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Jobst BJ, Owsijewitsch M, Kauczor HU, Biederer J, Ley S, Becker N, Kopp-Schneider A, Delorme S, Heussel CP, Puderbach M, Wielpütz MO, Ley-Zaporozhan J. GOLD stage predicts thoracic aortic calcifications in patients with COPD. Exp Ther Med 2018; 17:967-973. [PMID: 30651888 DOI: 10.3892/etm.2018.7039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 11/21/2018] [Indexed: 12/22/2022] Open
Abstract
Although some of the associations between chronic obstructive pulmonary disease (COPD) and atherosclerosis are based on shared risk factors such as smoking, recent epidemiological evidence suggests that COPD is a risk factor for vascular disease due to systemic inflammation. The present study assessed the hypothesis that disease severity (as expressed by the GOLD stage) independently predicts the extent of vascular calcifications. A total of 160 smokers diagnosed with COPD (GOLD I-IV, 40 subjects of each GOLD stage) and 40 smokers at risk (GOLD 0; median age of 60 years old; Q1:56;Q3:65; 135 males and 65 females) underwent non-contrast, non-electrocardiography synchronized chest computerised tomography. The volume of thoracic aortic calcifications was quantified semi-automatically within a region from T1 through T12. Multiparametric associations with GOLD stage, smoking history, sex, age, body mass index and emphysema index were evaluated using generalized linear regression analysis. Thoracic aortic calcifications were highly prevalent in this cohort (187/200 subjects, 709 (Q1:109;Q3:2163) mm3). Analysis of variance on ranks demonstrated a significant difference in calcium between different GOLD-stages as well as patients at risk of COPD (F=36.8, P<0.001). In the multivariable analysis, GOLD-stages were indicated to be predictive of thoracic aortic calcifications (P≤0.0033) besides age (P<0.0001), while age appeared to be the strongest predictor. Other variables were not statistically linked to thoracic aortic calcifications in the multivariable model. COPD severity, as expressed by the GOLD-stage, is a significant predictor of thoracic aortic calcifications, independent of covariates such as age or tobacco consumption.
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Affiliation(s)
- Bertram J Jobst
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, D-69120 Heidelberg, Germany.,Translational Lung Research Centre Heidelberg (TLRC), Member of The German Lung Research Centre (DZL), D-69120 Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, D-69126 Heidelberg, Germany
| | - Michael Owsijewitsch
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, D-69120 Heidelberg, Germany.,Translational Lung Research Centre Heidelberg (TLRC), Member of The German Lung Research Centre (DZL), D-69120 Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, D-69126 Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, D-69120 Heidelberg, Germany.,Translational Lung Research Centre Heidelberg (TLRC), Member of The German Lung Research Centre (DZL), D-69120 Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, D-69126 Heidelberg, Germany
| | - Jürgen Biederer
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, D-69120 Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, D-69126 Heidelberg, Germany.,Department of Radiology, Hospital Gross-Gerau, Darmstadt Private Practice for Radiology and Nuclear Medicine, D-64521 Gross-Gerau, Germany
| | - Sebastian Ley
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, D-69120 Heidelberg, Germany.,Diagnostic and Interventional Radiology, Surgical Hospital Munich South, D-81379 Munich, Germany
| | - Nikolaus Becker
- Division of Cancer Epidemiology, German Cancer Research Centre (DKFZ Heidelberg), D-69120 Heidelberg, Germany
| | | | - Stefan Delorme
- Department of Radiology, German Cancer Research Centre (DKFZ Heidelberg), D-69120 Heidelberg, Germany
| | - Claus Peter Heussel
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, D-69120 Heidelberg, Germany.,Translational Lung Research Centre Heidelberg (TLRC), Member of The German Lung Research Centre (DZL), D-69120 Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, D-69126 Heidelberg, Germany
| | - Michael Puderbach
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, D-69126 Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology, Hufeland Hospital, D-99947 Bad Langensalza, Germany
| | - Mark O Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, D-69120 Heidelberg, Germany.,Translational Lung Research Centre Heidelberg (TLRC), Member of The German Lung Research Centre (DZL), D-69120 Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, D-69126 Heidelberg, Germany
| | - Julia Ley-Zaporozhan
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, D-69120 Heidelberg, Germany.,Department of Radiology, Ludwig-Maximilians-University Hospital Munich, D-80337 Munich, Germany
