Abstract P186: Quality of Total Heart Adipose Tissue May Contribute to the Presence and Extent of Coronary Artery Calcification in Women at Midlife: The Study of Women’s Health Across the Nation

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Carrie L Hanley ◽  
Karen Matthews ◽  
Maria M Brooks ◽  
Imke Janssen ◽  
Matthew J Budoff ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Coronary Artery ◽  
Women’S Health ◽  
Women's Health ◽  
Coronary Artery Calcification ◽  
Agatston Score ◽  
Tobit Regression ◽  
Cvd Risk ◽  
Fat Depots

Background: The location and quantity of specific adipose tissue depots have been shown to be independent predictors of subclinical atherosclerosis. Most recently, attention has been focused on the quality of these fat depots as a novel marker of CVD risk. Adipose tissue attenuation, measured via radiodensity in computed tomography (CT) Hounsfield units (HU), is one such marker of fat quality. Our objective was to determine the cross-sectional association between total heart adipose tissue (TAT) radiodensity and coronary artery calcification (CAC) in women at midlife, a time period marked with an increase in CVD risk. Methods: Participants from the Study of Women’s Health Across the Nation (SWAN) Ectopic Cardiovascular Fat Ancillary Study were evaluated. CAC and TAT were measured using electron-beam CT. CAC was evaluated as 1) presence of CAC (CAC Agatston score >10), and 2) extent of CAC (continuous Agatston score). TAT radiodensity was evaluated as tertiles of HU (lowest tertile, -91 to -81 HU; middle tertile, -80 to -78 HU; highest tertile -77 to -67 HU). Logistic (for CAC presence) and Tobit regression (for CAC extent) were used for statistical analyses. Results: A total of 495 women with a mean age of 51 years were examined. This sample of women was 63% white, 37% black, 54% pre-/early peri-menopausal, 35% late peri-/postmenopausal, and 11% used hormones. In unadjusted logistic and Tobit regression models ( Table 1 ), the tertiles of TAT were significantly and inversely associated with the presence and extent of CAC. In fully adjusted models, the middle tertile remained significantly inversely associated with the presence and extent of CAC compared to the lowest tertile, but the adjusted estimates for the highest tertile were attenuated and non-significant ( Table 1 ). Conclusions: There appears to be an inverse relationship between TAT radiodensity and CAC which is more pronounced for those with mid-range radiodensity values. These results merit further investigation.

Abstract P401: Associations Between High-density Lipoprotein Subclasses and Coronary Artery Calcification Vary by Menopausal Stage. The Study of Women's Health Across the Nation Hdl Ancillary Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Samar R El Khoudary ◽  
Alexis Nasr ◽  
Xirun Chen ◽  
Karen A Matthews ◽  
Trevor Orchard ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Density Lipoprotein ◽  
Estimating Equation ◽  
High Density ◽  
Midlife Women ◽  
High Density Lipoproteins ◽  
Agatston Score ◽  
Cvd Risk ◽  
Menopause Transition

Objective: Higher levels of high-density lipoproteins cholesterol (HDL-C) may not always be cardio-protective in midlife women. Nuclear magnetic resonance (NMR) spectroscopy HDL subclasses have shown strong associations with CVD risk beyond HDL-C. Preliminary work suggests significant declines in large HDL particles (HDL-P) and overall HDL size, but increases in small HDL-P during the perimenopause stage. Our objective was to assess whether associations between NMR HDL subclasses and risk of coronary artery calcification (CAC) vary by menopausal stage. Design: We assessed 283 women (at baseline : age 51.4 ± 3.0 years; 56.6% Pre-/Early peri-, 8.8% late peri-, 34.6% post-menopausal) who had NMR HDL subclasses and CAC Agatston score measured once (N=48 [17%]) or twice (N=235 [83%]) around menopause. CAC presence was defined as CAC>0. Effect modifications of menopausal stage on associations between HDL subclasses and CAC presence overtime were tested using generalized estimating equation for binary outcome. Final models were adjusted for study site, race and time varying: age, body mass index, physical activity, alcohol consumption, insulin resistance, triglycerides and low-density lipoprotein cholesterol. Results: In final models, menopausal stage modified the associations of small HDL-P (p=.009), large HDL-P (p=.05) and overall HDL size (p=.007) with CAC presence ( Table ). Higher concentration of small HDL-P, lower concentration of large HDL-P, and smaller overall HDL size significantly associated with greater risk of CAC presence during the late-peri stage compared to pre-/early peri-menopausal stage ( Table) . Conclusions: Changes in HDL subclasses during the menopause transition may increase the likelihood of measurable CAC developing in women, particularly during the later peri-menopausal stage. Characterizing associations of HDL composition and function metrics with CVD risk over the menopause transition is critical to better understand the relationship of HDL to coronary disease in midlife women.

