scholarly journals Relationship Between the Coronary Artery Calcium (CAC) Score and the Angle Between the Aortic Valve and the Left Ventricular Inflow Long Axis (AV-LV) as Cardiovascular Risk Factors

2021 ◽  
Vol 18 (4) ◽  
Author(s):  
Taraneh Faghihi ◽  
Azadeh Ehsani ◽  
Fatemeh Shojaeian ◽  
Seyed Amir Ahmad Safavi Naini
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Significant Relationship ◽  
Left Ventricular ◽  
Cardiac Anatomy ◽  
History Of ◽  
Baseline Characteristics

Background: Cardiovascular disease (CVD) is one of the leading causes of mortality in both developed and developing countries. Therefore, identification of CVD risk factors is one of the most important steps in preventing this disease. Evidence suggests that imaging of the cardiac anatomy can be helpful for risk assessment. Objectives: This study aimed to assess two cardiac anatomy features, namely, the angle between the aortic valve and the left ventricular inflow long axis (AV-LV angle) and the coronary artery calcium (CAC) score. Patients and Methods: This cross-sectional study was conducted on 74 patients with indications for computed tomography angiography (CTA) according to the American Heart Association (AHA) guidelines from July 2019 to January 2020 in Iran. The Agatston method was applied to measure the CAC score. Besides, to determine the AV-LV angle, the angle between a line tangent to the aortic valve leaflets and a line through the center of the aorta toward the left ventricular apex was measured. The patients’ baseline characteristics were also documented by conducting interviews. Results: Of 74 patients, 56% were male. The mean age of the patients was 54.41 ± 12.31 years, and their mean body mass index (BMI) was 26.71 ± 3.89 kg/m2. The frequency of smoking was 28% among the participants. A history of hypertension was reported in 38.7% of the patients, and a history of dyslipidemia was reported in 36%. Besides, the history of myocardial infarction was reported in 4% of the patients, diabetes mellitus in 9.3% of the patients, and angioplasty in 6% of the patients. The CAC score only had significant relationships with hypertension and age (correlation coefficients = 0.51). On the other hand, the AV-LV angle had no significant relationship with the patients’ baseline characteristics. The statistical analysis of the AV-LV angle and CAC score showed no significant relationship between these parameters (P = 0.756). Conclusion: The AV-LV angle and the CAC score were not significantly associated. Further research is recommended to fill the knowledge gap regarding the cardiac anatomy features for cardiovascular risk assessment.

scholarly journals Echocardiographic and Electrocardiographic Findings in Patients with Ankylosing Spondylitis without Cardiovascular Risk Factors

2020 ◽  
Author(s):  
Simin Almasi ◽  
Behzad Farahani ◽  
Niloufar Samiei ◽  
Yousef Rezaei ◽  
Habib Mahmoodi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Ankylosing Spondylitis ◽  
Aortic Valve ◽  
Cardiovascular Risk Factors ◽  
Cardiac Involvement ◽  
Left Ventricular ◽  
Control Group ◽  
Number Of Patients ◽  
Chronic Inflammatory Condition

Background: Ankylosing spondylitis (AS) is a chronic inflammatory condition associated with more cardiac manifestations than those in the normal population. In this study, we sought to determine the prevalence of cardiac involvement in patients suffering from AS without cardiovascular risk factors. Methods: The present case-control study, conducted in 2 university hospitals in Tehran from January 2016 to December 2017, recruited 67 patients with AS and 40 age- and sex-matched healthy controls. The diagnosis of AS was based on the classification criteria of the Assessment of SpondyloArthritis International Society. All the participants were examined using transthoracic echocardiography and a standard 12-lead ECG. Baseline characteristics, echocardiographic findings, and ECG features were compared between the AS and control groups using univariate analyses. Results: The median age was 33.5 (IQR25-75%: 20.5–59) years in the AS group and 35 (IQR25-75%: 26–59) years in the control group (P=0.301). The number of patients with left ventricular systolic and diastolic dysfunction was significantly higher in the patients with AS than in the controls (7.5% vs. 20.9%; P=0.067, and 22.9% vs. 5.0%; P=0.026, respectively). The number of individuals with a left-axis deviation and a left anterior fascicular block was significantly higher in the patients suffering from AS than in the control group. The number of patients with aortic valve involvement was comparable between the groups (P=0.332). Conclusion: The most common cardiac involvement in our patients with AS was left ventricular dysfunction, followed by rhythm disturbances and aortic valve insufficiency. These findings were independent of age, AS severity, and disease duration. Therefore, the implementation of cardiovascular screening can be recommended for patients with AS.

