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Sample records for coronary artery calcification

  1. The relationship between aortic calcification volume and obstructive coronary artery disease: comparison with coronary calcification volume

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    Kim, Dae Seok; Kim, Jeong Ho; Park, Chul Hi; Park, Seon Young; Choe, Soo Jin; Hwang, Hee Young; Kim, Hyung Sik [Gachon University Gil Medical Center, Incheon (Korea, Republic of)

    2007-12-15

    We compared the diagnostic performance of aortic calcification volume with that of coronary artery calcification volume at CT in diagnosing obstructive coronary artery disease (OCAD). A total of 308 patients (M: F 141: 167) underwent coronary CT angiography using a 64-slice MDCT. We measured the calcification volume (mm{sup 3}) of coronary artery (CAC), thoracic aorta (TAC), abdominal aorta (AAC), and whole aorta (AC) at unenhanced CT. OCAD was defined as the significant stenosis ({>=} 50%) in any coronary artery at CT angiography. The diagnostic performance for OCAD was evaluated by calculating the area under the receiver operating characteristic (ROC) curve. Among the 308 patients studied, 45 patients were diagnosed with OCAD. The mean volumes of TAC, AAC, AC, and CAC were 518.8 mm{sup 3}, 551.5 mm{sup 3}, 1069.9 mm{sup 3}, 57.6 mm{sup 3} respectively. The areas under the ROC curve of TAC, AAC, AC, and CAC for OCAD were 0.766 (0.694 < 95% confidence interval < 0.838), 0.837 (0.784 < 95% confidence interval < 0.892), 0.814 (0.755 < 95% confidence interval < 0.873), 0.871 (0.812 < 95% confidence interval < 0.930), respectively. The volume of aortic calcification as well as coronary artery calcification is associated with obstructive coronary artery disease.

  2. Matrix Gla Protein polymorphisms are associated with coronary artery calcification

    Science.gov (United States)

    Matrix Gla Protein (MGP) is a key regulator of vascular calcification. Genetic variation at the MGP locus could modulate the development of coronary artery calcification (CAC). We examined the cross-sectional association between MGP SNPs [rs1800802 (T-138C), rs1800801 (G-7A),and rs4236 (Ala102Thr)...

  3. Significance of coronary artery calcification demonstrated by computed tomography in detecting coronary artery stenosis

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    Shiraki, Teruo; Akiyama, Yoko; Kita, Masahide [Iwakuni national Hospital, Yamaguchi (Japan)] [and others

    2002-02-01

    Serial 27 patients with angina attack were enrolled in this trial. Plain computed tomography (CT) of the chest and coronary angiogram were performed simultaneously. Calcification of main branch of coronary arteies (left main trunk, left anterior desending artery, left circumflex artery, right coronary artery) was judged visually. More than 50% stenosis was defined significant by quantitative coronary angiogram. Correlation between calcified lesions detected by CT and angiographic stenoses showed high specificity and negative predictive value was also high (sensitity=58%, specificity=80%, positive predictive value=27%, negative predictive value=94%, p<0.05). There was no significant correlation between patients with calcification of corornary artery and angiographic stenosis. The present study showed the low probability of significant stenosis without calcification and the high probability with multiple calcified lesions. (author)

  4. Magnesium intake is inversely associated with coronary artery calcification: the Framingham Heart Study

    Science.gov (United States)

    OBJECTIVES: The aim of this study was to examine whether magnesium intake is associated with coronary artery calcification (CAC) and abdominal aortic calcification (AAC). BACKGROUND: Animal and cell studies suggest that magnesium may prevent calcification within atherosclerotic plaques underlying c...

  5. Breast arterial calcifications are correlated with subsequent development of coronary artery calcifications, but their aetiology is predominantly different

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    Maas, Angela H.E.M. [Department of Cardiology, Isala Klinieken, Groot Wezenland 20, 8011 JW Zwolle (Netherlands)], E-mail: a.maas@diagram-zwolle.nl; Schouw, Yvonne T. van der; Atsma, Femke [Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht (Netherlands); Beijerinck, David; Deurenberg, Jan J.M. [Preventicon Breast Cancer Screening Center, Stationsplein 91, 3511ED Utrecht (Netherlands); Mali, Willem P.Th.M. [Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht (Netherlands); Graaf, Y. van der [Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht (Netherlands)

    2007-09-15

    Objective: To study whether calcifications in breast arteries, as seen on mammograms, predict future development of coronary artery calcifications. Methods: We studied 499 women, aged 49-70 years, participating in a breast cancer screening program and investigated whether arterial calcifications in the breast (BAC) are associated with coronary arterial calcifications (CAC) after 9 years follow-up. Mammograms were reviewed for the presence of BAC. CAC was assessed by multi slice computed tomography (MSCT). With logistic regression analysis the independent effect of various risk factors on BAC and CAC was measured. Results: BAC was present in 58 of 499 women (12%) and CAC score > 0 was present in 262 of 499 women (53%). BAC was strongly associated with CAC (OR 3.2, 95% CI 1.71-6.04) and this remained significant after adjustment for age at baseline and the duration of follow-up (OR 2.1, 95% CI 1.10-4.23). Most CV risk factors were associated with CAC but not with BAC. Only parity was significantly associated with both increased CAC (OR 2.1, 95% CI 1.21-3.60) and increased BAC (OR 5.3, 95% CI 1.23-22.43). Breastfeeding was associated with BAC (OR 3.4, 95% CI 1.40-8.23) but not with CAC (OR 1.3, 95% CI 0.84-1.93). Conclusion: Breast arterial calcifications are predictive of subsequent development of calcifications in the coronary arteries.

  6. [Multidetector row CT in assessment of coronary artery calcification on hemodialisis].

    Science.gov (United States)

    Caro, P; Delgado, R; Dapena, F; Núñez, A

    2007-01-01

    Vascular calcification is a strong predictor of cardiovascular and all-cause mortality. Coronary artery calcification is more frequent, more extensive and progresses more rapidly in CKD than in general population. They are also considered a marker of coronary heart disease, with high prevalence and functional significance. It suggests that detection and surveillance may be worthwhile in general clinical practice. New non-invasive image techniques, like Multi-detector row CT, a type of spiral scanner, assess density and volume of calcification at multiple sites and allow quantitative scoring of vascular calcification using calcium scores analogous to those from electron-beam CT. We have assessed and quantified coronary artery calcification with 16 multidetector row CT in 44 patients on hemodialysis and their relationship with several cardiovascular risk factors. Coronary artery calcification prevalence was of 84 % with mean calcium score of 1580 +/- 2010 ( r 0-9844) with calcium score > 400 in 66% of patients. It was usually multiple, affecting more than two vessels in more than 50%. In all but one patient, left anterior descending artery was involved with higher calcium score level at right coronary artery. Advanced age, male, diabetes, smoking, more morbidity, cerebrovascular disease previous, and calcium-binders phosphate and analogous vitamin D treatment would seem to be associated with coronary artery calcification. Coronary artery calcification is very frequent and extensive, usually multiple and associated to modifiable risk factors in hemodialysis patients. Multi-detector-row CT seems an effective, suitable, readily applicable method to assess and quantify coronary artery calcification.

  7. Genome-Wide Association Study for Coronary Artery Calcification With Follow-Up in Myocardial Infarction

    NARCIS (Netherlands)

    O'Donnell, Christopher J.; Kavousi, Maryam; Smith, Albert V.; Kardia, Sharon L. R.; Feitosa, Mary F.; Hwang, Shih-Jen; Sun, Yan V.; Province, Michael A.; Aspelund, Thor; Dehghan, Abbas; Hoffmann, Udo; Bielak, Lawrence F.; Zhang, Qunyuan; Eiriksdottir, Gudny; van Duijn, Cornelia M.; Fox, Caroline S.; de Andrade, Mariza; Kraja, Aldi T.; Sigurdsson, Sigurdur; Elias-Smale, Suzette E.; Murabito, Joanne M.; Launer, Lenore J.; van der Lugt, Aad; Kathiresan, Sekar; Krestin, Gabriel P.; Herrington, David M.; Howard, Timothy D.; Liu, Yongmei; Post, Wendy S.; Mitchell, Braxton D.; O'Connell, Jeffrey R.; Shen, Haiqing; Shuldiner, Alan R.; Altshuler, David; Elosua, Roberto; Salomaa, Veikko; Schwartz, Stephen M.; Siscovick, David S.; Voight, Benjamin F.; Bis, Joshua C.; Glazer, Nicole L.; Psaty, Bruce M.; Boerwinkle, Eric; Heiss, Gerardo; Blankenberg, Stefan; Zeller, Tanja; Wild, Philipp S.; Schnabel, Renate B.; Schillert, Arne; Ziegler, Andreas; Muenzel, Thomas; White, Charles C.; Rotter, Jerome I.; Nalls, Michael; Oudkerk, Matthijs; Johnson, Andrew D.; Newman, Anne B.; Uitterlinden, Andre G.; Massaro, Joseph M.; Cunningham, Julie; Harris, Tamara B.; Hofman, Albert; Peyser, Patricia A.; Borecki, Ingrid B.; Cupples, L. Adrienne; Gudnason, Vilmundur; Witteman, Jacqueline C. M.

    2011-01-01

    Background-Coronary artery calcification (CAC) detected by computed tomography is a noninvasive measure of coronary atherosclerosis, which underlies most cases of myocardial infarction (MI). We sought to identify common genetic variants associated with CAC and further investigate their associations

  8. Association of Aortic Calcification on Plain Chest Radiography with Obstructive Coronary Artery Disease

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    Kang, Yeong Han; Chang, Jeong Ho [Dept. of Diagnostic Radiology, Daegu Catholic University Hospital, Daegu (Korea, Republic of); Park, Jong Sam [Dept. of Radiologic Tecnology, Daegu Health College, Daegu (Korea, Republic of)

    2009-03-15

    This study was conducted to determine an association between aortic calcification viewed on plain chest radiography and obstructive coronary artery disease. Retrospective review of all chest radiography obtained from consecutive patients undergoing coronary angiography. Chest PA images were reviewed by technical radiologist and radiologist. Considering the presence of aortic arch calcification, images were compared with the results of coronary angiography. In addition, the size of aortic arch calcification were divided into two groups - the smaller and the larger than 10 mm. Among the total 846 patients, the number of the patients with obstructive coronary artery disease is total 417 (88.3%) in males and 312 (83.4%) in females. Considering the presence of aortic arch calcification, the positive predictive value of relation between aortic arch calcification and obstructive coronary artery disease was 91.4% and the relative risk of the group with aortic arch calcification to the opposite group was 1.10. According to the size of aortic arch calcification and obstructive coronary artery disease, the positive predictive value was 91.9% and the relative risk between two groups was 1.04. This study shows that aortic calcification was closely associated with obstructive coronary artery disease. If the aortic calcification is notified on plain chest radiography, we strongly recommend to consult with doctor.

  9. The role of coronary artery calcification score in clinical practice

    Directory of Open Access Journals (Sweden)

    Willems Tineke P

    2008-12-01

    Full Text Available Abstract Background Coronary artery calcification (CAC measured by electron-beam computed tomography (EBCT has been well studied in the prediction of coronary artery disease (CAD. We sought to evaluate the impact of the CAC score in the diagnostic process immediately after its introduction in a large tertiary referral centre. Methods 598 patients with no history of CAD who underwent EBCT for evaluation of CAD were retrospectively included into the study. Ischemia detection test results (exercise stress test, single photon emission computed tomography or ST segment analysis on 24 hours ECG detection, as well as the results of coronary angiography (CAG were collected. Results The mean age of the patients was 55 ± 11 years (57% male. Patients were divided according to CAC scores; group A Conclusion Our study showed that patients with a high CAC score are more often referred for CAG. The CAC scores can be used as an aid in daily cardiology practice to determine further decision making.

  10. Coronary artery calcification (CAC) classification with deep convolutional neural networks

    Science.gov (United States)

    Liu, Xiuming; Wang, Shice; Deng, Yufeng; Chen, Kuan

    2017-03-01

    Coronary artery calcification (CAC) is a typical marker of the coronary artery disease, which is one of the biggest causes of mortality in the U.S. This study evaluates the feasibility of using a deep convolutional neural network (DCNN) to automatically detect CAC in X-ray images. 1768 posteroanterior (PA) view chest X-Ray images from Sichuan Province Peoples Hospital, China were collected retrospectively. Each image is associated with a corresponding diagnostic report written by a trained radiologist (907 normal, 861 diagnosed with CAC). Onequarter of the images were randomly selected as test samples; the rest were used as training samples. DCNN models consisting of 2,4,6 and 8 convolutional layers were designed using blocks of pre-designed CNN layers. Each block was implemented in Theano with Graphics Processing Units (GPU). Human-in-the-loop learning was also performed on a subset of 165 images with framed arteries by trained physicians. The results from the DCNN models were compared to the diagnostic reports. The average diagnostic accuracies for models with 2,4,6,8 layers were 0.85, 0.87, 0.88, and 0.89 respectively. The areas under the curve (AUC) were 0.92, 0.95, 0.95, and 0.96. As the model grows deeper, the AUC or diagnostic accuracies did not have statistically significant changes. The results of this study indicate that DCNN models have promising potential in the field of intelligent medical image diagnosis practice.

  11. Associations between calcium-phosphate metabolism and coronary artery calcification

    DEFF Research Database (Denmark)

    Grønhøj, Mette H; Gerke, Oke; Mickley, Hans;

    2016-01-01

    calcium-phosphate metabolism is associated with the presence and extent of coronary artery calcification (CAC) in asymptomatic and apparently healthy individuals. METHODS: Serum samples from 1088 randomly recruited middle-aged men and women without known CVD and diabetes (DM), from the general population......, were analysed for total calcium, phosphate, parathyroid hormone (PTH) and 25-hydroxyvitamin D (25(OH)D). CAC was measured by a non-contrast cardiac CT scan and categorised into four groups: 0, 1-99, 100-399, ≥400 Agatston units. The association of calcium-phosphate metabolism with CAC was evaluated......)D values were placed within the normal range. In men, the odds of being in a higher CAC category, i.e. having more severe CAC, increased by 30% when serum calcium concentration increased by 0.1 mmol/l (95% CI: 1.04-1.61, p = 0.019), independently of traditional cardiovascular risk factors. In women...

  12. Mitral annular calcification and aortic valve calcification may help in predicting significant coronary artery disease.

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    Acartürk, Esmeray; Bozkurt, Abdi; Cayli, Murat; Demir, Mesut

    2003-01-01

    Mitral annular calcification (MAC) and aortic valve calcification (AVC) are manifestations of atherosclerosis. To determine whether mitral annular calcification and aortic valve calcification detected by transthoracic echocardiography (TTE) might help in predicting significant coronary artery disease (CAD), 123 patients with significant CAD and 93 patients without CAD detected by coronary angiography were investigated. MAC and AVC identified CAD with a sensitivity and specificity of 60.2%, 55.9% and 74.8%, 52.7%, respectively, and with a negative and a positive predictive values of 51.5%, 64.3% and 61.3% and 67.6%, respectively. The positive predictive value of MAC was greater than gender, hypertension, and hypercholesterolemia. AVC showed a positive predictive value greater than gender, hypertension, family history, and hypercholesterolemia. The negative predictive values of MAC and AVC for CAD were greater than those of all risk factors except diabetes mellitus. In conclusion, presence of MAC and AVC on TTE may help in predicting CAD and should be added to conventional risk factors. Absence of MVC and AVC is a stronger predictor for absence of CAD than all conventional risk factors, except diabetes mellitus. Patients with MAC and AVC should be taken into consideration for the presence of significant CAD and thereby for diagnostic and therapeutic interventions in order to improve the prognosis.

  13. The Association Between Serum Magnesium Concentrations and Coronary Artery Calcification Scores in Astronauts

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    Betcher, Jenna; Zwart, Sara; Smith, Scott M.

    2016-01-01

    Magnesium is a natural calcium antagonist, and is inversely associated with coronary heart disease, cardiovascular mortality rates, and vascular calcification. Coronary artery calcification score is a tool used to evaluate the prognosis of coronary artery disease in individuals. Higher magnesium intake is associated with lower coronary artery calcification scores (CACS), and recent studies have found a significant inverse relationship between serum magnesium concentrations and CACS in Korean and Mexican-mestizo populations. The correlation between serum magnesium concentrations and CACS is not well researched, so our aim was to examine this relationship in astronauts. We found that a higher serum magnesium concentration is significantly related to a higher coronary artery calcification score (p=.0217), and that there is a significant difference in magnesium concentrations of subjects who have a CACS greater than 100 and a CACS less than 100.

  14. Relationship between the arterial calcification detected in mammography and coronary artery disease

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    Topal, Ugur [Department of Radiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey)], E-mail: utopal@uludag.edu.tr; Kaderli, Aysel [Department of Cardiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Topal, Naile Bolca [Department of Radiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Ozdemir, Buelent; Yesilbursa, Dilek; Cordan, Jale [Department of Cardiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Ediz, Buelent [Department of Statistics, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Aydinlar, Ali [Department of Cardiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey)

    2007-09-15

    Objective: Arterial calcification is frequently encountered in mammography. The frequency of breast arterial calcification (BAC) increases with increasing age. Studies have shown that BAC is seen more frequently among the people who are under the risk of coronary artery diseases (CAD) such as diabetes and hypertension. The objective of this study is to investigate the relationship between the arterial calcification detected in mammography and the CAD. Material and methods: Screening mammography was performed in 123 women above the age of 40 years who had been examined with coronary angiography for the evaluation of CAD. The presence of BAC, number of affected vessels, and the distribution of calcification in the vessel wall were evaluated in the mammography. Subjects were questioned in terms of the cardiovasculary risk factors. The severity of CAD was evaluated according to the Gensini scoring. In addition, the number of blood vessels with stenosis of more than 50% was used as the vascular score. The correlation between Gensini and the vascular scores, and BAC was statistically evaluated using Mann-Whitney U and Kruskal-Wallis tests. Results: Eighty (65%) of 123 patients had CAD. BAC was detected in the mammography of 49 (39.8%) subjects. The ages and duration of menopause of the cases with BAC were significantly higher than those without BAC (p < 0.001). There was an almost significant correlation between the BAC and Gensini scores (p = 0.059). There was a significant increase in the frequency of BAC among subjects with more than two vessels with stenosis (p = 0.033). Conclusion: Frequency of BAC increases with increasing age. BAC is also frequently seen in subjects having severe coronary artery disease. Although increasing age may be a factor increasing the frequency of BAC, BAC may also be an indicator of CAD. Therefore, the mentioning of arterial calcification in mammography reports may be important in warning the clinician in terms of CAD.

  15. Association between metabolic syndrome, smoking status and coronary artery calcification.

    Science.gov (United States)

    Lee, Yun-Ah; Kang, Sung-Goo; Song, Sang-Wook; Rho, Jun-Seung; Kim, Eun-Kyung

    2015-01-01

    Coronary artery calcification (CAC), an indicator of coronary artery stenosis, is an independent risk factor of ischemic heart disease. Smoking increases the risk of metabolic syndrome (MS) and cardiovascular disease. Almost no previous studies have evaluated the combined effect of MS and smoking status on CAC. Therefore, in this study we examined the relationships between CAC, MS, and smoking. This study included 775 adult males without histories of cardiovascular disease who visited the Health Promotion Center at the University Hospital in Gyeonggi-do, Republic of Korea from January 2, 2010 to December 31, 2012. All subjects were screened for CAC by multi-detector computed tomography (MDCT). CAC increased significantly with age and body mass index (BMI). Among MS components, abdominal obesity and elevated fasting blood glucose were correlated with CAC. After adjusting for age and BMI, MS was associated with a 1.46-fold increase in CAC (95% CI:1.02-2.09), abdominal obesity was associated with a 1.45-fold increase (95% CI:1.04-2.04), elevated fasting blood glucose was associated with a 2-fold increase (95% CI:1.36-2.94), and MS and smoking combined were associated with 2.44-fold increase in CAC. Thus, the combination of smoking and MS had a greater impact on CAC than any single factor alone. MS is correlated with an increased risk of CAC, and a combination of MS and smoking is associated with even greater risk. These findings can be used to prevent cardiovascular disease in adults.