scholarly journals Prognostic significance of aortic valve calcium in relation to coronary artery calcification for long-term, cause-specific mortality: results from the CAC Consortium

2020 ◽  
Author(s):  
Donghee Han ◽  
Rhanderson Cordoso ◽  
Seamus Whelton ◽  
Alan Rozanski ◽  
Matthew J Budoff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Coronary Artery Calcification ◽  
Prognostic Significance ◽  
Agatston Score ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Score Method ◽  
Traditional Risk Factors

Abstract Aims Aortic valve calcification (AVC) has been shown to be associated with increased cardiovascular disease (CVD) risk; however, whether this is independent of traditional risk factors and coronary artery calcification (CAC) remains unclear. Methods and results From the multicentre CAC Consortium database, 10 007 patients (mean 55.8±11.7 years, 64% male) with concomitant CAC and AVC scoring were included in the current analysis. AVC score was quantified using the Agatston score method and categorized as 0, 1–99, and ≥100. The endpoints were all-cause, CVD, and coronary heart disease (CHD) deaths. AVC (AVC>0) was observed in 1397 (14%) patients. During a median 7.8 (interquartile range: 4.7–10.6) years of study follow-up, 511 (5.1%) deaths occurred; 179 (35%) were CVD deaths, and 101 (19.8%) were CHD deaths. A significant interaction between CAC and AVC for mortality was observed (P<0.001). The incidence of mortality events increased with higher AVC; however, AVC ≥100 was not independently associated with all-cause, CVD, and CHD deaths after adjusting for CVD risk factors and CAC (P=0.192, 0.063, and 0.206, respectively). When further stratified by CAC<100 or ≥100, AVC ≥100 was an independent predictor of all-cause and CVD deaths only in patients with CAC <100, after adjusting for CVD risk factors and CAC [hazard ratio (HR): 1.93, 95% confidence interval (CI): 1.14–3.27; P=0.013 and HR: 2.71, 95% CI: 1.15–6.34; P=0.022, respectively]. Conclusion Although the overall prognostic significance of AVC was attenuated after accounting for CAC, high AVC was independently associated with all-cause and CVD deaths in patients with low coronary atherosclerosis burden.

scholarly journals Assessing the Role of Pericardial Fat as a Biomarker Connected to Coronary Calcification—A Deep Learning Based Approach Using Fully Automated Body Composition Analysis

2021 ◽  
Vol 10 (2) ◽  
pp. 356
Author(s):  
Lennard Kroll ◽  
Kai Nassenstein ◽  
Markus Jochims ◽  
Sven Koitka ◽  
Felix Nensa
Keyword(s):  
Adipose Tissue ◽  
Deep Learning ◽  
Coronary Artery ◽  
Cardiac Ct ◽  
Coronary Calcification ◽  
Risk Scores ◽  
Agatston Score ◽  
Composition Analysis ◽  
Significance Level ◽  
Tissue Quantification