scholarly journals Early Onset of Coronary Artery Calcification in Women With Previous Preeclampsia

2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Laura Benschop ◽  
Laura Brouwers ◽  
Gerbrand A. Zoet ◽  
Cindy Meun ◽  
Eric Boersma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Odds Ratio ◽  
Coronary Computed Tomography ◽  
History Of ◽  
Normotensive Pregnancy

Background: Preeclampsia, coronary artery calcification (CAC), and atherosclerotic plaque are risk factors for the development of cardiovascular disease. We determined at what age CAC becomes apparent on coronary computed tomography after preeclampsia and to what extent modifiable cardiovascular risk factors were associated. Methods: We measured cardiovascular risk factors, CAC by coronary computed tomography, and coronary plaque by coronary computed tomography angiography in 258 previously preeclamptic women aged 40-63. Results were compared to 644 age- and ethnicity-equivalent women from the Framingham Heart Study with previous normotensive pregnancies. Results: Any CAC was more prevalent after preeclampsia than after a normotensive pregnancy (20% versus 13%). However, this difference was greatest and statistically significant only in women ages 45 to 50 (23% versus 10%). The degree of CAC advanced 4× faster between the ages of 40 to 45 and ages 45 to 50 in women with a history of preeclampsia (odds ratio, 4.3 [95% CI, 1.5–12.2] versus odds ratio, 1.2 [95% CI, 0.6–2.3]). Women with a preeclampsia history maintained greater advancement of CAC with age into their early 60s, although this difference declined after the perimenopausal years. Women with a previous normotensive pregnancy were 4.9 years (95% CI, 1.8–8.0) older when they had similar CAC scores as previously preeclamptic women. These observations were not explained by the greater prevalence of cardiovascular disease risk factors, and the higher Framingham Risk Scores also observed in women with a history of preeclampsia. Conclusions: Previously preeclamptic women have more modifiable cardiovascular risk factors and develop CAC ≈5 years earlier from the age of 45 years onwards compared to women with normotensive pregnancies. Therefore, women who experienced preeclampsia might benefit from regular cardiovascular screening and intervention before this age. Registration: URL: https://www.trialregister.nl/trial/5406 ; Unique identifier: NTR5531.

scholarly journals Circulating Oxidized LDL is a Useful Marker for Cardiovascular Risk Assessment

Circulation ◽  
2001 ◽  
Vol 103 (suppl_1) ◽  
pp. 1350-1350
Author(s):  
Ann Mertens ◽  
Peter P Verhamme ◽  
Raymond Verhaeghe ◽  
Erik Muls ◽  
Desire Collen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Oxidized Ldl ◽  
Global Risk ◽  
Artery Disease

0032 BACKGROUND: Coronary artery disease is associated with an increase in circulating oxidized (Ox)LDL (Circulation 1998; 98:1487-1494). OBJECTIVES: 1) To determine the usefulness of OxLDL for identifying cardiovascular disease patients and 2) to study the relation of OxLDL with cardiovascular risk factors. METHODS: 1) To determine the diagnostic value of OxLDL 308 subjects were studied: 178 patients with angiographically proven coronary artery disease and 130 age-matched subjects without cardiovascular disease (controls) confirmed by B mode ultrasonography of their carotid arteries. 2) Additional 307 patients without cardiovascular disease were studied to determine the relation of OxLDL with cardiovascular risk factors. Levels of OxLDL were directly measured in plasma using a mAb-4E6 based competition ELISA. RESULTS: Compared with controls, patients had 2.3-fold higher levels of circulating OxLDL. At a cutoff value of 2.30 mg/dL, the sensitivity of OxLDL for cardiovascular disease was 73% with a specificity of 90%. The Global Risk Assessment Score (GRAS) was calculated using age, total and HDL cholesterol, systolic blood pressure, diabetes mellitus and smoking. GRAS was 8.65±3.41 for patients versus 6.09±5.10 (p≤0.001) for controls. Compared with subjects with low OxLDL (≤2.30 mg/dL) and low GRAS (≤12), risk of having cardiovascular disease was 3.2 times higher for subjects with low OxLDL and high GRAS, 6.4 times higher for subjects with high OxLDL and low GRAS and 27 times higher for subjects with both high OxLDL and high GRAS. Among patients without cardiovascular disease, stepwise multivariate analysis showed that Body Mass Index (p<0.001), LDL cholesterol (p<0.001), diabetes type 2 (p=0.003), triglycerides (p=0.017) and smoking (p=0.046) were the strongest predictors of OxLDL. Conclusion: Circulating OxLDL is a sensitive marker of cardiovascular disease. Circulating oxidized LDL correlates with obesity, hypercholesterolemia, diabetes and smoking. Addition of OxLDL to the established risk factors may improve cardiovascular risk prediction. Inclusion of OxLDL in prospective studies of risk factors of cardiovascular disease seems to be warranted.