  16. Diagnostic accuracy of computed tomography coronary angiography according to pre-test probability of coronary artery disease and severity of coronary arterial calcification. The CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) International Multicenter Study

    National Research Council Canada - National Science Library

    Arbab-Zadeh, Armin; Miller, Julie M; Rochitte, Carlos E; Dewey, Marc; Niinuma, Hiroyuki; Gottlieb, Ilan; Paul, Narinder; Clouse, Melvin E; Shapiro, Edward P; Hoe, John; Lardo, Albert C; Bush, David E; de Roos, Albert; Cox, Christopher; Brinker, Jeffrey; Lima, Joăo A C

    2012-01-01

    ...) to detect obstructive coronary artery disease (CAD). The ability of CTA to exclude obstructive CAD in patients of different pre-test probabilities and in presence of coronary calcification remains uncertain. For the CORE-64...

  17. Coronary Artery Calcification in Japanese Men in Japan and Hawaii

    Science.gov (United States)

    Abbott, Robert D.; Ueshima, Hirotsugu; Rodriguez, Beatriz L.; Kadowaki, Takashi; Masaki, Kamal H.; Willcox, Bradley J.; Sekikawa, Akira; Kuller, Lewis H.; Edmundowicz, Daniel; Shin, Chol; Kashiwagi, Atsunori; Nakamura, Yasuyuki; El-Saed, Aiman; Okamura, Tomonori; White, Roger; Curb, J. David

    2013-01-01

    Explanations for the low prevalence of atherosclerosis in Japan versus United States are often confounded with genetic variation. To help remove such confounding, coronary artery calcification (CAC), a marker of subclinical atherosclerosis, was compared between Japanese men in Japan and Japanese men in Hawaii. Findings are based on risk factor and CAC measurements that were made from 2001 to 2005 in 311 men in Japan and 300 men in Hawaii. Men were aged 40 to 50 years and without cardiovascular disease. After age-adjustment, there was a 3-fold excess in the odds of prevalent CAC scores ≥10 in Hawaii versus Japan (relative odds [RO] = 3.2; 95% confidence interval [CI] = 2.1,4.9). While men in Hawaii had a generally poorer risk factor profile, men in Japan were 4-times more likely to smoke cigarettes (49.5 vs. 12.7%, pHawaii versus Japan was 4.0 (95% CI = 2.2,7.4). Further studies are needed to identify factors that offer protection against atherosclerosis in Japanese men in Japan. PMID:17728270

  18. Cardiorespiratory Fitness and Coronary Artery Calcification in Young Adults: The CARDIA Study

    OpenAIRE

    Lee, Chong-Do; Jacobs, David R; Hankinson, Arlene; Iribarren, Carlos; SIDNEY, Stephen

    2008-01-01

    Whether cardiorespiratory fitness relates to early subclinical atherosclerotic vascular disease remains unknown. We investigated the relation of cardiorespiratory fitness to coronary artery calcification (CAC) in 2373 African-American and White young adults from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. We measured cardiorespiratory fitness in 1985-1986 (baseline) using a symptom-limited exercise test on a treadmill. Coronary calcium scores were measured in 2001-200...

  19. Genetics of coronary artery calcification among African Americans, a meta-analysis

    NARCIS (Netherlands)

    M.K. Wojczynski (Mary ); M. Li (Mingyao); L.F. Bielak (Lawrence F.); K.F. Kerr (Kathleen); A. Reiner (Alexander); N.D. Wong (Nathan); L.R. Yanek (Lisa); L. Qu (Liming); C.C. White (Charles); L.A. Lange (Leslie); J.F. Ferguson (Jane); J. He (Jing); T. Young (Taylor); T.H. Mosley (Thomas); J.A. Smith (Jennifer A); B.G. Kral (Brian); X. Guo (Xiuqing); Q. Wong (Quenna); S.K. Ganesh (Santhi); S.R. Heckbert (Susan); M.D. Griswold (Michael); D.H. O'Leary (Daniel H.); M.J. Budoff (Matthew); J. Carr (Jeffrey); H.A. Taylor (Herman); D.A. Bluemke (David); S. Demissie (Serkalem); S.-J. Hwang (Shih-Jen); D.N. Paltoo (Dina); J.F. Polak (Joseph F.); B.M. Psaty (Bruce); D.M. Becker (Diane); M.A. Province (Mike); W.S. Post (Wendy S.); C.J. O'Donnell (Christopher); J.G. Wilson (James); T.B. Harris (Tamara); M. Kavousi (Maryam); L.A. Cupples (Adrienne); J.I. Rotter (Jerome); M. Fornage (Myriam); L.C. Becker (Lewis); P.A. Peyser (Patricia A.); I.B. Borecki (Ingrid); M.P. Reilly (Muredach)

    2013-01-01

    textabstractBackground: Coronary heart disease (CHD) is the major cause of death in the United States. Coronary artery calcification (CAC) scores are independent predictors of CHD. African Americans (AA) have higher rates of CHD but are less well-studied in genomic studies. We assembled the largest

  20. Renal Function Is Related to Severity of Coronary Artery Calcification in Elderly Persons : The Rotterdam Study

    NARCIS (Netherlands)

    el Barzouhi, Abdelilah; Elias-Smale, Suzette; Dehghan, Abbas; Vliegenthart-Proenca, Rozemarijn; Oudkerk, Matthijs; Hofman, Albert; Witteman, Jacqueline C. M.

    2011-01-01

    Background: Coronary artery calcification (CAC) has been proposed to be the underlying mechanism of the increased risk of coronary heart disease with reductions in glomerular filtration rate (GFR). Since renal function diminishes with aging we examined the association between GFR and CAC in the Rott

  1. Coronary artery calcification in Korean patients with incident dialysis.

    Science.gov (United States)

    Bae, Eunjin; Seong, Eun Yong; Han, Byoung-Geun; Kim, Dong Ki; Lim, Chun Soo; Kang, Shin-Wook; Park, Cheol Whee; Kim, Chan-Duck; Shin, Byung Chul; Kim, Sung Gyun; Chung, Wookyung; Park, Jae Yoon; Lee, Joo Yeon; Kim, Yon Su

    2016-10-05

    Introduction Patients with chronic kidney disease have an extremely high risk of developing cardiovascular disease (CVD). In patients with end-stage renal disease (ESRD), coronary artery calcification (CAC) is associated with increased mortality from CVD. Methods The present study aimed to investigate the risk factors for CAC in Korean patients with incident dialysis. Data on 423 patients with ESRD who started dialysis therapy between December 2012 and March 2014 were obtained from 10 university-affiliated hospitals. CAC was identified by using noncontrast-enhanced cardiac multidetector computed tomography. The CAC score was calculated according to the Agatston score, with CAC-positive subjects defined by an Agatston score >0. Findings Patients' mean age was 55.6 ± 14.6 years, and 64.1% were men. The CAC-positive rate was 63.8% (270 of 423). Results of univariate analyses showed significant differences in age, sex, etiology of ESRD and comorbid conditions according to the CAC score. However, results of multiple regression analysis showed that only a higher age was significantly associated with the CAC score. Receiver operating characteristic curves showed that the sensitivity and specificity of L-spine radiography for diagnosing CAC were 56% and 91%, respectively, for diagnosing CAC (area under the curve, 0.735). Discussion CAC was frequent in patients with incident dialysis, and multiple regression analysis showed that only age was significantly associated with the CAC score. In addition, L-spine radiography could be a helpful modality for diagnosing CAC in patients with incident dialysis.

  2. Pathology of Human Coronary and Carotid Artery Atherosclerosis and Vascular Calcification in Diabetes Mellitus.

    Science.gov (United States)

    Yahagi, Kazuyuki; Kolodgie, Frank D; Lutter, Christoph; Mori, Hiroyoshi; Romero, Maria E; Finn, Aloke V; Virmani, Renu

    2017-02-01

    The continuing increase in the prevalence of diabetes mellitus in the general population is predicted to result in a higher incidence of cardiovascular disease. Although the mechanisms of diabetes mellitus-associated progression of atherosclerosis are not fully understood, at clinical and pathological levels, there is an appreciation of increased disease burden and higher levels of arterial calcification in these subjects. Plaques within the coronary arteries of patients with diabetes mellitus generally exhibit larger necrotic cores and significantly greater inflammation consisting mainly of macrophages and T lymphocytes relative to patients without diabetes mellitus. Moreover, there is a higher incidence of healed plaque ruptures and positive remodeling in hearts from subjects with type 1 diabetes mellitus and type 2 diabetes mellitus, suggesting a more active atherogenic process. Lesion calcification in the coronary, carotid, and other arterial beds is also more extensive. Although the role of coronary artery calcification in identifying cardiovascular disease and predicting its outcome is undeniable, our understanding of how key hormonal and physiological alterations associated with diabetes mellitus such as insulin resistance and hyperglycemia influence the process of vascular calcification continues to grow. Important drivers of atherosclerotic calcification in diabetes mellitus include oxidative stress, endothelial dysfunction, alterations in mineral metabolism, increased inflammatory cytokine production, and release of osteoprogenitor cells from the marrow into the circulation. Our review will focus on the pathophysiology of type 1 diabetes mellitus- and type 2 diabetes mellitus-associated vascular disease with particular focus on coronary and carotid atherosclerotic calcification.

  3. Effect of type 1 diabetes on the gender difference in coronary artery calcification: a role for insulin resistance? The Coronary Artery Calcification in Type 1 Diabetes (CACTI) Study.

    Science.gov (United States)

    Dabelea, Dana; Kinney, Gregory; Snell-Bergeon, Janet K; Hokanson, John E; Eckel, Robert H; Ehrlich, James; Garg, Satish; Hamman, Richard F; Rewers, Marian

    2003-11-01

    The objective of this is study was to examine whether estimated insulin resistance and insulin resistance-related factors are associated with coronary artery calcification (CAC) in 1,420 asymptomatic participants in the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study. A total of 656 patients with type 1 diabetes and 764 control subjects aged 20-55 years were examined. CAC was assessed by electron-beam computed tomography. Insulin resistance was computed with linear regression based on an equation previously validated in clamp studies on type 1 diabetic adults. Insulin resistance was associated with CAC (OR 1.6 in type 1 diabetes and 1.4 in control subjects, P < 0.001), independent of coronary artery disease risk factors. There was a male excess of CAC in control subjects (OR 2.7, adjusted for age, smoking, and LDL and HDL cholesterol levels) and in type 1 diabetic patients (OR 2.2, adjusted for the same factors and diabetes duration). After adjusting for insulin resistance, the CAC male excess in diabetic patients decreased from OR 2.2 (P < 0.001) to 1.8 (P = 0.04). After adjustment for waist-to-hip ratio, waist circumference, or visceral fat, the gender difference in CAC was not significant in diabetic subjects. In conclusion, gender differences in insulin resistance-associated fat distribution may explain why type 1 diabetes increases coronary calcification in women relatively more than in men.

  4. Traditional Cardiovascular Risk Factors and Coronary Artery Calcification in Adults With Polymyositis and Dermatomyositis

    DEFF Research Database (Denmark)

    Diederichsen, Louise P; Diederichsen, Axel C P; Simonsen, Jane A

    2015-01-01

    OBJECTIVE: To determine the occurrence of traditional cardiovascular (CV) risk factors and coronary artery calcification (CAC) in adults with polymyositis (PM) or dermatomyositis (DM) compared to healthy controls and to assess the association between CV risk factors, PM/DM, and CAC score. METHODS...

  5. Calcium intake is not associated with increased coronary artery calcification: The Framingham Study

    Science.gov (United States)

    Adequate calcium intake is known to protect the skeleton. However, studies that have reported adverse effects of calcium supplementation on vascular events have raised widespread concern. We assessed the association between calcium intake (from diet and supplements) and coronary artery calcification...

  6. Coronary artery calcification scoring in low-dose ungated CT screening for lung cancer: interscan agreement.

    NARCIS (Netherlands)

    Jacobs, P.C.; Isgum, I.; Gondrie, M.J.; Mali, W.P.Th.; Ginneken, B. van; Prokop, M.; Graaf, Y. van der

    2010-01-01

    OBJECTIVE: In previous studies detection of coronary artery calcification (CAC) with low-dose ungated MDCT performed for lung cancer screening has been compared with detection with cardiac CT. We evaluated the interscan agreement of CAC scores from two consecutive low-dose ungated MDCT examinations.

  7. Coronary Artery Calcification Scoring in Low-Dose Ungated CT Screening for Lung Cancer : Interscan Agreement

    NARCIS (Netherlands)

    Jacobs, Peter C. A.; Isgum, Ivana; Gondrie, Martijn J. A.; Mali, Willem P. Th. M.; van Ginneken, Bram; Prokop, Mathias; van der Graaf, Yolanda

    2010-01-01

    OBJECTIVE. In previous studies detection of coronary artery calcification (CAC) with low-dose ungated MDCT performed for lung cancer screening has been compared with detection with cardiac CT. We evaluated the interscan agreement of CAC scores from two consecutive low-dose ungated MDCT examinations.

  8. Increased risk for intracranial arterial stenosis in subjects with coronary artery calcification.

    Science.gov (United States)

    Oh, Hyung-Geun; Chung, Pil-Wook; Rhee, Eun-Jung

    2015-01-01

    Intracranial arterial stenosis (ICAS) is considered an important cause of stroke in Asians. Coronary artery calcification (CAC) is a surrogate marker for subclinical atherosclerosis. We aimed to analyze the association of ICAS assessed by transcranial Doppler ultrasonography and CAC in middle-aged Korean population. This study included 10 550 participants (81.3% men, mean age 43 years) from a health screening program, in whom transcranial Doppler ultrasonography was used to detect >50% intracranial stenosis based on criteria modified from the stroke outcomes and neuroimaging of intracranial atherosclerosis trial. Multidetector computed tomography was used to assess coronary artery calcium score (CACS). CAC grade (0, 1-100, and >100) was defined by CACS. The subjects with CAC showed significantly higher proportion of subjects with ICAS compared with those without CAC (4.4% versus 2.8%; P400 compared with those with CACS=0 (odds ratio, 2.754; 95% confidence interval, 1.205-2.936). The risk for ICAS was significantly increased in middle-aged Korean subjects with CAC compared with that in those without CAC. These findings suggest the possibility of a separate undetected atherosclerotic focus in subjects with 1 atherosclerotic event. © 2014 American Heart Association, Inc.

  9. Aortic root, not valve, calcification correlates with coronary artery calcification in patients with severe aortic stenosis: A two-center study.

    Science.gov (United States)

    Henein, Michael; Hällgren, Peter; Holmgren, Anders; Sörensen, Karen; Ibrahimi, Pranvera; Kofoed, Klaus Fuglsang; Larsen, Linnea Hornbech; Hassager, Christian

    2015-12-01

    The underlying pathology in aortic stenosis (AS) and coronary artery stenosis (CAS) is similar including atherosclerosis and calcification. We hypothesize that coronary artery calcification (CAC) is likely to correlate with aortic root calcification (ARC) rather than with aortic valve calcification (AVC), due to tissue similarity between the two types of vessel rather than with the valve leaflet tissue. We studied 212 consecutive patients (age 72.5 ± 7.9 years, 91 females) with AS requiring aortic valve replacement (AVR) in two Heart Centers, who underwent multidetector cardiac CT preoperatively. CAC, AVC and ARC were quantified using Agatston scoring. Correlations were tested by Spearman's test and Mann-Whitney U-test was used for comparing different subgroups; bicuspid (BAV) vs tricuspid (TAV) aortic valve. CAC was present in 92%, AVC in 100% and ARC in 82% of patients. CAC correlated with ARC (rho = 0.51, p coronary arteries correlated with ARC (rho = 0.45, p coronary stenosis (>50%), but these were not different in the pattern of calcification from those without CAS. CAC was consistently higher in patients with risk factors for atherosclerosis compared to those without. The observed relationship between coronary and aortic root calcification suggests a diffuse arterial disease. The lack of relationship between coronary and aortic valve calcification suggests a different pathology. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Inverse relationship between bioavailable testosterone and subclinical coronary artery calcification in non-obese Korean men

    Institute of Scientific and Technical Information of China (English)

    Byoung-Jin Park; Jae-Yong Shim; Yong-Jae Lee; Jung-Hyun Lee; Hye-Ree Lee

    2012-01-01

    Although low testosterone levels in men have been associated with high risk for cardiovascular disease,little is known about the association between male sex hormones and subclinical coronary disease in men with apparently low cardiometabolic risk.This study was performed to investigate the association between male sex hormones and subclinical coronary artery calcification measured as coronary calcium score in non-obese Korean men.We examined the relationship of total testosterone,sex hormone-binding globulin,bioavai lable testosterone and free testosterone with coronary calcium score in 291 non-obese Korean men (mean age:52.8±9.3 years)not having a history of cardiovascular disease.Using multiple linear regression,we evaluated associations between log (sex hormone)levels and log (coronary calcium score) after adjusting for confounding variables in 105 men with some degree of coronary calcification defined as coronary calcium score ≥ 1.In multiple linear regression analysis,bioavailable testosterone was inversely associated with coronary calcium score (P=0.046) after adjusting for age,body mass index,smoking status,alcohol consumption,regular exercise,mean blood pressure,resting heart rate,C-reactive protein,fasting plasma glucose,total cholesterol,triglyceride,high-density lipoprotein (HDL) cholesterol,hypertension medication and hyperlipidemia medication,whereas total testosterone,sex hormone-binding globulin and free testosterone were not (P=0.674,P=0.121 and P=0.102,respectively).Our findings indicate that bioavailable testosterone is inversely associated with the degree of subclinical coronary artery calcification in non-obese men.

  11. Relation of heart rate recovery after exercise testing to coronary artery calcification.

    Science.gov (United States)

    Jae, Sae Young; Kurl, Sudhir; Laukkanen, Jari A; Yoon, Eun Sun; Choi, Yoon-Ho; Fernhall, Bo; Franklin, Barry A

    2017-08-01

    We examined whether slow heart rate recovery (HRR) after exercise testing as an estimate of impaired autonomic function is related to coronary artery calcification (CAC), an emerging marker of coronary atherosclerosis. We evaluated 2088 men who participated in a health-screening program that included measures of CAC and peak or symptom-limited cardiopulmonary exercise testing. HRR was calculated as the difference between peak heart rate (HR) during exercise testing and the HR at 2 min of recovery after peak exercise. We measured CAC using multidetector computed tomography to calculate the Agatston coronary artery calcium score. Advanced CAC was defined as a mean CAC >75th percentile for each age group. HRR was negatively correlated with CAC (r = -.14, p 52 bpm). Each 1 bpm decrease in HRR was associated with 1% increase in advanced CAC after adjusting for potential confounders. An attenuated HRR after exercise testing is associated with advanced CAC, independent of coronary risk factors and other related hemodynamic response. KEY MESSAGES Slow heart rate recovery (HRR) after maximal exercise testing, indicating decreased autonomic function, is associated with an increased risk of cardiovascular event and mortality. Slow HRR has been linked with the occurrence of malignant ventricular arrhythmias, but it remains unclear whether slow HRR is associated with an increased risk of coronary artery calcification (CAC), an emerging marker of coronary atherosclerosis. An attenuated HRR after exercise testing was associated with advanced CAC, independent of coronary risk factors and other potential hemodynamic confounder, supporting the hypothesis that slow HRR is related to the burden of atherosclerotic coronary artery disease.

  12. Correlates and Impact of Coronary Artery Calcifications in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents

    DEFF Research Database (Denmark)

    Giustino, Gennaro; Mastoris, Ioannis; Baber, Usman

    2016-01-01

    OBJECTIVES: The aim of this study was to investigate the clinical correlates and prognostic impact of coronary artery calcification (CAC) in women undergoing percutaneous coronary intervention with drug-eluting stents (DES). BACKGROUND: The clinical correlates and the prognostic significance of CAC...... in women undergoing percutaneous coronary intervention with DES remain unclear. METHODS: Patient-level data from female participants in 26 randomized trials of DES were pooled. Study population was categorized according to the presence of moderate or severe versus mild or no target lesion CAC, assessed......,371 women. Of these, 1,622 (25.5%) had moderate or severe CAC. In fully adjusted models, independent correlates of CAC were age, hypertension, hypercholesterolemia, smoking, previous coronary artery bypass graft surgery, and worse left ventricular and renal function. At 3 years, women with CAC were...