(1) Background: Epi- and Paracardial Adipose Tissue (EAT, PAT) have been spotlighted as important biomarkers in cardiological assessment in recent years. Since biomarker quantification is an increasingly important method for clinical use, we wanted to examine fully automated EAT and PAT quantification for possible use in cardiovascular risk stratification. (2) Methods: 966 patients with intermediate Framingham risk scores for Coronary Artery Disease referred for coronary calcium scans were included in clinical routine retrospectively. The Coronary Artery Calcium Score (CACS) was extracted and tissue quantification was performed by a deep learning network. (3) Results: The Computed Tomography (CT) segmentations predicted by the network indicated no significant correlation between EAT volume and EAT radiodensity when compared to Agatston score (r = 0.18, r = −0.09). CACS 0 category patients showed significantly lower levels of total EAT and PAT volumes and higher EAT and PAT densities than CACS 1–99 category patients (p < 0.01). Notably, this difference did not reach significance regarding EAT attenuation in male patients. Women older than 50 years, thus more likely to be postmenopausal, were shown to be at higher risk of coronary calcification (p < 0.01, OR = 4.59). CACS 1–99 vs. CACS ≥100 category patients remained below significance level (EAT volume: p = 0.087, EAT attenuation: p = 0.98). (4) Conclusions: Our study proves the feasibility of a fully automated adipose tissue analysis in clinical cardiac CT and confirms in a large clinical cohort that volume and attenuation of EAT and PAT are not correlated with CACS. Broadly available deep learning based rapid and reliable tissue quantification should thus be discussed as a method to assess this biomarker as a supplementary risk predictor in cardiac CT.

scholarly journals Plasma F2-Isoprostanes and Coronary Artery Calcification: The CARDIA Study

2005 ◽  
Vol 51 (1) ◽  
pp. 125-131 ◽  
Author(s):  
Myron Gross ◽  
Michael Steffes ◽  
David R Jacobs ◽  
Xinhua Yu ◽  
Linda Lewis ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Early Development ◽  
Coronary Artery Calcification ◽  
Continuous Variable ◽  
Oxidation Products ◽  
Gas Chromatography Mass Spectrometry ◽  
Agatston Score ◽  
Reactive Protein ◽  
Increased Risk ◽  
Coronary Artery Atherosclerosis

Abstract Background: Oxidation of lipids in lipoproteins and cells may initiate and enhance the early development of cardiovascular disease. Method and Results: We assayed F2-isoprostanes, oxidation products of arachidonic acid, by gas chromatography–mass spectrometry in a biracial cohort of 2850 young healthy adult men and women. Coronary artery calcification (CAC), a component of coronary artery atherosclerosis, was detectable in 10% of the cohort and appeared to be in its initial stages (Agatston scores &lt;20 in 47% and &lt;100 in 83% of CAC-positive participants). After adjusting for sex, clinical site, age, and race, the presence of any CAC was 24% more likely among those with high vs low concentrations of F2-isoprostanes [odds ratio (OR) = 1.24 per 92.2 pmol/L (32.7 ng/L; 1 SD of F2-isoprostanes); 95% confidence interval (CI), 1.09–1.41]. The OR was only slightly attenuated [1.18 per 92.2 pmol/L (32.7 ng/L); CI, 1.02–1.38] after further adjustment for body mass index, smoking, serum lipids, C-reactive protein, antioxidant supplementation use, diabetes, and blood pressure. As a continuous variable, the Agatston score increased by 6.9% per 92.2 pmol/L (32.7 ng/L) of F2-isoprostane concentration (P &lt;0.01). Whereas CAC prevalence was lower in women than men, mean (SD), F2-isoprostanes were higher in women {190 (108.9) pmol/L [67.4 (38.6) ng/L]} than in men {140.4 (55.6) pmol/L [49.8 (19.7) ng/L]}. Nevertheless, F2-isoprostanes were associated with an increased risk of CAC in both sexes. Conclusion: This association between increased concentrations of circulating F2-isoprostanes and CAC in young healthy adults supports the hypothesis that oxidative damage is involved in the early development of atherosclerosis.