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Engbers EM, Timmer JR, Ottervanger JP. Coronary artery calcium score as a gatekeeper in the non-invasive evaluation of suspected coronary artery disease in symptomatic patients. J Nucl Cardiol 2017; 24:826-831. [PMID: 28150157 DOI: 10.1007/s12350-017-0792-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/02/2016] [Indexed: 01/07/2023]
Affiliation(s)
- Elsemiek M Engbers
- Department of Cardiology, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
- Department of Nuclear Medicine, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
| | - Jorik R Timmer
- Department of Cardiology, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - Jan Paul Ottervanger
- Department of Cardiology, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands
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Moradi M, Varasteh E. Coronary atherosclerosis evaluation among Iranian patients with zero coronary calcium score in computed tomography coronary angiography. Adv Biomed Res 2016; 5:24. [PMID: 26962526 PMCID: PMC4770603 DOI: 10.4103/2277-9175.175920] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 09/23/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Coronary artery calcification (CAC) is a specific indicator of and a sensitive marker for the atherosclerotic disease process. However, calcium scoring may miss noncalcified plaques with clinical importance. The present study aimed to identify the presence and extent of coronary plaques in computed tomography coronary angiography (CTCA) in patients with a zero CAC score and the secondary endpoint was to evaluate the association between coronary risk factors and the presence of noncalcified plaques. MATERIALS AND METHODS In a retrospective descriptive-analytic study, a total of 2000 consecutive patients who undergone CTCA between September 2012 and September 2014 at Alzahra Hospital in Isfahan, Iran were analyzed. Three hundred and eighty-five patients with a zero calcium score were included in the study. The demographic information and coronary artery disease (CAD), risk factors including diabetes mellitus (DM), hypertension, hyperlipidemia, smoking, and family history of CAD, were obtained from the questionnaire. Furthermore, the presence of plaques and extent of stenosis were evaluated in patients with zero CAC score. RESULTS Of the 385 patients with a zero calcium score, 16 (4.2%) had atherosclerotic plaques. Among them, 6 (1.6%) had significant (>50%) coronary stenosis, and 10 (2.6%) had no significant (<50%) coronary stenosis. Hyperlipidemia, DM, and smoking were significantly associated with obstructive CAD. Furthermore, in patients with zero calcium score, DM, hyperlipidemia, and smoking had odds ratios of 5.9, 14, and 32.5 for the development of coronary artery plaques, respectively. CONCLUSION Although, CAC scoring is a noninvasive and valuable method to evaluate CAD; but zero CAC score does not absolutely exclude the CAD, especially in the presence of risk factors such as diabetes, hyperlipidemia, and smoking.
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Affiliation(s)
- Maryam Moradi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Varasteh
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
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Nafakhi H, Al-Mosawi A, Al-Nafakh H, Tawfeeq N. Association of pericardial fat volume with coronary atherosclerotic disease assessed by CT angiography. Br J Radiol 2014; 87:20130713. [PMID: 24738765 DOI: 10.1259/bjr.20130713] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the association of pericardial fat volume (PFV) with coronary artery disease (CAD) in patients with intermediate pre-test probability of ischaemic heart disease assessed by coronary CT angiography. METHODS From a total of 115 consecutive Iraqi patients who underwent 64-multislice multidetector CT angiography examinations, only 74 patients (females, 38% and males, 68%) with a mean age of 54 ± 8 years were found to be eligible for statistical analysis. The patients were divided into two groups according to the median value of PFV (above and below 100 ml). RESULTS The median value of PFV in our study was 100 ml (range, 17-319 ml). A significant association was observed between high PFV and significant coronary artery stenosis (p = 0.005), between high PFV and significant left circumflex stenosis (p = 0.021) and between high PFV and the presence of coronary plaque (p = 0.005). Whereas there was no significant correlation between high PFV and coronary calcium score (p = 0.188), between high PFV and number of diseased coronary vessels (p > 0.3), and between high PFV and body weight and body mass index. CONCLUSION Increased PFV is strongly associated with the presence and severity of CAD. ADVANCES IN KNOWLEDGE Our study highlights the role of pericardial fat as an emerging biomarker in cardiovascular risk assessment and supports its association with the magnitude of CAD.
