiko Kaneko ◽

Ryuji Koshima ◽

Hirosato Doi ◽

Tsutomu Fujita

Keyword(s):

Coronary Artery ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Coronary Arteries ◽

Transcatheter Aortic Valve Replacement ◽

Severe Aortic Stenosis ◽

Rare Complication ◽

Left Main ◽

Transcatheter Aortic Valve

Coronary obstruction, a rare complication of transcatheter aortic valve replacement, can be fatal. Few data exist on this phenomenon, and, to date, authors have reported only single coronary lesions. We present a case in which 2 coronary arteries obstructed immediately after transapical transcatheter aortic valve replacement. The patient was an 81-year-old woman with symptomatic severe aortic stenosis who underwent transapical transcatheter aortic valve replacement. Immediately after an Edwards Sapien XT valve was deployed, she experienced sudden cardiogenic shock resulting from obstruction of the left main coronary artery ostium and the distal left anterior descending coronary artery. The left main obstruction was caused by direct compression from a large calcified mass and the valve frame. The left anterior descending coronary artery obstruction was caused by ambient myocardial tightening and external compression around the apical sutures. Revascularization was achieved through coronary stent placement and suture removal, respectively. Our patient's case highlights the risk for coronary obstructions after transapical transcatheter aortic valve replacement, and we discuss how they can be managed.

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PP-187 A CASE REPORT OF ASYMPTOMATIC PLAQUE RUPTURE AT LEFT MAIN CORONARY ARTERY DETECTED BY IVUS

International Journal of Cardiology ◽

10.1016/s0167-5273(12)70387-x ◽

2012 ◽

Vol 155 ◽

pp. S160

Author(s):

U.Ç. Yüksel ◽

T. Çelik ◽

A. İyisoy ◽

M. Çelik ◽

B. Buğan ◽

...

Keyword(s):

Case Report ◽

Coronary Artery ◽

Left Main Coronary Artery ◽

Plaque Rupture ◽

Left Main

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Left main coronary artery aneurysm with chronic total occlusion of both left coronary arteries in a young athlete

Heart ◽

10.1136/heart.85.1.e1 ◽

2001 ◽

Vol 85 (1) ◽

pp. 1e-1 ◽

Cited By ~ 5

Author(s):

S-H Park

Keyword(s):

Coronary Artery ◽

Coronary Arteries ◽

Chronic Total Occlusion ◽

Coronary Artery Aneurysm ◽

Left Main Coronary Artery ◽

Young Athlete ◽

Artery Aneurysm ◽

Left Main ◽

Total Occlusion

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Abstract 18550: Association Between a Healthy Cardiovascular Risk Factors Profile and Coronary Artery Calcium Score: Results From the Brazilian Longitudinal Study of Adults Health (ELSA-Brasil)

Circulation ◽

10.1161/circ.132.suppl_3.18550 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Isabela M Bensenor ◽

Alessandra C Goulart ◽

Itamar S Santos ◽

Dora Chor ◽

Alexandre C Pereira ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Longitudinal Study ◽

Coronary Artery ◽

Cardiovascular Risk Factors ◽

Coronary Artery Calcium ◽

Task Force ◽

Coronary Artery Calcium Score ◽

Subclinical Atherosclerosis ◽

Calcium Score

Introduction: Few studies evaluated the relationship between a favorable lifestyle a healthy profile of cardiovascular risk factors and subclinical atherosclerosis measured by Coronary Artery Calcium Score (CAC). Hypothesis: to identify the association between lifestyle profile and CAC among mid-elderly men and women. Methods: We included 4058 participants of the Brazilian Longitudinal Study of Health aged 35-74 years who underwent CAC measurement. The 2010 Task Force of the American Heart Association cut-offs were used to define the ideal profile and included smoking, physical activity, diet, blood pressure, glucose/cholesterol levels, and body-mass index. Only 21 participants had at least 6 ideal metrics. Participants were categorized according the number of ideal risk factors (IRF): 0-1 (n=1152, 28.4%), 2 (n=1234, 30.4%), 3-4 (n=1489, 36.7%), or 5-7 (n=183, 4.5%). (Figure 1). Results: Compared to individuals with 0-1 IRF, the odds ratio (OR) of participants with 2 IRF presenting with CAC of 0 (compared to >0), <100 (compared to ≥100), and <400 (compared to ≥400) was 0.65 (95% confidence interval [CI]: 0.54-0.79), 0.59 (95%CI: 0.45-0.77), and 0.61 (95%CI: 0.39-0.94), respectively. Similarly, the ORs of CACs of 0, <100, and <400 in individuals with 3-4 IRF were 0.54 (95%CI: 0.44-0.66), 0.42 (95%CI: 0.31-0.57), and 0.56 (95%CI: 0.34-0.92), respectively. The ORs of CACs of 0, <100, and <400 in individuals with 5-7 IRF were 0.33 (95%CI: 018-0.58), 0.17 (95%CI: 0.04-0.72), and zero, respectively. Conclusion: Subjects with more IRF had lower CAC compared to subjects with lower ICH metrics, but CAC >0 was found even in these individuals.

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