Abstract P104: Higher Leptin Levels Are Associated With Increased Odds Of Coronary Artery Calcium Progression: The Multi-ethnic Study Of Atherosclerosis

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Bhavya Varma ◽  
Oluseye Ogunmoroti ◽  
Chiadi Ndumele ◽  
Di Zhao ◽  
Moyses Szklo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiac Ct ◽  
Subclinical Atherosclerosis ◽  
Community Dwelling ◽  
Ct Scans ◽  
Agatston Score ◽  
Cvd Risk ◽  
Ethnic Study ◽  
History Of

Background: Adipokines are secreted by adipose tissue, play a role in cardiometabolic pathways, and have differing associations with cardiovascular disease (CVD). Coronary artery calcium (CAC) and its progression indicate subclinical atherosclerosis and prognosticate CVD risk. However the association of adipokines with CAC progression is not well established. We examined the association of adipokines with the odds of a history of CAC progression in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We performed an analysis of 1,904 community dwelling adults free of clinical CVD in MESA. Participants underwent measurement of serum adipokines [leptin, resistin and adiponectin] at visits 2 or 3 (randomly assigned) and a contemporaneous cardiac CT scan at same visit. Participants also had a prior cardiac CT at visit 1, at a median of 2.4 years earlier. On both CTs, CAC was quantified by Agatston score. We defined a history of CAC progression between the CT scans at visit 1 and at visit 2 or 3 as those with >0 Agatston units of change per year (and compared to those with ≤0 units of change per year). We used logistic regression to examine the odds of having a history of CAC progression by adipokine tertiles using progressively adjusted models. Results: The mean participant age was 65 (10) years; 50% were women, 40% White, 13% Chinese, 21% Black and 26% Hispanic. The prevalences of CAC at visits 1 and 2/3 were 49% and 58%, respectively. There were 1,001 (53%) who had CAC progression between the 2 CT scans. In demographic-adjusted models (model 1, Table), higher leptin and lower adiponectin were associated with increased odds of prior CAC progression. In models fully adjusted for BMI and other CVD risk factors (model 3), only the highest tertile of leptin remained associated with a greater odds of prior CAC progression [OR 1.55 (95% CI 1.04, 2.30)]. Conclusions: Higher leptin levels were independently associated with a history of CAC progression. Atherosclerosis progression may be one mechanism through which leptin confers increased CVD risk

Health-related quality of life and its influencing factors in individuals with high cardiovascular disease risk: a cross-sectional study based on EQ-5D utility scores in Inner Mongolia, China

2021 ◽  
Author(s):  
Ning Cao ◽  
Yunfeng Xi ◽  
Yumin Gao ◽  
Hailing Li ◽  
Yanchao Liu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
High Risk ◽  
Influencing Factors ◽  
Inner Mongolia ◽  
Health Related Quality ◽  
Tobit Regression ◽  
Cvd Risk ◽  
Related Quality ◽  
Health Related

Abstract Background The high risk of cardiovascular disease (CVD) being associated with impaired Health-related quality of life (HRQoL). However, few studies have assessed the HRQoL of individuals with a high risk of CVD in Inner Mongolia, or even in China. We aimed to assess health-related quality of life (HRQoL) among individuals in Inner Mongolia with a high risk of CVD and its risk factors, to provide a reference to improve HRQoL in individuals with high CVD risk. Methods From 2015 to 2017, residents of six villages or communities in Inner Mongolia, selected using a multi-stage stratified cluster random sampling method, were invited to complete a questionnaire and undergo physical examination and laboratory testing. We selected participants whose predicted 10-year risk for CVD exceeded 10% as those with high CVD risk. HRQoL in individuals with high CVD risk was investigated based on the EuroQol-5 Dimension (EQ-5D) scale. The Chinese utility value integral system was used to calculate EQ-5D utility scores, and the Tobit regression model were used to analyze the influencing factors of HRQoL among individuals with high CVD risk. Results Of 13,359 participants with high CVD risk, 65.63% reported no problems in any of the five dimensions; the most frequently reported difficulty was pain/discomfort. The mean utility score was 1.000 (0.869, 1.000). Tobit regression analysis showed that sex, age, education level, residence area, household income, physical activity, hypertension, and dyslipidemia were influencing factors of HRQoL. Conclusion We found that female sex, older age, living in an urban area, lower education level, lower household income, and lower physical activity levels were associated with reduced HRQoL. People with a high risk of CVD should maintain their blood glucose and lipid levels within the normal range.

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