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Affiliation(s)
- H Nafakhi
- 1 Radiology and Internal Medicine Department, AL-Sader Teaching Hospital, Medicine College, Kufa University, Najaf, Iraq
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Moradi M, Adibi A, Abedi M. Relationship between breast arterial calcification on mammography with CT Calcium scoring and coronary CT angiography results. Adv Biomed Res 2014; 3:79. [PMID: 24761387 PMCID: PMC3988590 DOI: 10.4103/2277-9175.127992] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 06/17/2013] [Indexed: 12/02/2022] Open
Abstract
Background: Mammography as a non invasive method has been suggested to be helpful in predicting coronary artery disease. This study aimed to investigate whether presence and severity of breast artery calcification (BAC) on mammograms is associated with computed tomography coronary angiography (CTCA) finding such as coronary artery calcium (CAC) score and the severity of coronary artery stenosis. Materials and Methods: This cross-sectional study was performed on 150 women aged >40 years who were referred for CTCA. Women who had undergone screening mammography during the first year after CTCA entered the study. CAC score was determined and the severity of coronary artery stenosis was classified into normal, non-significant stenosis, or significant stenosis. Based on the severity of BAC, patients were also grouped into normal, mild, moderate, or severe groups. Then, the correlation between BAC severity and CAC score was determined. Patients with different BAC severity were also compared regarding the relative frequency of different grades of coronary artery stenosis. Results: Mean age of subjects with BAC (n: 35) was significantly higher than patients without BAC (n: 115) (68.03 ± 6.16 versus 54.36 ± 7.63 years, P < 0.0001). Although the relative frequency of different grades of coronary artery stenosis was significantly higher in women with BAC (P < 0.0001), after controlling for age, there was no significant difference between patients with different severity of BAC in the mean of CAC score (P: 0.09). In addition, the correlation between BAC severity and CAC score was not statistically significant (R: 0.09, P: 0.26). Conclusion: We concluded that presence and severity of BAC have no significant correlation with CAC score on CTCA.
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Affiliation(s)
- Maryam Moradi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atoosa Adibi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Abedi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
Diabetes is a global epidemic affecting individuals of all socioeconomic backgrounds. Despite intensive efforts, morbidity and mortality secondary to the micro- and macrovascular complications remain unacceptably high. As a result, the use of imaging modalities to determine the underlying pathophysiology, early onset of complications, and disease progression has become an integral component of the management of such individuals. Echocardiography, stress echocardiography, and nuclear imaging have been the mainstay of noninvasive cardiovascular imaging tools to detect myocardial ischemia, but newer modalities such as cardiac MRI, cardiac CT, and PET imaging provide incremental information not available with standard imaging. While vascular imaging to detect cerebrovascular and peripheral arterial disease non-invasively has traditionally used ultrasound, CT- and MRI-based techniques are increasingly being employed. In this review, we will provide an outline of recent studies utilizing non-invasive imaging techniques to assist in disease diagnosis as well as monitoring disease progression. In addition, we will review the evidence for newer modalities such as MR spectroscopy, 3D intravascular ultrasound, and optical coherence tomography that provide exquisite detail of metabolic function and coronary anatomy not available with standard imaging, but that have not yet become mainstream.
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Affiliation(s)
- K Levitt
- Keenan Research Centre for Biomedical Science, St Michael's hospital, University of Toronto, 209 Victoria Street, Toronto, Ontario, Canada, M5B 1C6
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Arjmand Shabestari A. Coronary artery calcium score: a review. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:e16616. [PMID: 24693399 PMCID: PMC3955514 DOI: 10.5812/ircmj.16616] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Revised: 09/25/2013] [Accepted: 09/27/2013] [Indexed: 02/06/2023]
Abstract
Context Coronary artery disease (CAD) is the foremost cause of death in many countries and hence, its early diagnosis is usually concerned as a major healthcare priority. Coronary artery calcium scoring (CACS) using either electron beam computed tomography (EBCT) or multislice computed tomography (MSCT) has been applied for more than 20 years to provide an early CAD diagnosis in clinical routine practice. Moreover, its association with other body organs has been a matter of vast research. Evidence Acquisition In this review article, techniques of CACS using EBCT and MSCT scanners as well as clinical and research indications of CACS are searched from PubMed, ISI Web of Science, Google Scholar and Scopus databases in a time period between late 1970s through July 2013 and following appropriate selection, dealt with. Moreover, the previous and ongoing research subjects and their results are discussed. Results The CACS is vastly applied in early detection of CAD and in many other research fields. Conclusions CACS has remarkably changed the screening techniques to detect CAD earlier than before and is generally accepted as a standard of reference for determination of risk of further cardiac events.
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Affiliation(s)
- Abbas Arjmand Shabestari
- Radiology Department, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran, IR Iran
- Corresponding Author: Abbas Arjmand Shabestari, Corresponding Author: Abbas Arjmand Shabestari, Radiology Department, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran, Tel.: +98-21-22083111, +98-21-88336335, Fax: +98-2122074101, E-mail:
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