scholarly journals Prevalence of coronary artery calcification in young adults in UK

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
G Koulaouzidis
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Young Adults ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Coronary Artery Calcification ◽  
Subclinical Atherosclerosis ◽  
Study Cohort ◽  
History Of

Abstract Funding Acknowledgements Type of funding sources: None. Background Coronary atherosclerosis is a continuous process beginning early in life, with a long and clinically asymptomatic phase, before manifestations appear in middle and/or late adulthood. Coronary artery calcification (CAC) is a well-established marker of atherosclerosis; but the clinical validity of CAC in young adults (traditionally considered as a population group of low cardiovascular risk) remains unclear. Aim We aimed to assess the prevalence of CAC in a population of young individuals without previous history of coronary artery disease (CAD) in the UK and its association with conventional cardiovascular risk factors. Methods This analysis includes 4186 asymptomatic young individuals who underwent electron beam computed tomography (EBCT). Demographic information and the presence of cardiovascular risk factors were abstracted from referral letters and/or questionnaires completed by the patients prior to their tests. Individuals with previously documented CAD or chronic kidney disease were excluded. All EBCT CAC studies were performed using the same scanner (Imatron C300 Ultrafast computed tomography scanner, GE Healthcare, London, UK) and the same scanning protocol. Results The age (mean SD) of the study cohort was 40.5 ±3.6 years (range 26–45 years, 83.8% males). Hypertension, dyslipidemia, and diabetes mellitus (DM) were present in 15.5, 7.9, and 2.8% of individuals, respectively. Family history of premature CAD was present in 17% and 17.4% were smokers.  CAC was present in 21.8% of the cohort, while individuals with CAC comparing with those with CAC score 0 were males (95.2 vs. 80%, p &lt; 0.002), older in age (41.4 3.2 vs. 40.3 3.7 years, p &lt; 0.0001), with DM (5.5 vs. 25%, p &lt; 0.0001), hypertension (22 vs. 13.7%, p &lt; 0.0001), and dyslipidemia (14.8 vs. 6%, p &lt; 0.0001). The prevalence of CAC score 0, 1–100, 101–400, 401–1000, &gt;1000 were 78.2, 19, 2.1, 0.5, and 0.2%, respectively. The prevalence and distribution of CAC among various age groups are shown in Table 1. CAC was found in 24.8% of males (CAC score 1–100, 101–400, 400–1000, &gt;1000 in 21.6, 2.5, 0.5, and 0.1%, respectively) and 6.6% of females (CAC score 1–100, 101–400, 400–1000, &gt;1000 in 5.4, 0.6, 0.15 and 0.4%, respectively) (p &lt; 0.0001). There was no statistical difference of mean CAC score between genders (males 13.8 72.7; females 11.8 142.4; p = 0.6). In multivariate analysis, the presence of CAC was associated with age (p&lt; 0.0001), male gender (p&lt; 0.0001), DM (p&lt; 0.0001), hypertension (p&lt; 0.0001), and dyslipidemia (p&lt; 0.0001).  Conclusion   In a large cohort of asymptomatic young individuals, subclinical atherosclerosis (CAC score &gt;0) was identified in approximately 20%. Assessment of CAC score is a useful clinical tool in young individuals, as it can confirm the presence of subclinical atherosclerosis.