  13. Pericardial adipose tissue and coronary artery calcification in the Multi-ethnic Study of Atherosclerosis (MESA).

    Science.gov (United States)

    McClain, Jill; Hsu, Fang; Brown, Elizabeth; Burke, Gregory; Carr, John; Harris, Tamara; Kritchevsky, Stephen; Szklo, Moyses; Tracy, Russell; Ding, Jingzhong

    2013-05-01

    To examine the relationship of pericardial adipose tissue (PAT) with coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis. The baseline cohort comprised 6,814 Caucasian (38%), African-American (28%), Chinese American (12%), and Hispanic (22%) adults aged 45-84, without known clinical cardiovascular disease. Cardiac CT was used to measure PAT (cm(3) ) and calcification (Agatston score). We examined cross-sectional associations of PAT with the presence (score >0) and severity (continuous score if >0) of calcification using prevalence ratio (PR) (n = 6,672) and linear regression (n = 3,362), respectively. Main models were adjusted for age, age(2) , gender, race/ethnicity, field site, smoking, physical activity, alcohol, and education. PAT volume (adjusted for age, height, weight, and site) was greatest in Chinese males, whereas Black males had less PAT than all but Black females. PAT was associated with presence [PR per standard deviation (SD): 1.06 (95% CI: 1.04, 1.08)] and severity [difference in log Agatston score per SD: 0.15 (0.09, 0.21)] of calcification, but neither association varied by race/ethnicity. Adjustment for generalized adiposity attenuated but did not eliminate the associations. With further adjustment for traditional risk factors and inflammatory markers, only the association with severity remained statistically significant [PR: 1.02 (1.00, 1.04); difference: 0.10 (0.03, 0.17)]. Heterogeneity by sex was observed for the presence of calcification (PR in men: 1.04; in women: 1.08; P for interaction PAT was associated with the presence and severity of coronary artery calcification in this cohort, but neither association varied by race/ethnicity. Copyright © 2013 The Obesity Society.

  14. Relationship between coronary artery calcification and osteopenic syndrome in men with coronary heart disease

    Directory of Open Access Journals (Sweden)

    T. A. Raskina

    2016-01-01

    Full Text Available Objective: to investigate the relationship between coronary artery calcification (CAC and osteopenic syndrome in men with coronary heart disease (CHD.Subjects and methods. A total of 102 men aged 51 to 75 years (mean age 61 (55; 65 years with verified CHD were examined. Bone mineral density (BMD and its T-score of LI–IV and femoral neck were determined by dual-energy X-ray absorptiometry. According to the T-score, the men were divided into 3 groups: 1 33 (32.4% patients with osteoporosis (OP (T-score <-2.5; 2 48 (47.0% patients with osteopenia (OSP (T-score -1 to -2.5 and 3 21 (20.6% examinees with normal BMD (NBMD (T-score ≥-1. In all the patients, CAC was quantified by multislice spiral computed tomography. The investigators calculated CA calcium scores by the Agatston method and rated the extent of calcification: none (0, minimal (1–10, mild (11–100, moderate (101–400, or severe (>400.Results and discussion. Severe CAC was detected in 57.8% of the men; moderate CAC was in 25.5%; mild CAC was in 6.9; minimal CAC was in 2.0%; and none CAC was in 7.8%. In the OP group, the majority (69.7% of the patients had severe CAC; 15.1% had moderate CAC, 6.1% had mild CAC; 3.0% had minimal CAC; CAC was undetected in 6.1% of cases. In the OSP group, there was severe CAC in 60.4%, moderate CAC in 33.3%, mild CAC in 4.2%, and minimal CAC in 2.1%. The patients without CAC were absent in this group. In the NBMD group, 33.3% of the examinees were recorded to have severe CAC; 23.8% had moderate CAC; 14.3% had mild CAC; CAC was undetected in 28.6%. Minimal CAC was also undetected in the patients of this group. There was a preponderance of patients with severe CAC in all the groups of those identified by the T-score. The extent of CAC was significantly lower in the NBMD group than in the OSP group (p<0.05. CAC was significantly more frequently absent in the NBMD group than in the low BMD group (p<0.05. There was an inverse correlation between

  15. Lack of Correlation Between Depression and Coronary Artery Calcification in a Non-Selected Danish Population

    DEFF Research Database (Denmark)

    Devantier, Torben Albert; Nørgaard, Bjarne Linde; Sand, Niels Peter;

    2013-01-01

    BACKGROUND: Depression is associated with coronary artery disease, and atherosclerosis seems to play a central role in this relation. In several studies, multislice computed tomography (CT) has been applied for detection and quantification of coronary artery calcification (CAC) in relation...... to depression. To our knowledge, only one previous study has investigated the relation between CAC and depression in an unselected population. METHODS: A total of 617 persons were randomly selected from the background population. The participants underwent CT of the heart and were screened for depression by use...... of the Major Depression Inventory questionnaire. Quantification of CAC was performed using the Agatston method. The Mann-Whitney U test, Spearman's correlational analysis, and logistic regression were used to assess the association between depression and CAC. RESULTS: The median Agatston score...

  16. Correlation between Systemic Arterial Hypertension and Bone Morphogenetic Protein-2 in Central Obese Non-Diabetic Men with Evidence of Coronary Artery Calcification

    Directory of Open Access Journals (Sweden)

    Antonia Anna Lukito

    2011-12-01

    Full Text Available BACKGROUND: Previous studies have confirmed separately the relationship between obesity, insulin-resistance, hypertension and bone morphogenetic protein-2 (BMP-2 with coronary artery calcification, a parameter of subclinical atherosclerosis. It was also reported that BMPs may function as proinflammatory, prohypertensive and proatherogenic mediators. The study aimed to assess the correlation between systemic hypertension and BMP-2 plasma concentration in central-obese non-diabetic men with evidence of coronary artery calcification. METHODS: This was a cross sectional study on 60 central-obese non-diabetic men, of an average age of 55.2 years, with evidence of coronary calcification, who came for health check-up and met the inclusion criteria consecutively as defined by waist circumference >90 cm and fasting blood glucose <126 mg/dL. Coronary calcification was defined by coronary artery calcium (CAC score ≥10 Agatson-unit Dual Source 64 slice CT scan. RESULTS: There is positive correlation between hypertension and BMP-2 in central-obese non-diabetic men with evidence of coronary artery calcification. BMP-2 plasma concentration was higher in the hypertensive subjects. The correlation was stronger in younger (<55 years old subjects and subjects with insulin-resitance. KEYWORDS: hypertension, BMP-2, coronary calcification, central obesity, age, insulin resistance.

  17. Correlation between coronary artery calcification and the need for revascularization in patients with no previous diagnosis of arterial coronary disease

    Energy Technology Data Exchange (ETDEWEB)

    Prazeres, Carlos Eduardo Elias dos; Cury, Roberto Caldeira; Bello, Juliana Hiromi Silva Matsumoto [Instituto do Coracao (InCor/FM/USP), Sao paulo, SP (Brazil); Magalhaes, Tiago Augusto [Hospital Pro-Cardiaco, Rio de Janeiro, RJ (Brazil); Moreira, Valeria de Melo; Carlos Eduardo Rochitte, E-mail: rochitte@gmail.com, E-mail: crochitte@hcor.com.br [Hospital do Coracao (HCOR), Sao Paulo, SP (Brazil)

    2012-10-15

    Introduction: about half of deaths from coronary heart disease (CHD) are not preceded by cardiac symptoms or previous diagnosis. Quantification of coronary artery calcification (CAC) by computed tomography is a strong predictor of events and improves the stratification the Framingham Risk Score. Objective: to evaluate the ability of the calcium score to predict the necessity invasive treatment (bypass (CABG) or intervention coronary percutaneous (ICP)) with no previous CAD. Method: retrospective study in pts without prior CAD and with quantification of CAC during 2009. The CAC was obtained in 64 multislice CT without contrast, with synchronized ECG acquisition, 120kV, 80-100mA, radiation <1mSv, and measured by the Agatston calcium score (CS) (threshold of 130 HU). Mean, median, and diagnostic tests were used. Results: We evaluated 263 pts (171 men), 59±13 years, BMI = 27.7 kg/m2, and mean follow up of 18±3 months. The total CS was 199.5±24.39. In patients with diabetes (DM), the CS was 320.5±67.56 and 166±24.47 in non-DM. The 23 patients who underwent invasive treatment had an average CS of 692 ± 72.3 versus 134.7 ± 21.35 in patients not treated (p <0.001). Of the 47 pts with CS ≥ 400, 17 were treated (CABG or ICP). Of the 216 pts with CS <400, 6 underwent treatment. Of the treated pts, 15 without diabetes had average CS 672.7 ± 92.04 versus 728.3 ± 11 of DM (8pts). In pts without DM who not underwent invasive treatment (191 pts), only 18 pts had SC ≥ 400. Conclusion: CS ≥ 400 was a strong predictor of revascularization (CABG or ICP) with good diagnostic performance in patients without prior diagnosis of CAD in the following 18 months. (author)

  18. Plasma apolipoprotein C-III levels, triglycerides, and coronary artery calcification in type 2 diabetics.

    Science.gov (United States)

    Qamar, Arman; Khetarpal, Sumeet A; Khera, Amit V; Qasim, Atif; Rader, Daniel J; Reilly, Muredach P

    2015-08-01

    Triglyceride-rich lipoproteins have emerged as causal risk factors for developing coronary heart disease independent of low-density lipoprotein cholesterol levels. Apolipoprotein C-III (ApoC-III) modulates triglyceride-rich lipoprotein metabolism through inhibition of lipoprotein lipase and hepatic uptake of triglyceride-rich lipoproteins. Mutations causing loss-of-function of ApoC-III lower triglycerides and reduce coronary heart disease risk, suggestive of a causal role for ApoC-III. Little data exist about the relationship of ApoC-III, triglycerides, and atherosclerosis in patients with type 2 diabetes mellitus (T2DM). Here, we examined the relationships between plasma ApoC-III, triglycerides, and coronary artery calcification in patients with T2DM. Plasma ApoC-III levels were measured in a cross-sectional study of 1422 subjects with T2DM but without clinically manifest coronary heart disease. ApoC-III levels were positively associated with total cholesterol (Spearman r=0.36), triglycerides (r=0.59), low-density lipoprotein cholesterol (r=0.16), fasting glucose (r=0.16), and glycosylated hemoglobin (r=0.12; Ptriglycerides (Tobit regression ratio, 1.43; 95% confidence interval, 0.94-2.18; P=0.086) and separately for very low-density lipoprotein cholesterol (Tobit regression ratio, 1.14; 95% confidence interval, 0.75-1.71; P=0.53). In persons with T2DM, increased plasma ApoC-III is associated with higher triglycerides, less favorable cardiometabolic phenotypes, and higher coronary artery calcification, a measure of subclinical atherosclerosis. Therapeutic inhibition of ApoC-III may thus be a novel strategy for reducing plasma triglyceride-rich lipoproteins and cardiovascular risk in T2DM. © 2015 American Heart Association, Inc.

  19. Coronary artery calcification is associated with atherogenic lipid changes, cardiac dysfunction and morphologic abnormalities in HIV-1 infected black adults

    Institute of Scientific and Technical Information of China (English)

    MENG Qing-yi; DU Jie-fu; LAI Hong; LAI Sheng-han

    2005-01-01

    @@ The heart is an organ frequently affected in the acquired immunodeficiency syndrome.1 But there is little information as to whether the coronary artery calcification can identify asymptomatic individuals at high risk for having cardiac morphological and functional abnormalities and cardiac risk factors in human immunodeficiency virus (HIV)-infected persons. Accordingly, the purpose of this study was to determine whether coronary artery calcification was associated with cardiac morphological and functional abnormalities, atherogenic lipid and C-reactive protein (CRP) changes in a black adult population with HIV-1 infection.

  20. Coronary artery calcification and ECG pattern of left ventricular hypertrophy or strain identify different healthy individuals at risk

    DEFF Research Database (Denmark)

    Diederichsen, Søren Zöga; Gerke, Oke; Olsen, Michael Hecht

    2013-01-01

    PURPOSE:: To improve risk stratification for development of ischaemic heart disease, several markers have been proposed. Both the presence of coronary artery calcification (CAC) and ECG pattern of left ventricular hypertrophy/strain have been shown to provide independent prognostic information....... In this study, we investigated the association between established risk factors, ECG measurements and the presence of coronary artery calcification. METHOD:: A random sample of healthy men and women aged 50 or 60 years were invited to the screening study. Established risk factors were measured. A noncontrast...

  1. Coronary artery calcification detected by a mobile helical CT unit in a mass screening. The frequency and relationship to coronary risk factors and coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Itani, Yasutaka; Watanabe, Shigeru; Masuda, Yoshiaki [Chiba Univ. (Japan). School of Medicine; Hanamura, Kazuhisa; Asakura, Kazuhiro; Sone, Shusuke; Sunami, Yuko; Shimura, Akimitsu; Miyamoto, Tadaaki

    2001-06-01

    A strong relationship is known to exist between coronary artery disease (CAD) and coronary artery calcification (CAC) detected by CT. In this study, we investigated the frequency of CAC and the relationship between coronary risk factors, CAD and CAC in a mass screening using a mobile helical CT unit. The total number of participants was 10008 people undergoing a medical examination for lung cancer and tuberculosis using a mobile helical CT unit. We measured the CT density of the coronary artery to detect CAC. The CT density threshold for determining CAC was above +110HU. The frequency of CAC was 16.0% in the overall patient population and significantly higher in males than in females (20.6% vs 10.7%). Frequency increased with age in both genders. Hypertension and diabetes mellitus were significantly related to CAC. Smoking showed a correlation with CAC only in males. A significant relationship was observed between CAD and CAC in males. In particular, the relationship between them was strongest in males under 60 years of age. Furthermore, the odds ratio of CAC in predicting CAD increased with increasing risk factors in both genders. (author)

  2. Coronary arterial calcification and thoracic spine mineral density in early menopause.

    Science.gov (United States)

    Miyabara, Y; Camp, J; Holmes, D; Lahr, B; Bailey, K; Miller, V M; Kearns, A E

    2011-08-01

    Cardiovascular disease and osteoporosis increase in women after menopause. While aortic calcification is associated with bone loss in women, a similar relationship for coronary arterial calcification (CAC), a risk factor for coronary artery disease in women, is less clear. This study was designed to examine the relationship between CAC and volumetric bone mineral density (vBMD) in women (n=137) who were within a median of 18 months past their last menses at screening for the Kronos Early Estrogen Prevention Study (KEEPS). CAC was measured using 64-slice computed tomography; vBMD was measured from these images using the Spine Cancer Assessment program. Concentrations of osteocalcin, bone alkaline phosphatase, tartrate-resident acid phosphatase-5b and osteopontin as bone matrix protein in serum and plasma were evaluated by ELISA. CAC scores ranged from 0 to 327.6 Agatston Units (AU); 113 women had a score of 0 AU, 20 had a CAC score between 0 and 50 AU, and four had a CAC score>50 AU. Although not statistically significant, there was a trend toward decreasing central density of thoracic T9 with increasing CAC. On average, levels of markers of bone turnover were within the normal range but did not correlate with age or with months past menopause. Clinically significant CAC and spine vBMD are quantifiable from the same scans within the first 3 years of menopause. Additional work is needed to determine how these measurements change with increasing age or with estrogenic treatments.

  3. Predictive value of osteoprotegerin for detecting coronary artery calcification in symptomatic patients: correlation with extent of calcification detected by multidetector computed tomography

    Directory of Open Access Journals (Sweden)

    Naser Aslanabadi

    2016-02-01

    Full Text Available Introduction: Osteoprotegerin (OPG could be a marker of vascular calcification extent. The purpose of this study was to evaluate relationships between OPG and coronary artery calcification (CAC extent in an Iranian population. Methods: A total of 151 patients with chest pain [107 males/44 females, mean age: 57.23 (30-85] were enrolled, excluding patients with previously established coronary artery diseases. All underwent chest multidetector computed tomography (MDCT for CAC scoring. Blood samples were collected for measurement of OPG. A potential relationship between CAC, OPG, age and number of involved coronary arteries was investigated, and a receiver-operating characteristic (ROC curve was designed thereafter to identify a cut-off value of OPG that best predicted the presence of CAC. Results: A total of 93 patients did not have CAC, who were younger than others. The mean age of patients with a different number of involved arteries was significantly different and is significantly correlated with a number of involved coronary arteries. The mean level of OPG differed by the number of calcified coronary arteries and is significantly correlated with the number of involved coronary arteries. The level of OPG had a weak but positive correlation with Ca score. ROC curve analysis showed that plasma OPG level had a fair prediction of CAC score, with an area under ROC curve of 0.62. The cut-off value best predicting CAC score was 59.1 pg/ml. Conclusion: This study suggests that a serum level of OPG can fairly predict extent of coronary retry calcification in symptomatic population.

  4. Aortic root, not valve, calcification correlates with coronary artery calcification in patients with severe aortic stenosis

    DEFF Research Database (Denmark)

    Henein, Michael; Hällgren, Peter; Holmgren, Anders

    2015-01-01

    calcification (AVC), due to tissue similarity between the two types of vessel rather than with the valve leaflet tissue. MATERIAL AND METHODS: We studied 212 consecutive patients (age 72.5 ± 7.9 years, 91 females) with AS requiring aortic valve replacement (AVR) in two Heart Centers, who underwent multidetector...

  5. Automated coronary artery calcification detection on low-dose chest CT images

    Science.gov (United States)

    Xie, Yiting; Cham, Matthew D.; Henschke, Claudia; Yankelevitz, David; Reeves, Anthony P.

    2014-03-01

    Coronary artery calcification (CAC) measurement from low-dose CT images can be used to assess the risk of coronary artery disease. A fully automatic algorithm to detect and measure CAC from low-dose non-contrast, non-ECG-gated chest CT scans is presented. Based on the automatically detected CAC, the Agatston score (AS), mass score and volume score were computed. These were compared with scores obtained manually from standard-dose ECG-gated scans and low-dose un-gated scans of the same patient. The automatic algorithm segments the heart region based on other pre-segmented organs to provide a coronary region mask. The mitral valve and aortic valve calcification is identified and excluded. All remaining voxels greater than 180HU within the mask region are considered as CAC candidates. The heart segmentation algorithm was evaluated on 400 non-contrast cases with both low-dose and regular dose CT scans. By visual inspection, 371 (92.8%) of the segmentations were acceptable. The automated CAC detection algorithm was evaluated on 41 low-dose non-contrast CT scans. Manual markings were performed on both low-dose and standard-dose scans for these cases. Using linear regression, the correlation of the automatic AS with the standard-dose manual scores was 0.86; with the low-dose manual scores the correlation was 0.91. Standard risk categories were also computed. The automated method risk category agreed with manual markings of gated scans for 24 cases while 15 cases were 1 category off. For low-dose scans, the automatic method agreed with 33 cases while 7 cases were 1 category off.

  6. Relation between uric acid and coronary artery calcification: a community-based cross-sectional survey among Beijing natural population

    Institute of Scientific and Technical Information of China (English)

    曹慧丽

    2013-01-01

    Objective To investigate the influence of uric acid on coronary artery calcification in the natural population in Beijing.Methods From April to July 2012,903 subjects from the natural population (aged 37—76 years for men,aged 42—76 years for women) in Xishan

  7. Severe hypovitaminosis D in chronic kidney disease: association with blood pressure and coronary artery calcification.

    Science.gov (United States)

    Pillar, Roberta; G Lopes, Miriam Ghedini; Rocha, Lillian Andrade; Cuppari, Lilian; Carvalho, Aluízio B; Draibe, Sérgio A; Canziani, Maria Eugênia F

    2013-05-01

    Hypovitaminosis D occurs early in the course of chronic kidney disease (CKD), and its association with cardiovascular morbidity and mortality is well known. In this study, we aimed to evaluate whether the degree of hypovitaminosis D may differently affect blood pressure (BP) and coronary artery calcification (CAC) in nondialyzed CKD patients. This study included 80 CKD patients with a creatinine clearance between 15 and 60 ml/min/1.73 m(2) and serum 25 hydroxivitamin D [25(OH)D] level hypovitaminosis D, were defined according to the median 25(OH)D value. Patients with severe hypovitaminosis D [25(OH)D hypovitaminosis D [25(OH)D >17.2 ng/ml; M-group]. No differences were found between the S and M-group in terms of diastolic BP and the presence of coronary calcification. In the multiple linear regression analysis, severe hypovitaminosis D was a predictor of 24-h, daytime and nighttime BP after controlling for a number of confounders. The severity of hypovitaminosis D was associated with increased BP in nondialyzed CKD patients. The degree of hypovitaminosis D was not related to CAC, which was equally elevated in both the severe and mild hypovitaminosis D groups.

  8. Is Mitral Annular Calcification Associated With Atherosclerotic Risk Factors and Severity and Complexity of Coronary Artery Disease?

    Science.gov (United States)

    Bhatt, Hemal; Sanghani, Dharmesh; Julliard, Kell; Fernaine, George

    2015-08-01

    We assessed the association of mitral annular calcification (MAC) with atherosclerotic risk factors and severity and complexity of coronary artery disease (CAD). Cardiac catheterization reports and electronic medical records from 2010 to 2011 were retrospectively reviewed. A total of 481 patients were divided into 2 groups: MAC present (209) and MAC absent (272). All major cardiovascular risk factors, comorbidities, and coronary lesion characteristics were included. On linear regression analysis, age (P = .001, β 1.12) and female gender (P = .031, β 0.50) were the independent predictors of MAC. Mitral annular calcification was not independently associated with the presence of lesions with >70% stenosis (P = .283), number of obstructive vessels (P = .469), lesions with 50% to 70% stenosis (P = .458), and Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery score (P = .479). Mitral annular calcification is probably a benign marker of age-related degenerative changes in the heart independent of the severity and complexity of CAD.

  9. Association between high-sensitive troponin I and coronary artery calcification in a Danish general population

    DEFF Research Database (Denmark)

    Olson, Fredrik; Engborg, Jonathan; Grønhøj, Mette H.;

    2016-01-01

    BACKGROUND: High-sensitive troponin I (hs-TnI) is an individual predictor of future cardiovascular disease (CVD). However, the relationship between hs-TnI and coronary artery calcification (CAC) as determined by computed tomography (CT) has not previously been investigated in a general population....... METHODS: 1173 randomized, middle-aged subjects without known CVD underwent a non-contrast cardiac-CT scan for CAC determination. Hs-TnI was detected using ARCHITECT STAT High Sensitive Troponin-I immunoassay. Total 10-year cardiovascular mortality risk was estimated using HeartScore. The relationship...... between hs-TnI and CAC was assessed using logistic regression analyses and receiver operating characteristic curves (ROC). RESULTS: Concentrations of hs-TnI above the limit of detection were measured in 89.3% of all subjects. Presence of CAC (Agatston score >0) was detected in 29% in the lowest hs...

  10. Coronary artery calcification is associated with insulin resistance index in patients with type 1 diabetes

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    T.C. Rodrigues

    2010-11-01

    Full Text Available The objective of the present study was to evaluate the risk factors associated with the presence of coronary artery calcification (CAC in patients with type 1 diabetes (T1D. A cross-sectional study was conducted on 100 consecutive T1D patients without coronary artery disease, with at least 5 years of diabetes and absence of end-stage renal disease. Mean age was 38 ± 10 years and 57% were males. CAC score was measured by multidetector computed tomography (Siemens Sensation 64 Cardiac. The insulin resistance index was measured using the estimated glucose disposal rate (eGDR. The eGDR was lower among CAC-positive patients than among CAC-negative patients, suggesting an increased insulin resistance. In a logistic regression model adjusted for age (at 10-year intervals, eGDR, diabetic nephropathy and gender, CAC was associated with age [OR = 2.73 (95%CI = 1.53-4.86, P = 0.001] and with eGDR [OR = 0.08 (95%CI = 0.02-0.21, P = 0.004]. In T1D subjects, insulin resistance is one of the most important risk factors for subclinical atherosclerosis.

  11. Arterial calcification: A new perspective?

    Science.gov (United States)

    Nicoll, R; Henein, M

    2017-02-01

    Arterial calcification is commonly seen in atherosclerosis, chronic kidney disease (CKD) and diabetes and has long been considered a natural progression of atherosclerosis. Yet it is a systemic condition, occurring in a wide and diverse range of disease states and no medical treatment for cardiovascular disease has yet found a way to regress it; on the contrary, lipid-lowering therapy may worsen its progression. Although numerous studies have found associations between calcification and biomarkers, none has yet found a unifying mechanism that explains the calcification found in atherosclerosis, CKD or diabetes and many of the biomarkers are equally associated with atheroma development and cardiovascular events. Furthermore, both presence and absence of coronary artery calcification appear predictive of plaque rupture and cardiovascular events, indicating that the association is not causal. This suggests that we are no further forward in understanding the true nature of arterial calcification or its pathogenesis, other than noting that it is 'multifactorial'. This is because most researchers view arterial calcification as a progressive pathological condition which must be treated. Instead, we hypothesise that calcification develops as an immune response to endothelial injury, such as shear stress or oxidative stress in diabetics, and is consequently part of the body's natural defences. This would explain why it has been found to be protective of plaque rupture and why it is unresponsive to lipid-lowering agents. We propose that instead of attempting to treat arterial calcification, we should instead be attempting to prevent or treat all causes of endothelial injury.

  12. Correlation between serum parathyroid hormone levels and coronary artery calcification in patients without renal failure.

    Science.gov (United States)

    Wu, Gang-Yong; Xu, Bai-Da; Wu, Ting; Wang, Xiao-Ying; Wang, Tian-Xiao; Zhang, Xiao; Wang, Xiao; Xia, Yang; Zong, Gang-Jun

    2016-11-01

    The aim of the present study was to investigate the correlation between serum parathyroid hormone (PTH) levels and coronary artery calcification (CAC) in patients without renal failure, as well as to determine independent risk factors of CAC score (CACS). A total of 157 patients who underwent coronary computed tomography angiographic examination at the 101th Hospital of the People's Liberation Army between December 2013 and February 2015 were retrospectively evaluated. The correlation between PTH levels and CACS was determined using a Pearson correlation analysis. A receiver operating characteristic (ROC) curve was drawn to determine the best cutoff PTH level for prediction of CAC. The independent association between serum PTH levels and CAC was analyzed by using a logistic regression analysis model with the response variable Be binary class. The results revealed that PTH levels in patients in the CAC group were significantly higher than those of patients in the non-calcification group. PTH levels were positively correlated with CACS (r=0.288, PCAC, with a sensitivity of 80.88%, specificity of 60.67% and an area under the curve of 0.761. After including predictive factors for CAC (gender, age, smoking status, diabetes, hypertension, hyperlipidemia, body mass index, glomerular filtration rate and calcium, phosphorus, calcium-phosphorus product, magnesium, PTH, total cholesterol, low-density lipoprotein cholesterol, triglyceride, high-density lipoprotein cholesterol and C-reactive protein levels), the odds ratio of the serum PTH levels regarding the prediction of CAC was 1.050 (95% confidence interval, 1.027-1.074; PCAC in patients without renal failure and may thus be used as a reliable predictor of CAC.

  13. [Effect of sodium thiosulfate on coronary artery calcification in maintenance hemodialysis patients].

    Science.gov (United States)

    Yu, Y; Bi, Z M; Wang, Y; Chen, Z Q; Xu, S W

    2016-12-13

    Objective: To investigate the factors correlated to coronary artery calcification (CAC)in maintenance hemodialysis (MHD) patients and observe the effect of sodium thiosulfate (STS) on the progression of vascular calcification and its safety. Methods: Thirty-eight subjects from Fuzhou Genernal Hospital who underwent coronary artery CT scan using Philip's spiral CT were enrolled and the calcification degree was evaluated by CAC scores from December 2013 to December 2014. The hemodialysis patients were divided into CAC group (CAC scores>10, 27 cases) and non-CAC group (CAC scores≤10, 11 cases)according to the CT scan results.The differences of age, duration of dialysis, blood pressure and other hematological indices between the two groups were analyzed to investigate the factors correlated to CAC. Next, those with CAC (CAC scores≥50) received intravenous 0.18 g/kg STS (dissolved in 100 ml saline) in 30 minutes after each dialysis for 3 months (n=17, only 15 patients completed STS treatment) or received conventional treatment (n=10). Baseline data between the two groups before treatment had no significant statistical difference. All examination indices were evaluated before and after the treatment course. The changes of vascular calcification imaging, CAC scores, biochemical indices and bone mineral density were compared between two groups before and after the treatment. Besides, adverse reactions were observed during the treatment of STS. This study was approved by the Ethics Committee of Fuzhou General Hospital(2013No1). Results: Twenty-seven out of 38 patients (71.05%) had CAC, and the patients with CAC had significantly higher age, phosphate, the product of calcium and phosphate, intact parathyroid hormone (hPTH), hypersensitive C-reactive protein (hsCRP), and longer duration of dialysis (P=0.017, 0.038, 0.037, 0.012, 0.002, 0.037) and lower serum albumin (P=0.026) than patients without CAC.There was no significant statistical difference in the baseline

  14. Coronary Artery Calcification Is Often Unreported in CT Pulmonary Angiograms in Patients With Suspected Pulmonary Embolism: An Opportunity to Improve Diagnosis of Acute Coronary Syndrome

    OpenAIRE

    Johnson, Patrick Connor

    2015-01-01

    Objective: In patients with suspected pulmonary thromboembolism (PTE), coronary artery calcification (CAC) can be an incidental finding in CT pulmonary angiograms. We evaluated the frequency of unreported CAC and its association with diagnosis of acute coronary syndrome (ACS). Methods: The data of 469 consecutive patients who were referred to the emergency radiology department for CT pulmonary angiography because of suspicion for PTE were reviewed. Radiology reports were rechecked, and pos...

  15. Changes in medical treatment six months after risk stratification with HeartScore and coronary artery calcification scanning of healthy middle-aged subjects

    DEFF Research Database (Denmark)

    Sørensen, Mette Hjortdal; Gerke, Oke; Lambrechtsen, Jess;

    2012-01-01

    Objectives: The aim was to examine and compare the impact of HeartScore and coronary artery calcification (CAC) score on subsequent changes in the use of medication. Methods: A total of 1156 healthy men and women, aged 50 or 60, had a baseline medical examination and a coronary artery CT-scan as ...

  16. Hyperphosphatemia and hs-CRP Initiate the Coronary Artery Calcification in Peritoneal Dialysis Patients.

    Science.gov (United States)

    Shang, Da; Xie, Qionghong; Shang, Bin; Zhang, Min; You, Li; Hao, Chuan-Ming; Zhu, Tongying

    2017-01-01

    Background. Coronary artery calcification (CAC) contributes to high risk of cardiocerebrovascular diseases in dialysis patients. However, the risk factors for CAC initiation in peritoneal dialysis (PD) patients are not known clearly. Methods. Adult patients with baseline CaCS = 0 and who were followed up for at least 3 years or until the conversion from absent to any measurable CAC detected were included in this observational cohort study. Binary logistic regression was performed to identify the risk factors for CAC initiation in PD patients. Results. 70 patients recruited to our study were split into a noninitiation group (n = 37) and an initiation group (n = 33) according to the conversion of any measurable CAC during their follow-up or not. In univariate analysis, systolic blood pressure, serum phosphorus, fibrinogen, hs-CRP, serum creatinine, and triglycerides were positively associated with the initiation of CAC, while the high density lipoprotein and nPCR did the opposite function. Multivariate analysis revealed that hyperphosphatemia and hs-CRP were the independent risk factors for CAC initiation after adjustments. Conclusions. Hyperphosphatemia and hs-CRP were the independent risk factors for CAC initiation in PD patients. These results suggested potential clinical strategies to prevent the initiation of CAC in PD patients.

  17. Haptoglobin genotype predicts development of coronary artery calcification in a prospective cohort of patients with type 1 diabetes

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    Simpson Melissa

    2011-11-01

    Full Text Available Abstract Background Coronary artery disease has been linked with genotypes for haptoglobin (Hp which modulates extracorpuscular hemoglobin. We hypothesized that the Hp genotype would predict progression of coronary artery calcification (CAC, a marker of subclinical atherosclerosis. Methods CAC was measured three times in six years among 436 subjects with type 1 diabetes and 526 control subjects participating in the Coronary Artery Calcification in Type 1 Diabetes (CACTI study. Hp typing was performed on plasma samples by polyacrylamide gel electrophoresis. Results The Hp 2-2 genotype predicted development of significant CAC only in subjects with diabetes who were free of CAC at baseline (OR: 1.95, 95% CI: 1.07-3.56, p = 0.03, compared to those without the Hp 2-2 genotype, controlling for age, sex, blood pressure and HDL-cholesterol. Hp 2 appeared to have an allele-dose effect on development of CAC. Hp genotype did not predict CAC progression in individuals without diabetes. Conclusions Hp genotype may aid prediction of accelerated coronary atherosclerosis in subjects with type 1 diabetes.

  18. Increased discordance between HeartScore and coronary artery calcification score after introduction of the new ESC prevention guidelines

    DEFF Research Database (Denmark)

    Diederichsen, Axel C P; Mahabadi, Amir-Abbas; Gerke, Oke;

    2015-01-01

    -contrast Cardiac-CT scan was performed to detect coronary artery calcification (CAC). RESULTS: Agreement of HeartScore risk groups with CAC groups was poor, but higher when applying the algorithm for the low-risk compared to the high-risk country model (agreement rate: 77% versus 63%, and weighted Kappa: 0.......22 versus 0.15). However, the number of subjects with severe coronary calcification (CAC score ≥400) increased in the low and intermediate HeartScore risk group from 78 to 147 participants (from 2.7 % to 4.2 %, p = 0.001), when estimating the risk based on the algorithm for low-risk countries. CONCLUSION...

  19. Relation of aortic calcification, wall thickness, and distensibility with severity of coronary artery disease: evaluation with coronary CT angiography

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    Jang, Seonah; Yong, Hwan Seok; Doo, Kyung Won; Kang, Eun-Young; Woo, Ok Hee; Choi, Eun Jung [Dept. of Radiology, Korea Univ. Guro Hospital, Korea Univ. College of Medicine, Seoul (Korea, Republic of)], e-mail: yhwanseok@naver.com

    2012-10-15

    Background Three known risk factors for aortic atherosclerosis predict the severity of coronary artery disease (CAD): aortic calcification (AC), aortic wall thickness (AWT), and aortic distensibility (AD). Purpose To determine the relationship of AC, AWT, and AD with the severity of CAD. Material and Methods A total of 104 patients who underwent both coronary CT angiography (CCTA) and invasive coronary angiography were enrolled. The severity of CAD was assessed by three methods: the segment involvement score (SIS), the segment stenosis score (SSS), and the modified Gensini score (mG). We quantified AC using the Agatston method on low-dose ungated chest CT (LDCT). We measured AWT at the thickest portion of the descending thoracic aorta on CCTA. AD was calculated as the difference between the maximum and minimum areas of the ascending aorta and the pulse pressure. The relationships between the severity of CAD and the three aortic factors were assessed. Results The AC and AWT of the thoracic aorta were significantly higher in the occlusive CAD (OCAD) group (1984.21 {+-} 2986.10 vs. 733.00 {+-} 1648.71, P = 0.01; 4.13 {+-} 1.48 vs. 3.40 {+-} 1.01, P = 0.22). Patients with OCAD had more than one epicardial coronary artery with >50% luminal stenosis. The AC (r = 0.453 with SIS; r = 0.454 with SSS; r = 0.427 with mG) and the AWT (r = 0.279 with SIS; r = 0.324 with SSS; r = 0.304 with mG) were significantly correlated with all three methods, and the AD was negatively correlated with the SIS (r = - 0.221, P < 0.05, respectively) in the unadjusted model. After adjustment for cardiovascular risk factors, only the correlations between AC and all three methods assessing CAD remained significant. Conclusion There are significant relationships between AC, AWT and AD and severity of CAD. In particular, AC measured on LDCT is the most consistent predictor of severity of CAD.

  20. Metabolic syndrome and coronary artery calcification:a community-based natural population study

    Institute of Scientific and Technical Information of China (English)

    CAO Hui-li; CHEN Xiong-biao; LU Jin-guo; HOU Zhi-hui; FANG Xiang; GAO Yang; YU Fang-fang

    2013-01-01

    Background Little is known about the influence of metabolic syndrome (MetS) on coronary artery calcification (CAC) in China.In this article,we aimed to explore the distribution of CAC in populations with and without MetS,and estimate the influence of MetS and its components on CAC in a community-based population of Beijing.Methods A total of 1647 local residents of Beijing,age 40-77 years,were recruited for a cardiovascular risk factors survey and were determined fasting plasma glucose (FPG),blood lipids,and 64 multi-detector computed tomography (64-MDCT)coronary artery calcium score (CACS) measurement (Agatston scoring).The distribution of CAC was described,and the influence of MetS components on CAC was evaluated.Results In this population,the prevalence and extent of CAC increased with increasing age and both were higher in MetS subjects compared to nonMetS subjects (all P <0.05),with the exception of those older than 65 years old.The risk of CAC increased with increasing numbers of MetS components,and the odds ratios for predicting positive CAC in subjects with 1,2,3,and->4 MetS components were 1.60,1.84,2.12,and 3.12,respectively (all P <0.05).Elevated blood pressure,elevated FPG,elevated triglycerides,and overweight increased the risk of CAC,yielding odds ratios of 2.64,1.67,1.32,and 1.37,respectively (all P <0.05).Conclusions In the Beijing community-based population,MetS increases the risk of CAC.The risk of CAC increases with increasing numbers of MetS components.Not only the number,but also the variety of risk factors for MetS is correlated with the risk of CAC.Elevated blood pressure,hyperglycemia,hypertriglyceridemia and overweight increase the risk of CAC.

  1. Associations of Coffee, Tea, and Caffeine Intake with Coronary Artery Calcification and Cardiovascular Events.

    Science.gov (United States)

    Miller, P Elliott; Zhao, Di; Frazier-Wood, Alexis C; Michos, Erin D; Averill, Michelle; Sandfort, Veit; Burke, Gregory L; Polak, Joseph F; Lima, Joao A C; Post, Wendy S; Blumenthal, Roger S; Guallar, Eliseo; Martin, Seth S

    2017-02-01

    Coffee and tea are 2 of the most commonly consumed beverages in the world. The association of coffee and tea intake with coronary artery calcium and major adverse cardiovascular events remains uncertain. We examined 6508 ethnically diverse participants with available coffee and tea data from the Multi-Ethnic Study of Atherosclerosis. Intake for each was classified as never, occasional (coffee drinkers, regular coffee intake (≥1 cup per day) was not statistically associated with coronary artery calcium progression or cardiovascular events (adjusted hazard ratio 0.97; 95% confidence interval 0.78-1.20). Caffeine intake was marginally inversely associated with coronary artery calcium progression. Moderate tea drinkers had slower progression of coronary artery calcium and reduced risk for cardiovascular events. Future research is needed to understand the potentially protective nature of moderate tea intake. Published by Elsevier Inc.

  2. Osteoprotegerin Serum Level is Associated with Severity of Coronary Artery Calcification in Non Diabetic Centrally Obese Men

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    Trilis Yulianti

    2012-04-01

    Full Text Available BACKGROUND: Osteoprotegerin (OPG is produced by a variety of tissues including those of the cardiovascular system. Recent clinical studies have suggested a significant correlation between elevated OPG serum level and cardiovascular mortality. Since coronary artery calcification (CAC is positively associated with cardiovascular disease (CVD events, we carried out a study to investigate whether OPG serum level is associated with the severity of CAC in non diabetic centrally obese men. METHODS: A cross sectional study was done on seventy non diabetic centrally obese men. CAC score was determined by using dual source computed tomography (DSCT. OPG serum level was measured by enzyme-linked immunosorbent assay (ELISA method. Statistical analysis was done with SPSS for windows ver 16. ANOVA was performed to analyze mean, maximum, minimum value, and standard deviation. Spearman correlation test was performed to determine the correlation between OPG serum level and CAC score. Significance value was defined as alpha level=0.05 based on two-tailed tests. RESULTS: OPG serum level was significantly correlated with CAC score. The severity of CAC increased with the increase of OPG level. Age was significantly correlated with OPG serum level and CAC score. CONCLUSIONS: Our data show that serum OPG level was associated with the severity of CAC, which highlights that OPG could be involved in the progression of CAC in non diabetic obese men. KEYWORDS: obesity, vascular calcification, osteoprotegerin, coronary artery calcification.