scholarly journals Cardiovascular risk factors and blood pressure response to various types of exercise in veteran athletes

2021 ◽  
Vol 20 (3) ◽  
pp. 2575
Author(s):  
A. S. Shmoilova ◽  
M. O. Vyalova ◽  
Yu. G. Shvarts
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Positive Family History ◽  
Football Players ◽  
Post Exercise ◽  
History Of ◽  
Artery Disease

Aim. To study the main cardiovascular risk (CVR) factors and assess the blood pressure (BP) response to various types of exercise in veteran athletes.Material and methods. In order to identify the main CVR factors, 234 competitive athletes and 29 persons practicing physical training were interviewed. We also measured their pre- and post-exercise BP. The previously diagnosed hypertension (HTN) was also taken into account.Results. Among the participants, HTN was diagnosed in 48,5% of athletes, obesity — in 21%, smoking — in 22,9%, while 15,5% had a positive family history of coronary artery disease. The combination of two or more studied risk factors was observed in 35,7% of the subjects. The prevalence of the studied risk factors in participants significantly depended on the type of physical activity. The most unfavorable situation was obtained among hockey players. The highest pre-exercise diastolic BP values were registered in football players (p<0,05), while after exercise, in hockey and football players. In persons with obesity and HTN, the pre- and post-exercise systolic and diastolic BP, as well as the double product, were significantly (p<0,05) higher than in those without HTN and obesity.Conclusion. Veteran athletes practically do not differ from the general population in prevalence of HTN, smoking, and obesity. Elevated pre-and post-exercise BP values (>139/89 mm Hg) was recorded in >40% of veteran athletes. The highest BP levels were found among volleyball and football players. The factors predisposing to such an increase in pre- and post-exercise BP in veteran athletes are obesity, diagnosed HTN, and a positive family history of coronary artery disease. There is reason to consider BP >139/89 mm Hg in the early recovery period as an unfavorable indicator.

Abstract 14240: Thoracic Aortic Calcium for the Prediction of Stroke Mortality: The Coronary Artery Calcium Consortium

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Olufunmilayo H Obisesan ◽  
Albert D Osei ◽  
Daniel Berman ◽  
Zeina Dardari ◽  
S M Iftekhar Uddin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Predictive Value ◽  
Prediction Models ◽  
Prior History ◽  
Stroke Mortality ◽  
History Of ◽  
Traditional Risk Factors

Introduction: Thoracic aortic calcium(TAC) is an important marker of extra-coronary atherosclerosis with known predictive value for all-cause mortality. We sought to explore the predictive value of TAC for stroke mortality, independent of the more established coronary artery calcium score. Methods: The Coronary Artery Calcium(CAC) Consortium is a retrospectively assembled database of 66,636 patients aged ≥18 years with no prior history of cardiovascular disease, who had CAC scans done for risk stratification and were followed-up for an average of 12±4years. CAC scans capture a view of the adjacent thoracic aorta, enabling us to assess TAC at no extra cost. TAC was analyzed as present or not present and we restricted analysis to those with this information available. To account for competing risks for death from other causes, we utilized multivariable-adjusted competing risk regression models adjusted for traditional cardiovascular risk factors (age, sex, hypertension, hyperlipidemia, cigarette smoking, diabetes, family history of CHD) and CAC score. We report the relationship between TAC and stroke mortality using sub-distribution hazard ratios(SHR) with 95% CI. Results: There were 41,066 patients with information on TAC, 110 of whom had stroke mortality. The mean age of participants was 53.8±10.3 years, with 34.4% female. The unadjusted SHR for stroke mortality among those who had TAC compared to those who did not was 8.80(95%CI:5.97,12.98). After adjusting for traditional risk factors and CAC score, the SHR was 2.21(95%CI:1.39,3.49). The fully adjusted SHR for females was 3.42(95%CI:1.74,6.73) while for males it was 1.55(95%CI:0.83,2.90). Conclusion: TAC was predictive of stroke mortality independent of traditional risk factors and CAC, more so in females. The presence of TAC appears to be an independent marker of stroke mortality risk though further research is needed to study its incremental value over existing cardiovascular risk prediction models.

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