  3. Obesity and coronary artery calcification: Can it explain the obesity-paradox?

    Science.gov (United States)

    Aljizeeri, Ahmed; Coutinho, Thais; Pen, Ally; Chen, Li; Yam, Yeung; Dent, Robert; McPherson, Ruth; Chow, Benjamin J W

    2015-06-01

    The inverse relationship between obesity and adverse cardiovascular outcomes has been coined the 'obesity-paradox'. We sought to determine the relationship between measures of obesity [body mass index (BMI), body surface area (BSA) and body fat percentage (BF%)] and coronary artery calcification (CAC). We retrospectively analyzed patients who underwent CAC using the Agatston score. Baseline demographics were collected and BMI, BSA and BF% were calculated. A two-stage regression modeling approach was used to evaluate the association between BMI, BSA, BF% and Agatston score. Of the 6661 patients [mean age = 57.1 ± 10.8 years, men = 54.3%, median Agatston score = 14 (0, 163)], 0.1% were underweight, 21.3% had normal BMI, 39.1% were overweight and 39.4% were obese. The mean BMI, BSA and BF% were 29.6 ± 6.1 kg/m(2), 1.97 ± 0.25 m(2) and 37 ± 10 %, respectively. There was an independent association between the presence of CAC and BMI (5 kg/m(2) increments) (OR 1.05, CI 1.00-1.11, P = 0.038) and BF% (OR 2.38, CI 1.05-5.41, P = 0.038). Neither BMI categories nor large BSA independently predicted the presence of CAC. BF% predicted the extent of CAC in men but not in women, and higher BF% was associated with higher category of CAC severity in men only. BMI and BF% were independent predictors of the presence of CAC. BF% was associated with the extent of CAC and higher BF% was associated with higher category of CAC severity in men only. These results suggest that further study is needed to better understand the obesity-paradox.

  4. Relationship between cardio-ankle vascular index (CAVI) and coronary artery calcification (CAC) in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Mineoka, Yusuke; Fukui, Michiaki; Tanaka, Muhei; Tomiyasu, Ki-ichiro; Akabame, Satoshi; Nakano, Koji; Yamazaki, Masahiro; Hasegawa, Goji; Oda, Yohei; Nakamura, Naoto

    2012-03-01

    Early detection of atherosclerosis is important for patients with type 2 diabetes mellitus because cardiovascular disease (CVD) is a main cause of death in these people. In this study, we investigated the relationship between an arterial stiffness parameter called cardio-ankle vascular index (CAVI) and coronary artery calcification (CAC). We performed a cross-sectional study in 371 type 2 diabetic patients with clinical suspicion of coronary heart disease (CHD). We evaluated the relationships between CAVI and CAC score determined by multislice computed tomography as well as major cardiovascular risk factors, including age, body mass index, hemoglobinA1c and the Framingham CHD risk score. CAVI was correlated with age (r = 0.301, p CAC + 1) (r = 0.303, p CAC >0, CAC >100, CAC >400, or CAC >1000. CAVI is positively correlated with CAC, and is considered to be a useful method to detect CAC.

  5. Study of association between the aortic valve calcification and coronary artery disease%主动脉瓣钙化与冠心病的关系研究

    Institute of Scientific and Technical Information of China (English)

    耿峰; 葛艺东; 秦信

    2014-01-01

    Objective To explore the relationship between the aortic valve calcification(AVC)and coronary artery disease(CAD). Methods Six hundred and fifty-three patients underwent transthoracic echocardiography and coronary arteriography at the same time were analyzed retro-spectively in the study. All patients were divided into two groups: normal control group and aortic valve calcification group (left valve calcification, right valve calcification, multiple aortic valve calcification), comparison of the incidence of coronary artery disease between aortic valve calcification group and normal control group. Analysis of the correlation between single aortic valve calcification and coronary artery stenosis. Results The incidence of coronary artery disease aortic in AVC group was markedly higher than in normal control group. There was no obvious correlation between single aortic valve calcification and the same side coronary artery stenosis. Conclusion Patients with aortic valve calcification have a higher incidence of coronary artery disease, aortic valve calcification can be used as a reference index of noninvasive assessment of coronary artery disease.%目的:探讨主动脉瓣钙化与冠心病发病之间的关系。方法回顾性研究同期行冠状动脉造影检查和超声心动图检查患者653例,并对所有患者分组:正常对照组和主动脉瓣钙化组(左冠瓣钙化、右冠瓣钙化,主动脉瓣多瓣膜钙化),对比研究主动脉瓣钙化组与正常对照组间冠心病发病率差异,同时比较单瓣主动脉瓣钙化与冠状动脉狭窄是否发生于同侧。结果主动脉瓣钙化组冠心病的检出率明显高于正常对照组,单瓣主动脉瓣钙化与同侧冠脉狭窄无明显相关性。结论主动脉瓣钙化患者有更高的冠心病发病率,主动脉瓣钙化可以作为冠心病无创评估的一个参考指标。

  6. Menaquinone-7 Supplementation to Reduce Vascular Calcification in Patients with Coronary Artery Disease: Rationale and Study Protocol (VitaK-CAC Trial).

    Science.gov (United States)

    Vossen, Liv M; Schurgers, Leon J; van Varik, Bernard J; Kietselaer, Bas L J H; Vermeer, Cees; Meeder, Johannes G; Rahel, Braim M; van Cauteren, Yvonne J M; Hoffland, Ge A; Rennenberg, Roger J M W; Reesink, Koen D; de Leeuw, Peter W; Kroon, Abraham A

    2015-10-28

    Coronary artery calcification (CAC) develops early in the pathogenesis of atherosclerosis and is a strong and independent predictor of cardiovascular disease (CVD). Arterial calcification is caused by an imbalance in calcification regulatory mechanisms. An important inhibitor of calcification is vitamin K-dependent matrix Gla protein (MGP). Both preclinical and clinical studies have shown that inhibition of the vitamin K-cycle by vitamin K antagonists (VKA) results in elevated uncarboxylated MGP (ucMGP) and subsequently in extensive arterial calcification. This led us to hypothesize that vitamin K supplementation may slow down the progression of calcification. To test this, we designed the VitaK-CAC trial which analyses effects of menaquinone-7 (MK-7) supplementation on progression of CAC. The trial is a double-blind, randomized, placebo-controlled trial including patients with coronary artery disease (CAD). Patients with a baseline Agatston CAC-score between 50 and 400 will be randomized to an intervention-group (360 microgram MK-7) or a placebo group. Treatment duration will be 24 months. The primary endpoint is the difference in CAC-score progression between both groups. Secondary endpoints include changes in arterial structure and function, and associations with biomarkers. We hypothesize that treatment with MK-7 will slow down or arrest the progression of CAC and that this trial may lead to a treatment option for vascular calcification and subsequent CVD.

  7. Evaluation of RANKL/OPG Serum Concentration Ratio as a New Biomarker for Coronary Artery Calcification: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Amir Hooshang Mohammadpour

    2012-01-01

    Full Text Available Objective. There is a strong need for biomarkers to identify patients at risk for future cardiovascular events related with progressive atherosclerotic disease. Osteoprotegerin (OPG protects the skeleton from excessive bone resorption by binding to receptor activator of nuclear factor-κB ligand (RANKL and preventing it from binding to its receptor, receptor activator of nuclear factor-κB. However, conflicting results have been obtained about association of serum level of OPG or RANKL with coronary artery disease (CAD. Based on their role in inflammation and matrix degradation and the fact that atherosclerotic plaque formation is an inflammatory process, we hypothesized that RANKL : OPG ratio could be a better biomarker for CAD. Methods. In this cross-sectional study, the correlation between RANKL : OPG ratio serum concentration and coronary artery calcification (CAC in 50 patients with ischemic coronary disease has been investigated. We used ELISA method for measuring RANKL and OPG serum concentrations. Results. There was a significant correlation between RANKL : OPG serum concentration ratio and CAC in our study population (P=0.01. Conclusion. Our results suggested that RANKL : OPG ratio concentration has a potential of being used as a marker for coronary artery disease.

  8. Association of ectopic fat with abdominal aorto-illiac and coronary artery calcification in african ancestry men.

    Science.gov (United States)

    Kuipers, Allison L; Zmuda, Joseph M; Carr, J Jeffrey; Terry, James G; Nair, Sangeeta; Cvejkus, Ryan; Bunker, Clareann H; Patrick, Alan L; Wassel, Christina L; Miljkovic, Iva

    2017-08-01

    There is strong evidence that fat accumulating in non-adipose sites, "ectopic fat", is associated with cardiovascular disease (CVD), including vascular calcification. Most previous studies of this association have assessed only a single ectopic fat depot. Therefore, our aim was to assess the association of total, regional, and ectopic fat with abdominal aorto-illiac calcification (AAC) and coronary artery calcification (CAC) in 798 African ancestry men. Participants (mean age 62) were from the Tobago Bone Health Study cohort. Adiposity was assessed via clinical examination, dual x-ray absorptiometry, and computed tomography (CT). Ectopic fat depots included: abdominal visceral adipose tissue (VAT), liver attenuation, and calf intermuscular adipose tissue (IMAT). Vascular calcification was assessed by CT and quantified as present versus absent. Associations were tested using multiple logistic regression adjusted for traditional cardiovascular risk factors. Models of ectopic fat were additionally adjusted for total body fat and standing height. All adiposity measures, except VAT, were associated with AAC. Lower liver attenuation or greater calf IMAT was associated with 1.2-1.3-fold increased odds of AAC (p ectopic fat measure was associated with CAC. Greater adiposity in the skeletal muscle and liver, but not in the visceral compartment, was associated with increased odds of AAC in African ancestry men. These results highlight the potential importance of both quantity and location of adiposity accumulation throughout the body. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Concomitant atherosclerotic disease detected by whole-body MR angiography in relation to coronary artery calcification in patients with coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Seng, K.; Schlosser, T.; Barkhausen, J.; Ladd, S.C. [Universitaetsklinikum Essen (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Breuckmann, F.; Geckeis, K.; Schmermund, A.; Erbel, R. [Universitaetsklinikum Essen (Germany). Abt. fuer Kardiologie, Westdeutsches Herzzentrum Essen; Budde, T.; Hoefs, C. [Krupp Krankenhaus, Essen (Germany). Abt. fuer Kardiologie

    2010-04-15

    Purpose: Patients with coronary artery disease (CAD) show a high prevalence for concomitant atherosclerotic peripheral arterial disease (PAD). On the other hand, PAD seems to be an additional risk factor for cardiac events. We evaluated the correlation between arterial pathologies as found in whole-body MR angiography and coronary artery calcification (CAC) detected by electron beam computed tomography (EBCT) and multislice CT (MSCT). Materials and Methods: Two hundred and twenty-eight patients (161 men; 67 women) with suspicion for CAD/known CAD underwent whole-body contrast-enhanced MR angiography (wb-ce-MRA) and EBCT/MSCT. An atherosclerosis index was calculated for each patient Index = sum {sub n=1}{sup 40}w{sub i} with w{sub i} being the grading of the stenosis of the i{sup ten} of 40 arteria segments (grade: 0 - no plaque; 1 - plaque - {<=} 50 % stenosis; 2 - > 50 % stenosis - {<=} 90 % stenosis; 3 - > 90 % stenosis - < 100 % stenosis; 4 - occlusion). Correlations between CAC and atherosclerosis index were performed. Results: Wb-ce MRA and CAC correlate only moderately in this population. An atherosclerosis index 8 renders a positive predictive value for a CAC 100 of 63.3 %. Conclusion: An atherosclerosis index as defined in this study does not fully correlate with the extent of CAD as revealed by catheter angiography or EBCT/MSCT, but it might theoretically mirror the increased risk by PAD. It thus might be a promising complementary parameter for the prediction of cardiac events. Future studies need to show its possible additional predictive impact.

  10. Serum Gamma-glutamyltransferase Levels Predict the Progression of Coronary Artery Calcification in Adults With Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Gang, Li; Wei-Hua, Lu; Rong, Ai; Jian-Hong, Yang; Zi-Hua, Zhou; Zhong-Zhi, Tang

    2015-08-01

    Progression of coronary artery calcification (CAC) may be more predictive of future coronary heart disease events than a baseline CAC score. We determined whether serum gamma-glutamyltransferase (GGT) activity can independently predict the progression of CAC in adults with type 2 diabetes mellitus (T2DM). Patients (n = 326) without symptomatic cardiovascular (CV) disease were evaluated by CAC imaging. The CAC scores were assessed at baseline and after 20 ± 4 months. Serum GGT activities were significantly higher in progressors compared with nonprogressors (39 ± 16 vs. 27 ± 11 U/L, P < .001). Multivariable analyses demonstrated that GGT activity retained a strong association with CAC progression after adjustment for CV risk factors. Additionally, there was a graded association between GGT activity quartile and annualized CAC progression. In asymptomatic patients with T2DM, we prospectively found that serum GGT activity may be an independent predictor of CAC progression but not a predictor of CAC incidence.

  11. The relation between coronary artery calcification in asymptomatic subjects and both traditional risk factors and living in the city centre

    DEFF Research Database (Denmark)

    Lambrechtsen, J; Gerke, Oke; Egstrup, Kenneth

    2012-01-01

    Objective:  To evaluate the association between the risk factor of living in the city centre as a surrogate for air pollution and the presence of coronary artery calcification (CAC) in a population of asymptomatic Danish subjects. Design and subjects:  A random sample of 1825 men and women...... of either 50 or 60 years of age were invited to take part in a screening project designed to assess risk factors for cardiovascular disease (CVD). Non-contrast cardiac computed tomography was performed on all subjects and their Agatston scores were calculated to evaluate the presence of subclinical coronary...... atherosclerosis. The relationship between CAC and several demographic and clinical parameters were evaluated using multivariate logistic regression. Results:  A total of 1225 individuals participated in the study, of whom 250 (20%) were living in the centres of major Danish cities. Gender and age showed...

  12. Predictive value of mitral annular calcification for the diagnosis of coronary artery disease in patients with dilated cardiomyopathy.

    Science.gov (United States)

    Dincer, I; Ozdol, C; Dandachi, R; Akyurek, O; Atmaca, Y; Kiliçkap, M; Erol, C; Oral, D

    2001-08-01

    Mitral annulus calcification (MAC) is an independent predictor of coronary artery disease (CAD). The present study was designed to determine whether an association exists between MAC and CAD in patients with dilated cardiomyopathy. Among the 286 patients with MAC on echocardiographic examination who underwent coronary angiography, 55 patients with echocardiographic findings of dilated cardiomyopathy (group I) were compared to 60 age-matched controls without MAC and an echocardiographic diagnosis of dilated cardiomyopathy (group II) who underwent coronary angiography during the same time. There were no differences in echocardiographic findings between two groups. The prevalence of CAD was higher in group I when compared to group II (74% vs 28%, pMAC (p=0.001), diabetes mellitus (p=0.048), and history of anginal chest pain (p=0.009) are the independent predictors for the presence of CAD in patients with dilated cardiomyopathy. In conclusion, MAC may be a marker for the presence of coronary artery disease in patients with dilated cardiomyopathy.

  13. Arterial calcification: friend or foe?

    Science.gov (United States)

    Nicoll, Rachel; Henein, Michael Y

    2013-07-31

    There is a significant relationship between the presence, extent and progression of coronary artery calcification (CAC) and cardiovascular (CV) events and mortality in both CV and renal patients and CAC scoring can provide improved predictive ability over risk factor scoring alone. There is also a close relationship between CAC presence and atherosclerotic plaque burden, with angiography studies showing very high sensitivity but poor specificity of CAC score for predicting obstructive disease. Nevertheless, there are objections to CAC screening because of uncertainties and lack of studies showing improved outcome. Furthermore, histopathology studies indicate that heavily calcified plaque is unlikely to result in a CV event, while the vulnerable plaque tends to be uncalcified or 'mixed', suggesting that calcification may be protective. This scenario highlights a number of paradoxes, which may indicate that the association between CAC and CV events is spurious, following from the adoption of CAC as a surrogate for high plaque burden, which itself is a surrogate for the presence of vulnerable plaque. Since studies indicate that arterial calcification is a complex, organised and regulated process similar to bone formation, there is no particular reason why it should be a reliable indicator of either the plaque burden or the risk of a future CV event. We suggest that it is time to divorce arterial calcification from atherosclerosis and to view it as a distinct pathology in its own right, albeit one which frequently coexists with atherosclerosis and is related to it for reasons which are not yet fully understood.

  14. Extra-coronary calcification (aortic valve calcification, mitral annular calcification, aortic valve ring calcification and thoracic aortic calcification) in HIV seropositive and seronegative men: Multicenter AIDS Cohort Study.

    OpenAIRE

    Rezaeian, P.; Miller, PE; Haberlen, SA; Razipour, A; Bahrami, H; Castillo, R.; Witt, MD; Kingsley, L; Palella, FJ; Nakanishi, R; Matsumoto, S.; Alani, A; Jacobson, LP; Post, WS; Budoff, MJ

    2016-01-01

    Previous studies have demonstrated an association between HIV infection and coronary artery disease (CAD); little is known about potential associations between HIV infection and extra-coronary calcification (ECC).We analyzed 621 HIV infected (HIV+) and 384 HIV uninfected (HIV-) men from the Multicenter AIDS Cohort Study who underwent non-contrast computed tomography (CT) from 2010-2013. Agatston scores were calculated for mitral annular calcification (MAC), aortic valve calcification (AVC), a...

  15. The absence of coronary artery calcification does not rule out the presence of significant coronary artery disease in Asian patients with acute chest pain.

    Science.gov (United States)

    Yoon, Yeonyee E; Chang, Sung-A; Choi, Sang-Ii; Chun, Eun-Ju; Cho, Young-Seok; Youn, Tae-Jin; Chung, Woo-Young; Chae, In-Ho; Choi, Dong-Joo; Chang, Hyuk-Jae

    2012-02-01

    The absence of coronary artery calcification (CAC) has been used to as an indication to rule out significant coronary artery disease (CAD). However, diagnostic usefulness of 'zero calcium score criteria' as a decision-making strategy to rule out significant CAD as the etiology of acute chest pain has not been studied in depth, especially in Asian ethnicity. We prospectively enrolled 136 Korean patients (58% men, 56 ± 13 years) who presented to the emergency department (ED) with acute chest pain and non-diagnostic ECG. All patients underwent 64-slice CT for calcium scoring and coronary CT angiography (cCTA). We investigated the association of CAC with the presence of ≥50% CAD on cCTA and with a final diagnosis of an acute coronary syndrome (ACS). Ninety-two patients out of 136 (68%) did not show detectable CAC, and 14 out of these 92 without CAC (15%) had ≥50% CAD on cCTA. Sensitivity, specificity, positive predictive value and negative predictive value of zero calcium score criteria for the detection of ≥50% CAD were 0.66 (95% confidence interval, 0.50-0.80), 0.83 (0.74-0.90), 0.64 (0.48-0.77), 0.85 (0.75-0.91), respectively. Patients who had ≥50% CAD without detectable CAC were younger (P = 0.001), and had a higher prevalence of smoking (P = 0.048) as compared to patients with a degree of CAC. Most of the patients with ≥50% CAD of non-calcified plaque were younger than 60 years of age (79%, 11/14), however, 3 of them were older than 60 years of age. Forty-five patients (33%) were subsequently diagnosed as having ACS, and 38% (17/45) of them had no CAC. Zero calcium score did not necessarily guarantee the absence of significant CAD, even in patients older than 60 years, in Asian ethnicity presenting to the ED with chest pain.

  16. A Preoperative Assessment of Significant Coronary Stenosis Based on a Semiquantitative Analysis of Coronary Artery Calcification on Noncontrast Computed Tomography in Aortic Stenosis Patients Undergoing Aortic Valve Replacement

    Science.gov (United States)

    Hwang, Ji-Won; Kim, Sung Mok; Park, Sung-Ji; Cho, Eun Jeong; Lee, Sans-Chol; Choe, Yeon Hyeon; Park, Seung Woo

    2016-01-01

    Abstract Invasive coronary angiography (ICA) is the recommended assessment for coronary artery disease in patients undergoing elective aortic valve replacement (AVR). Noncontrast computed tomography (CT) is useful for evaluating lung lesions and calcifications at the cannulation site of the ascending aorta. The purpose of this study was to evaluate the role of noncontrast CT in the visual assessment of coronary artery calcification (CAC) in patients undergoing AVR. We retrospectively identified patients with significant aortic stenosis (AS) who were referred for AVR between January 2006 and December 2013. Among these, we included 386 patients (53.6% males, 69.2 ± 8.4 years) who underwent both noncontrast CT and ICA. Significant coronary artery stenosis (CAS) in the ICA was defined as luminal stenosis ≥70%. The 4 main coronary arteries were visually assessed on noncontrast CT and were scored based on the Weston score as follows: 0, no visually detected calcium; 1, a single high-density pixel detected; 3, calcium was dense enough to create a blooming artifact; and 2, calcium in between 1 and 3. Four groups were reclassified by the sum of the Weston scores from each vessel, as follows: noncalcification (0); mild calcification (1–4); moderate calcification (5–8); and severe calcification (9–12). Receiver-operating characteristic (ROC) analysis was generated to identify the cutoff Weston score values for predicting significant CAS. Diagnostic estimates were calculated based on these cutoffs. In the ICA analysis, 62 of the 386 patients (16.1%) had significant CAS. All patients were divided into 4 groups. The noncalcification group had 97 subjects (Weston score 0), the mild degree group had 100 (2.6 ± 1.0), the moderate calcification group had 114 (6.6 ± 1.1), and the severe calcification group had 75 (10.7 ± 1.1). The prevalence of significant CAS in the noncalcification, mild, moderate, and severe groups was 1% (1/97), 5% (5/100), 24% (27

  17. Calcification of coronary arteries and abdominal aorta in relation to traditional and novel risk factors of atherosclerosis in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Pencak Przemysław

    2013-01-01

    Full Text Available Abstract Background Process of accelerated atherosclerosis specific for uremia increases cardiovascular risk in patients with chronic kidney disease (CKD and may be influenced by the different structure of arteries. The study assesses the influence of traditional and novel risk factors on calcification of coronary arteries (CAC and abdominal aorta (AAC in hemodialysis patients (HD. Methods CAC and AAC were assessed by CT in 104 prevalent adult HD and 14 apparently healthy subjects with normal kidney function (control group. Mineral metabolism parameters, plasma levels of FGF-23, MGP, osteoprotegerin, osteopontin, fetuin-A, CRP, IL-6 and TNF-α were measured. Results CAC and AAC (calcification score ≥ 1 were found in 76 (73.1% and 83 (79.8% HD respectively, more frequent than in the control group. In 7 HD with AAC no CAC were detected. The frequency and severity of calcifications increased with age. Both CAC and AAC were more frequently detected in diabetics (OR = 17.37 and 13.00, respectively. CAC score was significantly greater in males. CAC and AAC scores were correlated significantly with pack-years of smoking and plasma osteoprotegrin levels. However the independent contribution of plasma osteoprotegerin levels was not confirmed in multiple regression analysis. Age (OR = 1.13 and hemodialysis vintage (OR = 1.14 were the independent risk factor favoring the occurrence of CAC; while age (OR = 1.20 was the only predictor of AAC occurrence in HD. Conclusions 1. AAC precedes the occurrence of CAC in HD patients. 2. The exposition to uremic milieu and systemic chronic microinflammation has more deteriorative effect on the CAC than the AAC.

  18. Coronary artery calcification is increased in patients with COPD and associated with increased morbidity and mortality

    DEFF Research Database (Denmark)

    Williams, M. C.; Murchison, J. T.; Edwards, L. D.;

    2014-01-01

    , functional capacity and outcomes in patients with COPD. Methods Coronary artery calcium score (CACS; Agatston score) was measured using chest CT in patients with COPD, smokers with normal spirometry and nonsmokers from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE......) study. Results CACS was measured in 942 subjects: 672 with COPD (mean age+/-SD, 63+/-7 years; FEV1 49+/-16% predicted), 199 smokers with normal spirometry (54+/-9 years; FEV1 110+/-12% predicted) and 71 nonsmokers (55+/-9 years; FEV1 114+/-14% predicted). CACS was higher in patients with COPD than...

  19. Coffee Consumption and Coronary Calcification: The Rotterdam Coronary Calcification Study

    NARCIS (Netherlands)

    Woudenbergh, van G.J.; Vliegenthart, R.; Rooij, van F.J.A.; Hofman, A.; Oudkerk, M.; Witteman, J.C.M.; Geleijnse, J.M.

    2008-01-01

    Background¿ The role of coffee in the cardiovascular system is not yet clear. We examined the relation of coffee intake with coronary calcification in a population-based cohort. Methods and Results¿ The study involved 1570 older men and women without coronary heart disease who participated in the Ro

  20. Coffee consumption and coronary calcification - The Rotterdam Coronary Calcification Study

    NARCIS (Netherlands)

    van Woudenbergh, Geertruida J.; Vliegenthart, Rozemarijn; van Rooij, Frank J. A.; Hofman, Albert; Oudkerk, Matthijs; Witteman, Jacqueline C. M.; Geleijnse, Johanna M.

    2008-01-01

    Background-The role of coffee in the cardiovascular system is not yet clear. We examined the relation of coffee intake with coronary calcification in a population-based cohort. Methods and Results-The study involved 1570 older men and women without coronary heart disease who participated in the Rott

  1. Coffee consumption and coronary calcification: The Rotterdam coronary calcification study

    NARCIS (Netherlands)

    G.J. van Woudenbergh (Geertruida); R. Vliegenthart (Rozemarijn); F.J.A. van Rooij (Frank); A. Hofman (Albert); M. Oudkerk (Matthijs); J.C.M. Witteman (Jacqueline); J.M. Geleijnse (Marianne)

    2008-01-01

    textabstractBACKGROUND - The role of coffee in the cardiovascular system is not yet clear. We examined the relation of coffee intake with coronary calcification in a population-based cohort. METHODS AND RESULTS - The study involved 1570 older men and women without coronary heart disease who particip

  2. Diagnostic accuracy of dual-source CT coronary angiography in a population unselected for degree of coronary artery calcification and without heart rate modification

    Energy Technology Data Exchange (ETDEWEB)

    Lin, C.-J., E-mail: bcjlin@gmail.co [Department of Medical Imaging, Far Eastern Memorial Hospital, Pan-Chiao, Taiwan (China); National Yang-Ming University School of Medicine, Taipei, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Hsu, J.-C. [National Yang-Ming University School of Medicine, Taipei, Taiwan (China); Division of Cardiovascular Medicine, Far Eastern Memorial Hospital, Pan-Chiao City, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Lai, Y.-J. [Department of Medical Imaging, Far Eastern Memorial Hospital, Pan-Chiao, Taiwan (China); National Yang-Ming University School of Medicine, Taipei, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Wang, K.-L. [Department of Medical Imaging, Far Eastern Memorial Hospital, Pan-Chiao, Taiwan (China); Department of Radiological Technology, Yuanpei University, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Lee, J.-Y. [Department of Medical Imaging, Far Eastern Memorial Hospital, Pan-Chiao, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Li, A.-H. [Division of Cardiovascular Medicine, Far Eastern Memorial Hospital, Pan-Chiao City, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Chu, S.-H. [Division of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, Pan-Chiao City, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China)

    2010-02-15

    Aim: To assess the ability of coronary angiography performed using dual-source computed tomography (DSCT) to evaluate coronary artery disease (CAD) in a population with unselected heart rates and extensive coronary calcification. Materials and methods: Forty-four patients at intermediate to high risk for CAD underwent both DSCT coronary angiography and invasive coronary angiography (ICA) within 30 days. No beta blockers were administered prior to imaging. Image quality and quantitatively stenosis of all coronary segments with a diameter >=1.5 mm were accessed. Patients were stratified according to mean heart rate (<70 versus >=70 bpm) and heart rate variability (<10 versus >=10 bpm). DSCT detection of coronary stenosis by segment, vessel, and patient characteristics were compared to the reference standard of ICA. Results: Diagnostic accuracy for all patients was high regarding sensitivity (97%), positive predictive value (PPV, 84.2%), and negative predictive value (NPV, 83.3%) but low regarding specificity (45.5%) with a moderate interobserver agreement (Kappa = 0.50). The accuracy for vessel-based diagnosis was high regarding sensitivity (96.6%), specificity (80.8%), PPV (80.3%), and NPV (96.7%). The segment-based diagnostic results revealed a moderate interobserver agreement for image quality and sensitivity, specificity, PPV and NPV for all segments of 66.9, 97.8, 90.8, and 89.9%, respectively. Conclusion: DSCT coronary angiography has high diagnostic accuracy in assessing CAD among patients at intermediate to high risk without using heart rate-modulating premedication. DSCT is not superior to ICA for diagnosis of calcified segments.

  3. Clinical decision-making for vitamin K-1 and K-2 deficiency and coronary artery calcification with warfarin therapy: are diet, factor Xa inhibitors or both the answer?

    Science.gov (United States)

    Wahlqvist, Mark L; Tanaka, Kiyoshi; Tzeng, Bing-Hsiean

    2013-01-01

    Coronary artery calcification is a recognised risk factor for ischaemic heart disease and mortality. Evidence is now strong that Mönckeberg's arteriosclerosis, a form of vascular calcification, can be attributable to vitamin K deficiency, but that vitamin K-2, especially the MK-4 form from foods like cheese can be protective. Warfarin blocks the recycling of hepatic and peripheral vitamin K leading to secondary vitamin K deficiency with adverse effects on vasculature, bone, kidneys, brain and other tissues and systems (inflammatory, immune function and neoplasia at least). There is individual susceptibility to vitamin K deficiency and warfarin sensitivity, partly explicable in terms of genetic polymorphisms, epigenetics, diet and pharmacotherapy. The emergence of extensive coronary calcification in a man with atrial fibrillation treated for a decade with warfarin is described by way of illustration and to raise the present clinical management conundrums. Finally, a putative set of recommendations is provided.

  4. Coronary artery calcification detected in lung cancer screening predicts cardiovascular death

    DEFF Research Database (Denmark)

    Rasmussen, Thomas; Køber, Lars; Abdulla, Jawdat;

    2015-01-01

    OBJECTIVES: It remains unknown whether non-electrocardiogram-gated coronary artery calcium (CAC) score in lung cancer screening provides incremental prognostic value. The aim of this study was to evaluate the prognostic value of CAC in the Danish Lung Cancer Screening Trial (DLCST), in addition...... to conducting a systematic review and meta-analysis including previously published studies regarding CAC in lung cancer screening. DESIGN: In DLCST, we measured Agatston CAC scores in 1,945 current and former smokers. Causes of death were extracted from the Danish National Death Registry. We used Cox...... proportional hazards model to determine hazard ratios (HRs) of CAC scores. A weighted fixed-effects model was used for the meta-analysis. RESULTS: Median follow-up in DLCST was 7.1 years, and 55% were men. Overall survival rates associated with CAC scores of 0, 1-400, and > 400 were 98%, 96%, and 92% (p

  5. Sugar-sweetened carbonated beverage consumption and coronary artery calcification in asymptomatic men and women.

    Science.gov (United States)

    Chun, Sohyun; Choi, Yuni; Chang, Yoosoo; Cho, Juhee; Zhang, Yiyi; Rampal, Sanjay; Zhao, Di; Ahn, Jiin; Suh, Byung-Seong; Pastor-Barriuso, Roberto; Lima, Joao A C; Chung, Eun Chul; Shin, Hocheol; Guallar, Eliseo; Ryu, Seungho

    2016-07-01

    Sugar-sweetened carbonated beverage consumption has been linked to obesity, metabolic syndrome, type 2 diabetes, and clinically manifest coronary heart disease, but its association with subclinical coronary heart disease remains unclear. We investigated the relationship between sugar-sweetened carbonated beverage consumption and coronary artery calcium (CAC) in a large study of asymptomatic men and women. This was a cross-sectional study of 22,210 adult men and women who underwent a comprehensive health screening examination between 2011 and 2013 (median age 40 years). Sugar-sweetened carbonated beverage consumption was assessed using a validated food frequency questionnaire, and CAC was measured by cardiac computed tomography. Multivariable-adjusted CAC score ratios and 95% CIs were estimated from robust Tobit regression models for the natural logarithm (CAC score +1). The prevalence of detectable CAC (CAC score >0) was 11.7% (n = 2,604). After adjustment for age; sex; center; year of screening examination; education level; physical activity; smoking; alcohol intake; family history of cardiovascular disease; history of hypertension; history of hypercholesterolemia; and intake of total energy, fruits, vegetables, and red and processed meats, only the highest category of sugar-sweetened carbonated beverage consumption was associated with an increased CAC score compared with the lowest consumption category. The multivariable-adjusted CAC ratio comparing participants who consumed ≥5 sugar-sweetened carbonated beverages per week with nondrinkers was 1.70 (95% CI, 1.03-2.81). This association did not differ by clinical subgroup, including participants at low cardiovascular risk. Our findings suggest that high levels of sugar-sweetened carbonated beverage consumption are associated with a higher prevalence and degree of CAC in asymptomatic adults without a history of cardiovascular disease, cancer, or diabetes. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. CT-based abdominal aortic calcification score as a surrogate marker for predicting the presence of asymptomatic coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    An, Chansik; Lee, Hye-Jeong; Ahn, Sung Soo; Choi, Byoung Wook; Kim, Myeong-Jin; Chung, Yong Eun [Severance Hospital, Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, 50 Yonsei-Ro, Seodaemun-Gu, Seoul (Korea, Republic of); Lee, Hye Sun [Yonsei University College of Medicine, Biostatistics Collaboration Unit, Department of Research Affairs, Seoul (Korea, Republic of)

    2014-10-15

    To assess the value of a CT-based abdominal aortic calcification (AAC) score as a surrogate marker for the presence of asymptomatic coronary artery disease (CAD). The AAC scores of 373 patients without cardiac symptoms who underwent both screening coronary CT angiography and abdominal CT within one year were calculated according to the Agatston method. Logistic regression was used to derive two multivariate models from traditional cardiovascular risk factors, with and without AAC scores, to predict the presence of CAD. The AAC score and the two multivariate models were compared by calculating the area under the receiver operating characteristic curve (AUC) and the net reclassification improvement (NRI). The AAC score alone showed a marginally higher AUC (0.823 vs. 0.767, P = 0.061) and significantly better risk classification (NRI = 0.158, P = 0.048) than the multivariate model without AAC. The multivariate model using traditional factors and AAC did not show a significantly higher AUC (0.832 vs. 0.823, P = 0.616) or NRI (0.073, P = 0.13) than the AAC score alone. The optimal cutoff value of the AAC score for predicting CAD was 1025.8 (sensitivity, 79.5 %; specificity, 75.9 %). AAC scores may serve as a surrogate marker for the presence or absence of asymptomatic CAD. (orig.)

  7. Vitamin K intake and calcifications in breast arteries

    NARCIS (Netherlands)

    Maas, Angela H. E. M.; van der Schouw, Yvonne T.; Beijerinck, David; Deurenberg, Jan J. M.; Mali, Willem P. Th. M.; Grobbee, Diederick E.; van der Graaf, Yolanda

    2007-01-01

    Objectives: Vitamin K is an important co-factor in the production of proteins that inhibit vascular calcification. A low dietary Vitamin K intake has been associated with aortic and coronary calcifications and an elevated cardiovascular risk. Calcifications in the arteries of the breasts have also b

  8. Vitamin K intake and calcifications in breast arteries

    NARCIS (Netherlands)

    Maas, Angela H. E. M.; van der Schouw, Yvonne T.; Beijerinck, David; Deurenberg, Jan J. M.; Mali, Willem P. Th. M.; Grobbee, Diederick E.; van der Graaf, Yolanda

    2007-01-01

    Objectives: Vitamin K is an important co-factor in the production of proteins that inhibit vascular calcification. A low dietary Vitamin K intake has been associated with aortic and coronary calcifications and an elevated cardiovascular risk. Calcifications in the arteries of the breasts have also b

  9. Significant inverse association of equol-producer status with coronary artery calcification but not dietary isoflavones in healthy Japanese men.

    Science.gov (United States)

    Ahuja, Vasudha; Miura, Katsuyuki; Vishnu, Abhishek; Fujiyoshi, Akira; Evans, Rhobert; Zaid, Maryam; Miyagawa, Naoko; Hisamatsu, Takashi; Kadota, Aya; Okamura, Tomonori; Ueshima, Hirotsugu; Sekikawa, Akira

    2017-01-01

    Equol, a metabolite of the dietary isoflavone daidzein, is produced by the action of gut bacteria in some individuals who are termed as equol-producers. It is proposed to have stronger atheroprotective properties than dietary isoflavones. We examined a cross-sectional association of dietary isoflavones and equol-producer status with coronary artery calcification (CAC), a biomarker of coronary atherosclerosis, among men in Japan. A population-based sample of 272 Japanese men aged 40-49 years recruited from 2004 to 2007 was examined for serum isoflavones, serum equol, CAC and other factors. Equol-producers were classified as individuals having a serum level of equol >83 nm. The presence of CAC was defined as a coronary Ca score ≥10 Agatston units. The associations of dietary isoflavones and equol-producers with CAC were analysed using multiple logistic regression. The median of dietary isoflavones, equol and CAC were 512·7 (interquartile range (IQR) 194·1, 1170·0), 9·1 (IQR 0·10, 33·1) and 0·0 (IQR 0·0, 1·0) nm, respectively. Prevalence of CAC and equol-producers was 9·6 and 16·0 %, respectively. Dietary isoflavones were not significantly associated with CAC. After multivariable adjustment, the OR for the presence of CAC in equol-producers compared with equol non-producers was 0·10 (95 % CI 0·01, 0·90, PCAC than equol non-producers, but there was no significant association between dietary isoflavones and CAC, suggesting that equol may be a key factor for atheroprotective properties of isoflavones in Japanese men. This finding must be confirmed in larger studies or clinical trials of equol that is now available as a dietary supplement.

  10. Increased association of coronary artery calcification in apparently healthy Korean adults with hypertriglyceridemic waist phenotype: The Kangbuk Samsung Health Study.

    Science.gov (United States)

    Moon, Byung Sub; Park, Hye-Jeong; Lee, Min-Kyung; Jeon, Won Seon; Park, Se Eun; Park, Cheol-Young; Lee, Won-Yong; Oh, Ki-Won; Park, Sung-Woo; Rhee, Eun-Jung

    2015-09-01

    Hypertriglyceridemic waist phenotype is a simple screening parameter to identify people at increased risk for cardiovascular disease. We evaluated whether hypertriglyceridemic waist (HTGW) phenotype increases the risk for coronary artery calcification (CAC) in apparently healthy Korean adults. A total of 32,186 participants (mean age 41.3, 80.2% men) in a health screening program, in whom the coronary artery calcium score (CACS) was measured, were analyzed. Subjects were divided into four groups: 1) normal waist circumference (WC)-normal triglyceride (TG) (NWNT), 2) normal WC-high TG (NWHT), 3) enlarged WC-normal TG (EWNT), and 4) enlarged WC-high TG (EWHT). Enlarged WC was defined as WC ≥ 90 cm for men and ≥ 85 cm for women; high serum TG was defined as TG ≥ 150 mg/dL. The presence of CAC was defined by CACS >0, and CACS was analyzed in a logarithmized form of CACS plus 1 {ln(CACS+1)}. A total of 14.9% of the participants had CAC. The EWHT group showed the highest mean value for ln(CACS+1) among the four groups. The EWHT group showed the highest odds ratio for CAC, with NWHT group the second, and with EWNT group the third compared with the NWNT group after adjusting for confounding variables (1.579, 1.302, and 1.266 vs. NWNT). The EWHT group showed the highest association for CAC, suggesting this HTGW phenotype as a useful marker for the detection of subjects with high cardiometabolic risk in healthy Korean adults. Copyright © 2015. Published by Elsevier Ireland Ltd.

  11. Association of Advanced Glycation End Products with coronary Artery Calcification in Japanese Subjects with Type 2 Diabetes as Assessed by Skin Autofluorescence

    OpenAIRE

    Hangai, Mari; Takebe, Noriko; Honma, Hiroyuki; Sasaki, Atsumi; Chida, Ai; Nakano, Rieko; Togashi, Hirobumi; Nakagawa, Riyuki; Oda, Tomoyasu; Matsui, Mizue; Yashiro, Satoshi; Nagasawa, Kan; Kajiwara, Takashi; Takahashi, Kazuma; Takahashi, Yoshihiko

    2016-01-01

    Aim: Advanced glycation end products (AGE) are considered to be among the critical pathogenic factors involved in the progression of diabetic complications. Skin autofluorescence (AF), a noninvasive measurement of AGE accumulation, has been recognized as a useful and convenient marker for diabetic vascular diseases in Caucasians. This study aimed to evaluate the association of tissue AGE, assessed using skin AF, with coronary artery calcification in Japanese subjects with type 2 diabetes. Met...

  12. Idiopathic arterial calcification in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Maya [Department of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa); Red Cross Children' s Hospital, School of Child and Adolescent Health, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town (South Africa); Andronikou, Savvas; Solomon, Rustum; Sinclair, Paul; McCulloch, Mignon [Department of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa)

    2004-08-01

    Idiopathic arterial calcification in infancy is usually fatal with death in early life and diagnosis at post mortem. This report describes a unique, late presentation with hypertension and cardiac failure in a child aged 33 months, found to have widespread arterial calcification at radiological imaging. The calcium-phosphate axis was normal and there was no other demonstrable cause for calcification. Additionally, the histological features of arterial calcification at renal biopsy paralleled the findings in infants with this disorder. The late presentation in this case is unusual and has not been previously reported. Ultrasound and CT are sensitive for calcification, and the disease should be suspected in children presenting with cardiac or respiratory manifestations and features of arterial calcification, where no metabolic cause is established. (orig.)

  13. Fasting plasma glucose levels and coronary artery calcification in subjects with impaired fasting glucose.

    Science.gov (United States)

    Eun, Young-Mi; Kang, Sung-Goo; Song, Sang-Wook

    2016-01-01

    Prediabetes is associated with an increased risk of cardiovascular disease (CVD). While the association of impaired glucose tolerance with CVD has been shown in many studies, the relationship between impaired fasting glucose (IFG) and CVD remains unclear. The purpose of this study was to compare the coronary artery calcium (CAC) scores of participants with normal fasting glucose versus those with IFG, according to fasting plasma glucose (FPG) levels, and to assess whether differences in CAC scores were independent of important confounders. Retrospective study. Health Promotion Center of the University Hospital (Gyeonggi-do, South Korea), during the period 2010-2014. Participants were enrolled from the general population who visited for a medical check-up. CAC was assessed in asymptomatic individuals by multidetector computed tomography. Anthropometric parameters and metabolic profiles were also recorded. Subjects were divided into four fasting glucose groups. Participants with a history of CVD or diabetes mellitus were excluded. Correlation between FPG and CAC scores, CAC score categories, and association between CAC score and FPG categories. Of 1112 participants, 346 (34.2%) had a CAC score > 0. FPG values in the IFG patients were positively but weakly correlated with CAC scores (r=0.099, P=.001). The incidence of CAC differed according to FPG level (P =110 mg/dL had a significantly higher risk of CAC than did subjects with normal fasting glucose (110.

  14. Coronary artery fistula

    Science.gov (United States)

    Congenital heart defect - coronary artery fistula; Birth defect heart - coronary artery fistula ... A coronary artery fistula is often congenital, meaning that it is present at birth. It generally occurs when one of the coronary arteries ...

  15. Coronary Artery Calcification Is Related to Inflammation in Rheumatoid Arthritis: A Long-Term Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Bengt Wahlin

    2016-01-01

    Full Text Available Objective. A long-term follow-up of patients with rheumatoid arthritis (RA to evaluate factors related to coronary artery calcification (CAC. Methods. All 22 eligible patients (4 males/18 females, mean age 65 years, and RA-duration 30–36 years from the original (baseline; n=39 study of atherosclerosis were included. Inflammation, cardiovascular risk factors, and biomarkers were measured at baseline. At follow-up 13 years later, CAC was assessed by computed tomography (CT and the grade of inflammation was measured. Multivariate analysis of differences between patients with low (0–10 and high CAC (>10 was done by orthogonal projection to latent structures (OPLS. Results. Ten patients had CAC 0–10 and 12 had >10 (range 18–1700. Patients with high CAC had significantly higher ESR (24.3 versus 9.9 mm/h and swollen joint count (2 versus 0. The OPLS models discriminated between patients having high or low CAC. With only baseline variables, the sensitivity was 73% and the specificity 82%. The model that also included inflammatory variables from follow-up had a sensitivity of 89% and a specificity of 85%. Exclusion of baseline intima media thickness and plaque from the latter model modestly reduced the accuracy (sensitivity 80% and specificity 83%. Conclusions. CAC is related to inflammation in patients with RA.

  16. Ideal Cardiovascular Health Metrics and Coronary Artery Calcification in Northern Chinese Population:A Cross-sectional Study

    Institute of Scientific and Technical Information of China (English)

    LUO Tai Yang; LIU Xiao Hui; DAI Tian Yi; LIU Xin Min; ZHANG Qian; DONG Jian Zeng

    2016-01-01

    Objective Coronary artery calcification (CAC) is a well-established risk predictor of coronary heart disease events and is recognized as an indicator of subclinical atherosclerosis. Methods A cross-sectional study consisting of 2999 participants aged ≥40 years from the Jidong community of Tangshan City, an industrial and modern city of China, was conducted between 2013 and 2014 to examine the association between the ideal cardiovascular health (CVH) metrics and CAC. The ideal CVH metrics were determined based on the definition of the American Heart Association (AHA). The participants were then grouped into 4 categories according to the quartiles of their CVH metric scores as follows: first quartile (0-2), second quartile (3), third quartile (4), and fourth quartile (5-7). CAC was assessed by using high-pitch dual-source CT, and patients were identified based on thresholds of 0, 10, 100, or 400 Agatston units, as per common practice. Results The prevalence of subclinical atherosclerosis was 15.92%, 13.85%, 6.76%, and 1.93%, determined by using the CAC scores at thresholds of 0, 10, 100, and 400 Agatston units, respectively. Compared with the group in the first quartile, the other three CVH groups had a lower odds ratio of CAC>0 after adjusting for age, sex, income level, education level, and alcohol use in the logistic regression analysis. The odds ratios in these groups were 0.86 [95% confidence interval (CI), 0.63-1.17; P Conclusion The participants with more-ideal cardiovascular metrics had a lower prevalence of subclinical atherosclerosis determined according to CAC score. Maintaining an ideal cardiovascular health may be valuable in the prevention of atherosclerosis in the general population.

  17. Cortisol responses to mental stress and the progression of coronary artery calcification in healthy men and women.

    Directory of Open Access Journals (Sweden)

    Mark Hamer

    Full Text Available BACKGROUND: Psychosocial stress is a risk factor for coronary heart disease (CHD. The mechanisms are incompletely understood, although dysfunction of the hypothalamic pituitary adrenal (HPA axis might be involved. We examined the association between cortisol responses to laboratory-induced mental stress and the progression of coronary artery calcification (CAC. METHODS AND RESULTS: Participants were 466 healthy men and women (mean age = 62.7±5.6 yrs, without history or objective signs of CHD, drawn from the Whitehall II epidemiological cohort. At the baseline assessment salivary cortisol was measured in response to mental stressors, consisting of a 5-min Stroop task and a 5-min mirror tracing task. CAC was measured at baseline and at 3 years follow up using electron beam computed tomography. CAC progression was defined as an increase >10 Agatston units between baseline and follow up. 38.2% of the sample demonstrated CAC progression over the 3 years follow up. There was considerable variation in the cortisol stress response, with approximately 40% of the sample responding to the stress tasks with an increase in cortisol of at least 1 mmol/l. There was an association between cortisol stress reactivity (per SD and CAC progression (odds ratio = 1.27, 95% CI, 1.02-1.60 after adjustments for age, sex, pre-stress cortisol, employment grade, smoking, resting systolic BP, fibrinogen, body mass index, and use of statins. There was no association between systolic blood pressure reactivity and CAC progression (odds ratio per SD increase = 1.03, 95% CI, 0.85-1.24. Other independent predictors of CAC progression included age, male sex, smoking, resting systolic blood pressure, and fibrinogen. CONCLUSION: Results demonstrate an association between heightened cortisol reactivity to stress and CAC progression. These data support the notion that cortisol reactivity, an index of HPA function, is one of the possible mechanisms through which

  18. Intra-Section Analysis of Human Coronary Arteries Reveals a Potential Role for Micro-Calcifications in Macrophage Recruitment in the Early Stage of Atherosclerosis.

    Directory of Open Access Journals (Sweden)

    Martijn L L Chatrou

    Full Text Available Vascular calcification is associated with poor cardiovascular outcome. Histochemical analysis of calcification and the expression of proteins involved in mineralization are usually based on whole section analysis, thereby often ignoring regional differences in atherosclerotic lesions. At present, limited information is available about factors involved in the initiation and progression of atherosclerosis.This study investigates the intra-section association of micro-calcifications with markers for atherosclerosis in randomly chosen section areas of human coronary arteries. Moreover, the possible causal relationship between calcifying vascular smooth muscle cells and inflammation was explored in vitro.To gain insights into the pathogenesis of atherosclerosis, we performed analysis of the distribution of micro-calcifications using a 3-MeV proton microbeam. Additionally, we performed systematic analyses of 30 to 40 regions of 12 coronary sections obtained from 6 patients including histology and immuno-histochemistry. Section areas were classified according to CD68 positivity. In vitro experiments using human vascular smooth muscle cells (hVSMCs were performed to evaluate causal relationships between calcification and inflammation.From each section multiple areas were randomly chosen and subsequently analyzed. Depositions of calcium crystals at the micrometer scale were already observed in areas with early pre-atheroma type I lesions. Micro-calcifications were initiated at the elastica interna concomitantly with upregulation of the uncarboxylated form of matrix Gla-protein (ucMGP. Both the amount of calcium crystals and ucMGP staining increased from type I to IV atherosclerotic lesions. Osteochondrogenic markers BMP-2 and osteocalcin were only significantly increased in type IV atheroma lesions, and at this stage correlated with the degree of calcification. From atheroma area type III onwards a considerable number of CD68 positive cells were observed

  19. Coronary artery calcification in obese youth: What are the phenotypic and metabolic determinants?

    Science.gov (United States)

    Obesity in adolescence has been associated with increased risk for coronary heart disease in adulthood. This study evaluated subclinical atherosclerosis in obese youth and the underlying risk factors. Ninety obese adolescents (37 normal glucose tolerant, 27 prediabetes, and 26 type 2 diabetes) under...

  20. Association between Density of Coronary Artery Calcification and Serum Magnesium Levels among Patients with Chronic Kidney Disease

    Science.gov (United States)

    Sakaguchi, Yusuke; Hamano, Takayuki; Nakano, Chikako; Obi, Yoshitsugu; Matsui, Isao; Kusunoki, Yasuo; Mori, Daisuke; Oka, Tatsufumi; Hashimoto, Nobuhiro; Takabatake, Yoshitsugu; Takahashi, Atsushi; Kaimori, Jun-Ya; Moriyama, Toshiki; Yamamoto, Ryohei; Horio, Masaru; Sugimoto, Ken; Yamamoto, Koichi; Rakugi, Hiromi; Isaka, Yoshitaka

    2016-01-01

    Background The Agatston score, commonly used to quantify coronary artery calcification (CAC), is determined by the plaque area and density. Despite an excellent predictability of the Agatston score for cardiovascular events, the density of CAC has never been studied in patients with pre-dialysis chronic kidney disease (CKD). This study aimed to analyze the CAC density and its association with serum mineral levels in CKD. Methods We enrolled patients with pre-dialysis CKD who had diabetes mellitus, prior cardiovascular disease history, elevated low-density lipoprotein cholesterol levels, or smoking history. The average CAC density was calculated by dividing the Agatston score by the total area of CAC. Results The mean estimated glomerular filtration rate (eGFR) of 109 enrolled patients was 35.7 mL/min/1.73 m2. The correlation of the Agatston score with density was much weaker than that with the total area (R2 = 0.19, P < 0.001; and R2 = 0.99, P < 0.001, respectively). Multivariate analyses showed that serum magnesium level was inversely associated with the density, but not with the total area, after adjustment for demographics and clinical factors related to malnutrition-inflammation-atherosclerosis syndrome and mineral and bone disorders including fibroblast growth factor 23 (P = 0.006). This inverse association was pronounced among patients with higher serum phosphate levels (P for interaction = 0.02). Conclusion CAC density was inversely associated with serum magnesium levels, particularly in patients with higher serum phosphate levels. PMID:27662624

  1. Change in abdominal obesity and risk of coronary calcification

    NARCIS (Netherlands)

    Sabour, S.; Grobbee, D.E.; Prokop, M.; Schouw, Y.T. van der; Bots, M.L.

    2011-01-01

    BACKGROUND: A prospective follow-up study was conducted to examine the relationship between 9 year change in abdominal obesity and risk of coronary artery calcification (CAC). METHODS: Data on coronary risk factors for 573 postmenopausal women were collected at baseline (1993-1997) and follow

  2. Pharmacogenomics of estrogens on changes in carotid artery intima-medial thickness and coronary arterial calcification: Kronos Early Estrogen Prevention Study.

    Science.gov (United States)

    Miller, Virginia M; Jenkins, Gregory D; Biernacka, Joanna M; Heit, John A; Huggins, Gordon S; Hodis, Howard N; Budoff, Matthew J; Lobo, Rogerio A; Taylor, Hugh S; Manson, JoAnn E; Black, Dennis M; Naftolin, Frederick; Harman, S Mitchell; de Andrade, Mariza

    2016-01-01

    Prior to the initiation of menopausal hormone treatment (MHT), genetic variations in the innate immunity pathway were found to be associated with carotid artery intima-medial thickness (CIMT) and coronary arterial calcification (CAC) in women (n = 606) enrolled in the Kronos Early Estrogen Prevention Study (KEEPS). Whether MHT might affect these associations is unknown. The association of treatment outcomes with variation in the same 764 candidate genes was evaluated in the same KEEPS participants 4 yr after randomization to either oral conjugated equine estrogens (0.45 mg/day), transdermal 17β-estradiol (50 μg/day), each with progesterone (200 mg/day) for 12 days each month, or placebo pills and patch. Twenty SNPs within the innate immunity pathway most related with CIMT after 4 yr were not among those associated with CIMT prior to MHT. In 403 women who completed the study in their assigned treatment group, single nucleotide polymorphisms (SNPs) within the innate immunity pathway were found to alter the treatment effect on 4 yr change in CIMT (i.e., significant interaction between treatment and genetic variation in the innate immunity pathway; P 5 Agatston units after 4 yr. Results of this study suggest that hormonal status may interact with genetic variants to influence cardiovascular phenotypes, specifically, the pharmacogenomic effects within the innate immunity pathway for CIMT.

  3. Progression of coronary artery calcification in black and white women: do the stresses and rewards of multiple roles matter?

    Science.gov (United States)

    Janssen, Imke; Powell, Lynda H; Jasielec, Mateusz S; Matthews, Karen A; Hollenberg, Steven M; Sutton-Tyrrell, Kim; Everson-Rose, Susan A

    2012-02-01

    Black women experience higher rates of cardiovascular disease (CVD) than white women, though evidence for racial differences in subclinical CVD is mixed. Few studies have examined multiple roles (number, perceived stress, and/or reward) in relation to subclinical CVD, or whether those effects differ by race. The aim of this study was to investigate the effects of multiple roles on 2-year progression of coronary artery calcium. Subjects were 104 black and 232 white women (mean age 50.8 years). Stress and reward from four roles (spouse, parent, employee, caregiver) were assessed on five-point scales. Coronary artery calcium progression was defined as an increase of ≥10 Agatston units. White women reported higher rewards from their multiple roles than black women, yet black women showed cardiovascular benefits from role rewards. Among black women only, higher role rewards were related significantly to lower progression of coronary artery calcium, adjusting for body mass index, blood pressure, and other known CVD risk factors. Blacks reported fewer roles but similar role stress as whites; role number and stress were unrelated to coronary artery calcium progression. Rewarding roles may be a novel protective psychosocial factor for progression of coronary calcium among black women.

  4. Very low density lipoprotein cholesterol associates with coronary artery calcification in type 2 diabetes beyond circulating levels of triglycerides.

    Science.gov (United States)

    Prenner, Stuart B; Mulvey, Claire K; Ferguson, Jane F; Rickels, Michael R; Bhatt, Anish B; Reilly, Muredach P

    2014-10-01

    While recent genomic studies have focused attention on triglyceride (TG) rich lipoproteins in cardiovascular disease (CVD), little is known of very low-density lipoprotein cholesterol (VLDL-C) relationship with atherosclerosis and CVD. We examined, in a high-risk type-2 diabetic population, the association of plasma VLDL-C with coronary artery calcification (CAC). The Penn Diabetes Heart Study (PDHS) is a cross-sectional study of CVD risk factors in type-2 diabetics (n = 2118, mean age 59.1 years, 36.5% female, 34.1% Black). Plasma lipids including VLDL-C were calculated (n = 1879) after ultracentrifugation. In Tobit regression, VLDL-C levels were positively associated with increasing CAC after adjusting for age, race, gender, Framingham risk score, body mass index, C-reactive protein, exercise, medication and alcohol use, hemoglobin A1c, and diabetes duration [Tobit ratio (TR) and 95% confidence interval (CI) 0.38 (0.12-0.65), P = 0.005] and even after inclusion of apolipoprotein B data [TR 0.31 (0.03-0.58), P = 0.030]. Approximately 3-fold stronger effect was observed in women [TR 0.75 (0.16-1.34), P = 0.013] than men [TR 0.20 (-0.10-0.50), P = 0.189; gender interaction P = 0.034]. Plasma VLDL-C was related more strongly to CAC scores than TG levels (e.g., Akaike information criteria of 7263.65 vs. 7263.94) and had stronger CAC association in individuals with TGs >150 mg/dl (TR 0.80, P = 0.010) vs. those with TGs <150 mg/dl (TR 0.27, P = 0.185). In PDHS, VLDL-C is associated with CAC independent of established CVD risk factors, particularly in women, and may have value even beyond apolipoprotein B levels and in patients with elevated TGs. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Soluble urokinase plasminogen activator receptor is in contrast to high-sensitive C-reactive-protein associated with coronary artery calcifications in healthy middle-aged subjects

    DEFF Research Database (Denmark)

    Sørensen, Mette Hjortdal; Gerke, Oke; Eugen-Olsen, Jesper;

    2014-01-01

    OBJECTIVE: The main objective of this study was to investigate the association between two markers of low-grade inflammation; soluble urokinase plasminogen activator receptor (suPAR) and high-sensitive C-reactive protein (hs-CRP); and coronary artery calcification (CAC) score detected by cardiac...... computed tomography (CT) scan. DESIGN: A cross sectional study of 1126 randomly sampled middle-aged men and women. METHODS: CAC score was measured by a non-contrast cardiac CT scan and total 10-year cardiovascular mortality risk was estimated using the Systematic Coronary Risk Evaluation (SCORE). Plasma...... samples were analysed for suPAR and hs-CRP. The association of suPAR and hs-CRP to CAC was evaluated by logistic regression analyses adjusting for categorised SCORE. The additive effect of suPAR to SCORE was evaluated by comparing area under curve (AUC) and net reclassification improvement (NRI). RESULTS...

  6. Coronary artery calcification score by multislice computed tomography predicts the outcome of dobutamine cardiovascular magnetic resonance imaging

    NARCIS (Netherlands)

    Janssen, CHC; Kuijpers, D; Vliegenthart, R; Overbosch, J; van Dijkman, PRM; Zijlstra, F; Oudkerk, M

    The aim of this study was to determine whether a coronary artery calcium (CAC) score of less than 11 can reliably rule out myocardial ischemia detected by dobutamine cardiovascular magnetic resonance imaging (CMR) in patients suspected of having myocardial ischemia. In 114 of 136 consecutive

  7. Diabetes and Hypertension Consistently Predict the Presence and Extent of Coronary Artery Calcification in Symptomatic Patients: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Rachel Nicoll

    2016-09-01

    Full Text Available Background: The relationship of conventional cardiovascular risk factors (age, gender, ethnicity, diabetes, dyslipidaemia, hypertension, obesity, exercise, and the number of risk factors to coronary artery calcification (CAC presence and extent has never before been assessed in a systematic review and meta-analysis. Methods: We included only English language studies that assessed at least three conventional risk factors apart from age, gender, and ethnicity, but excluded studies in which all patients had another confirmed condition such as renal disease. Results: In total, 10 studies, comprising 15,769 patients, were investigated in the systematic review and seven studies, comprising 12,682 patients, were included in the meta-analysis, which demonstrated the importance of diabetes and hypertension as predictors of CAC presence and extent, with age also predicting CAC presence. Male gender, dyslipidaemia, family history of coronary artery disease, obesity, and smoking were overall not predictive of either CAC presence or extent, despite dyslipidaemia being a key risk factor for coronary artery disease (CAD. Conclusion: Diabetes and hypertension consistently predict the presence and extent of CAC in symptomatic patients.

  8. Genetic polymorphisms associated with carotid artery intima-media thickness and coronary artery calcification in women of the Kronos Early Estrogen Prevention Study.

    Science.gov (United States)

    Miller, Virginia M; Petterson, Tanya M; Jeavons, Elysia N; Lnu, Abhinita S; Rider, David N; Heit, John A; Cunningham, Julie M; Huggins, Gordon S; Hodis, Howard N; Budoff, Matthew J; Santoro, Nanette; Hopkins, Paul N; Lobo, Rogerio A; Manson, JoAnn E; Naftolin, Frederick; Taylor, Hugh S; Harman, S Mitchell; de Andrade, Mariza

    2013-01-15

    Menopausal hormone treatment (MHT) may limit progression of cardiovascular disease (CVD) but poses a thrombosis risk. To test targeted candidate gene variation for association with subclinical CVD defined by carotid artery intima-media thickness (CIMT) and coronary artery calcification (CAC), 610 women participating in the Kronos Early Estrogen Prevention Study (KEEPS), a clinical trial of MHT to prevent progression of CVD, were genotyped for 13,229 single nucleotide polymorphisms (SNPs) within 764 genes from anticoagulant, procoagulant, fibrinolytic, or innate immunity pathways. According to linear regression, proportion of European ancestry correlated negatively, but age at enrollment and pulse pressure correlated positively with CIMT. Adjusting for these variables, two SNPs, one on chromosome 2 for MAP4K4 gene (rs2236935, β = 0.037, P value = 2.36 × 10(-06)) and one on chromosome 5 for IL5 gene (rs739318, β = 0.051, P value = 5.02 × 10(-05)), associated positively with CIMT; two SNPs on chromosome 17 for CCL5 (rs4796119, β = -0.043, P value = 3.59 × 10(-05); rs2291299, β = -0.032, P value = 5.59 × 10(-05)) correlated negatively with CIMT; only rs2236935 remained significant after correcting for multiple testing. Using logistic regression, when we adjusted for waist circumference, two SNPs (rs11465886, IRAK2, chromosome 3, OR = 3.91, P value = 1.10 × 10(-04); and rs17751769, SERPINA1, chromosome 14, OR = 1.96, P value = 2.42 × 10(-04)) associated positively with a CAC score of >0 Agatston unit; one SNP (rs630014, ABO, OR = 0.51, P value = 2.51 × 10(-04)) associated negatively; none remained significant after correcting for multiple testing. Whether these SNPs associate with CIMT and CAC in women randomized to MHT remains to be determined.

  9. Coronary artery and thoracic aorta calcification is inversely related to coronary flow reserve as measured by 82Rb PET/CT in intermediate risk patients

    OpenAIRE

    Kim, Jongho; Bravo, Paco E.; Gholamrezanezhad, Ali; Sohn, Seil; Rafique, Ash; Travis, Arlene; Machac, Josef

    2013-01-01

    Background The strength and nature of the relationship between myocardial perfusion imaging (MPI), coronary flow reserve (CFR), and coronary artery calcium (CAC) and thoracic aorta calcium (TAC) remain to be clarified. Methods Dynamic rest-pharmacological stress 82Rb positron emission tomography/computed tomography MPI with CFR, CAC, and TAC was performed in 75 patients (59 ± 13 years; F/M = 38/37) with intermediate risk of coronary artery disease. Results A total of 29 (39%) patients had isc...

  10. Threshold-dependent variability of coronary artery calcification measurements - implications for contrast-enhanced multi-detector row-computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Moselewski, Fabian [Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Ferencik, Maros [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Achenbach, Stephan [Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Department of Internal Medicine II (Cardiology), University of Erlangen (Germany); Abbara, Suhny [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Cury, Ricardo C. [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Booth, Sarah L. [Jean Mayer USDA Human Nutrition Research Center on Aging, 711 Washington St., Boston, MA 02114 (United States); Jang, Ik-Kyung [Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Brady, Thomas J. [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Hoffmann, Udo [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)]. E-mail: uhoffman@partners.org

    2006-03-15

    Introduction: The present study investigated the threshold-dependent variability of coronary artery calcification (CAC) measurements and the potential to quantify CAC in contrast-enhanced multi-detector row-computed tomography (MDCT). Methods: We compared the mean CT attenuation of CAC to luminal contrast enhancement of the coronary arteries in 30 patients (n = 30) undergoing standard coronary contrast-enhanced spiral MDCT. The modified Agatston score [AS], calcified plaque volume [CV], and mineral mass [MM] at four different thresholds (130, 200, 300, and 400 HU) were measured in 50 patients who underwent non-contrast-enhanced MDCT. Results: Mean CT attenuation of CAC was similar to the attenuation of the contrast-enhanced coronary lumen (CAC 297.1 {+-} 68.7 HU versus 295 {+-} 65 HU (p < 0.0001), respectively). Above a threshold of 300 HU CAC measurements significantly varied to standard measurements obtained at a threshold of 130 HU (p < 0.0001). The threshold-dependent variation of MM measurements was significantly smaller than for AS and CV (130 HU versus 400 HU: 63, 75, and 81, respectively; p < 0.001). These differences resulted in a change of age and gender based percentile category for AS in 78% of subjects. Discussion: We demonstrated that CAC measurements are threshold dependent with MM measurements having significantly less variation than AS or CV. Due to the similarity of mean CT attenuation of CAC and the contrast-enhanced coronary lumen accurate quantification of CAC may be difficult in standard coronary contrast-enhanced spiral MDCT.

  11. Coronary calcification and risk of cardiovascular disease : an epidemiologic study

    NARCIS (Netherlands)

    R. Vliegenthart (Rozemarijn)

    2003-01-01

    textabstractAlready in the eighteenth century, calcification of the coronary artery wall was recognized as being part of the atherosclerotic process.1 However, only after the recent development of electron-beam tomography (EBT), an ultrafast CT technique, it became possible to accurately quantify th

  12. Genetic association of glutathione peroxidase-1 with coronary artery calcification in type 2 diabetes: a case control study with multi-slice computed tomography

    Directory of Open Access Journals (Sweden)

    Fujimoto Kei

    2007-09-01

    Full Text Available Abstract Background Although oxidative stress by accumulation of reactive oxygen species (ROS in diabetes has become evident, it remains unclear what genes, involved in redox balance, would determine susceptibility for development of atherosclerosis in diabetes. This study evaluated the effect of genetic polymorphism of enzymes producing or responsible for reducing ROS on coronary artery calcification in type 2 diabetes (T2D. Methods An index for coronary-arteriosclerosis, coronary artery calcium score (CACS was evaluated in 91 T2D patients using a multi-slice computed tomography. Patients were genotyped for ROS-scavenging enzymes, Glutathione peroxidase-1 (GPx-1, Catalase, Mn-SOD, Cu/Zn-SOD, as well as SNPs of NADPH oxidase as ROS-promoting elements, genes related to onset of T2D (CAPN10, ADRB3, PPAR gamma, FATP4. Age, blood pressure, BMI, HbA1c, lipid and duration of diabetes were evaluated for a multivariate regression analysis. Results CACS with Pro/Leu genotype of the GPx-1 gene was significantly higher than in those with Pro/Pro (744 ± 1,291 vs. 245 ± 399, respectively, p = 0.006. In addition, genotype frequency of Pro/Leu in those with CACS ≥ 1000 was significantly higher than in those with CACS OR = 3.61, CI = 0.97–13.42; p = 0.045 when tested for deviation from Hardy-Weinberg's equilibrium. Multivariate regression analyses revealed that CACS significantly correlated with GPx-1 genotypes and age. Conclusion The presence of Pro197Leu substitution of the GPx-1 gene may play a crucial role in determining genetic susceptibility to coronary-arteriosclerosis in T2D. The mechanism may be associated with a decreased ability to scavenge ROS with the variant GPx-1.

  13. Coronary anomaly: the single coronary artery

    Institute of Scientific and Technical Information of China (English)

    QIN Xu-guang; XIONG Wei-guo; LU Chun-peng; GONG Cheng-jie; SHANG Li-hua

    2010-01-01

    @@ Single coronary artery (SCA), defined as an artery that arises from the arterial trunk and nourishes the entire myocardium, is rare. We report two cases of SCA, one is the right coronary artery (RCA) originating from the middle of left descending artery (LAD), and the other is the left main coronary artery (LMCA) arising from the proximal right coronary artery.

  14. Waist Circumference as a Marker of Obesity Is More Predictive of Coronary Artery Calcification than Body Mass Index in Apparently Healthy Korean Adults: The Kangbuk Samsung Health Study.

    Science.gov (United States)

    Park, Jongsin; Lee, Eun Seo; Lee, Da Young; Kim, Jihyun; Park, Se Eun; Park, Cheol Young; Lee, Won Young; Oh, Ki Won; Park, Sung Woo; Rhee, Eun Jung

    2016-12-01

    We aimed to assess the risk for coronary artery calcification (CAC) according to groups subdivided by body mass index (BMI) and waist circumference (WC) in apparently healthy Korean adults. Thirty-three thousand four hundred and thirty-two participants (mean age, 42 years) in a health screening program were divided into three groups according to BMI: 25 kg/m² (obese). In addition, the participants were divided into two groups according to WC. Coronary artery calcium score (CACS) was measured with multi-detector computed tomography in all participants. Presence of CAC was defined as CACS >0. When logistic regression analysis was performed with the presence of CAC as the dependent variable, the risk for CAC increased as BMI increased after adjusting for confounding variables (1.102 [95% confidence interval (CI), 1.000 to 1.216]; 1.284 [95% CI, 1.169 to 1.410]; in the overweight and obese groups vs. the normal weight group). When the participants were divided into six groups according to BMI and WC, the subjects with BMI and WC in the obese range showed the highest risk for CAC (1.321 [95% CI, 1.194 to 1.461]) and those with BMI in the overweight range and WC in the obese range showed the second highest risk for CAC (1.235 [95% CI, 1.194 to 1.461]). Participants with obesity defined by both BMI and WC showed the highest risk for CAC. Those with BMIs in the overweight range but with WC in the obese range showed the second highest risk for CAC, suggesting that WC as a marker of obesity is more predictive of CAC than BMI.

  15. Higher association of coronary artery calcification with non-alcoholic fatty liver disease than with abdominal obesity in middle-aged Korean men: the Kangbuk Samsung Health Study.

    Science.gov (United States)

    Lee, Min-Kyung; Park, Hye-Jeong; Jeon, Won Seon; Park, Se Eun; Park, Cheol-Young; Lee, Won-Young; Oh, Ki-Won; Park, Sung-Woo; Rhee, Eun-Jung

    2015-07-15

    It is uncertain whether non-alcoholic fatty liver disease (NAFLD) or abdominal obesity is more associated with atherosclerosis. The aim of this study was to determine whether NAFLD or abdominal obesity is more strongly associated with subclinical atherosclerosis represented by coronary artery calcification (CAC). A total of 21,335 male participants in a health screening program (mean age 41 years) were enrolled. Ultrasonographic measurements of fatty liver and multi-detector computed tomography were performed to determine the coronary artery calcium score (CACS). The presence of CAC was defined as CACS > 0. Subjects were divided into four groups according to the presence or absence of NAFLD and/or abdominal obesity as assessed by waist-hip ratio (WHR) > 0.9. The presence of CAC was detected in 2,385 subjects (11.2%). The proportion of subjects with CAC was highest in the abdominal obesity only group (23.2%). After adjustment for age, diabetes history, hypertension, cigarette smoking, and physical inactivity, the odds ratio (OR) for CAC was the highest in the group with both abnormalities [1.465 (1.324-1.623)]. The NAFLD only group showed significantly increased OR for CAC compared to that in the abdominal obesity only group [1.286 (1.151-1.436) vs. 1.076 (0.939-1.233)]. Non-alcoholic fatty liver disease is more closely associated with CAC than abdominal obesity as assessed by the WHR. NAFLD could be considered an independent determinant of subclinical atherosclerosis as assessed by CAC.

  16. The ability of the 2013 American College of Cardiology/American Heart Association cardiovascular risk score to identify rheumatoid arthritis patients with high coronary artery calcification scores.

    Science.gov (United States)

    Kawai, Vivian K; Chung, Cecilia P; Solus, Joseph F; Oeser, Annette; Raggi, Paolo; Stein, C Michael

    2015-02-01

    Patients with rheumatoid arthritis (RA) have increased risk of atherosclerotic cardiovascular disease that is underestimated by the Framingham Risk Score (FRS). We undertook this study to test the hypothesis that the 2013 American College of Cardiology/American Heart Association (ACC/AHA) 10-year risk score would perform better than the FRS and the Reynolds Risk Score (RRS) in identifying RA patients known to have elevated cardiovascular risk based on high coronary artery calcification (CAC) scores. Among 98 RA patients eligible for risk stratification using the ACC/AHA risk score, we identified 34 patients with high CAC (defined as ≥300 Agatston units or ≥75th percentile of expected coronary artery calcium for age, sex, and ethnicity) and compared the ability of the 10-year FRS, RRS, and ACC/AHA risk scores to correctly assign these patients to an elevated risk category. All 3 risk scores were higher in patients with high CAC (P risk category was similar among the 3 scores (FRS 32%, RRS 32%, ACC/AHA risk score 41%) (P = 0.223). The C statistics for the FRS, RRS, and ACC/AHA risk score predicting the presence of high CAC were 0.65, 0.66, and 0.65, respectively. The ACC/AHA 10-year risk score does not offer any advantage compared to the traditional FRS and RRS in the identification of RA patients with elevated risk as determined by high CAC. The ACC/AHA risk score assigned almost 60% of patients with high CAC to a low risk category. Risk scores and standard risk prediction models used in the general population do not adequately identify many RA patients with elevated cardiovascular risk.

  17. Increased risk of coronary artery calcification progression in subjects with high baseline Lp(a) levels: The Kangbuk Samsung Health Study.

    Science.gov (United States)

    Cho, Jung Hwan; Lee, Da Young; Lee, Eun Seo; Kim, Jihyun; Park, Se Eun; Park, Cheol-Young; Lee, Won-Young; Oh, Ki-Won; Park, Sung-Woo; Rhee, Eun-Jung

    2016-11-01

    Results from previous studies support the association of lipoprotein(a) [Lp(a)] levels and coronary artery disease risk. In this study, we analyzed the association between baseline Lp(a) levels and future progression of coronary artery calcification (CAC) in apparently healthy Korean adults. A total of 2611 participants (mean age: 41years, 92% mend) who underwent a routine health check-up in 2010 and 2014 were enrolled. Coronary artery calcium score (CACS) were measured by multi-detector computed tomography. Baseline Lp(a) was measured by high-sensitivity immunoturbidimetric assay. Progression of CAC was defined as a change in CACS >0 over four years. Bivariate correlation analyses with baseline Lp(a) and other metabolic parameters revealed age, total cholesterol, HDL-C, LDL-C and CACS to have a significant positive correlation, while body weight, fasting glucose level, blood pressure and triglyceride level were negatively correlated with baseline Lp(a) level. After four years of follow-up, 635 subjects (24.3%) had CAC progression. The participants who had CAC progression were older, composed of more men, more obese, and had higher fasting glucose levels and worse baseline lipid profiles compared to those who did not have CAC progression. The mean serum Lp(a) level was significantly higher in subjects who had CAC progression compared to those who did not (32.5 vs. 28.9mg/dL, p<0.01). When the risk for CAC progression according to baseline Lp(a) was calculated, those with Lp(a) level≥50mg/dL had an odds ratio of 1.333 (95% CI 1.027-1.730) for CAC progression compared to those with Lp(a)<50mg/dL after adjusting for confounding factors. In this study, the subjects who had higher Lp(a) were at significantly higher risk for CAC progression after four years of follow-up, suggesting the role of high Lp(a) in CAC progression. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Coronary Artery Bypass Surgery

    Science.gov (United States)

    In coronary artery disease (CAD), the arteries that supply blood and oxygen to your heart muscle grow hardened and narrowed. You may try ... these treatments don't help, you may need coronary artery bypass surgery. The surgery creates a new ...

  19. 冠状动脉钙化积分与血钙、血磷的关系探讨%Association of Coronary Artery Calcification Scores with Serum Calcium and Phosphorus Levels

    Institute of Scientific and Technical Information of China (English)

    张春旺; 郭维军; 严士荣; 王连生

    2012-01-01

    目的 探讨64排螺旋CT冠状动脉钙化积分(CACS)与血清钙、磷的关系.方法 入选可疑冠状动脉粥样硬化患者84例,所有患者均行64排螺旋CT测量CACS以及行相关血液生化检查.结果 CACS与血清钙、磷有明显的相关性,血清钙、磷水平越高,CACS值越大.结论 血清钙、磷水平的变化能较好的预测冠状动脉粥样钙化的发生、发展.%Objective To explore the relationship between the scrum calcium and phosphorus levels and coronary artery calcification scores(CACS) in coronary atherosclerosis patients,and to investigate its clinical value in the diagnosis of coronary atherosclerosis. Methods Eighty- four patients with doubtful coronary atherosclerosis were enrolled in this study. All of them performed 64 slice spiral CT angiography and blood biochemical test. CACS were calculated using the computer. Results There was a significant correlation between CACS and the scrum calcium and phosphorus levels. As the scrum calcium and phosphorus levels increased , CACS tended to increase. Conclusion The scrum calcium and phosphorus levels could predict the occurrence and development of coronary artery calcification.

  20. Analyze Mentioned of Serum Levels of Osteoprotegerin and Coronary Artery Calcification%骨保护素与冠状动脉钙化的相关性研究

    Institute of Scientific and Technical Information of China (English)

    于慧春

    2012-01-01

      Objective:To analyze the serum levels of osteoprotegerin in the patients with Coronary artery calcification, and to explore the relevance between above mentioned.Methods: 50 cases patients were collected in the people’s hospital of Zhalantun, All patients were screened for carotid plaque by using 16-slice spiral CT. According to the results, patients were classed as follows:the Coronary artery calcification group (n=30),no Coronary artery calcification group (n=20), General data of each patient, including gender, age, blood fat and blood glucose ,blood pressure, etc, were measured within 24 hours after admission to hospital, serum OPG levels were measured, coronary artery calcification scores were counted according to the result of The 16-slice spiral CT were used to analyze mentioned of the serum levels of osteoprotegerin and Coronary artery calcification. Results:(1)Serum OPG levels were significantly higher in the Coronary artery calcification patients than the control patients (p<0.01);(2)The scores of CACwere positively correlated with OPG levels (p<0.01);(3)Fasting plasma glucose (FPG) and LDL levels were significantly higher in CAC patients than the control patients (p<0.01, P<0.05).Conclusions: Serum OPG were significantly higher in CAC patients. Serum OPG levels were related with the scores of CAC, with the scores increased and OPG levels rised, this means that the marker has close relation with lesions progress of CAC. And the levels of OPG are significantly and positively correlated to FPG and LDL, which signifies in the development of CAC.%  目的:探讨血清骨保护素(OPG)水平与冠状动脉钙化(Coronary artery calcification,CAC)的相关性.方法:入选50例患者,所有入选患者均冠状动脉16层螺旋CT扫描,根据结果,CAC的患者30例作为实验组,冠脉无钙化者20例作为对照组,在入院24小时内记录各组患者的一般资料(包括性别、年龄、血脂、血糖、血压等),ELISA法检测各组

  1. Coronary Artery Disease

    Science.gov (United States)

    Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death ... happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due ...

  2. Inflammation in coronary artery diseases

    Institute of Scientific and Technical Information of China (English)

    LI Jian-jun

    2011-01-01

    The concept that atherosclerosis is an inflammation has been increasingly recognized,and subsequently resulted in great interest in revealing the inflammatory nature of the atherosclerotic process.More recently,a large body of evidence has supported the idea that inflammatory mechanisms play a pivotal role throughout all phases of atherogenesis,from endothelial dysfunction and the formation of fatty streaks to plaque destabilization and the acute coronary events due to vulnerable plaque rupture.Indeed,although triggers and pathways of inflammation are probably multiple and vary in different clinical entities of atherosclerotic disorders,an imbalance between anti-inflammatory mechanisms and pro-inflammatory factors will result in an atherosclerotic progression.Vascular endothelial dysfunction and lipoprotein retention into the arterial intima have been reported as the earliest events in atherogenesis with which inflammation is linked.Inflammatory has also been extended to the disorders of coronary microvasculature,and associated with special subsets of coronary artery disease such as silent myocardial ischemia,myocardial ischemia-reperfusion,cardiac syndrome X,variant angina,coronary artery ectasia,coronary calcification and in-stent restenosis.Inflammatory biomarkers,originally studied to better understand the pathophysiology of atherosclerosis,have generated increasing interest among researches and clinicians.The identification of inflammatory biomarkers and cellular/molecular pathways in atherosclerotic disease represent important goals in cardiovascular disease research,in particular with respect of the development of therapeutic strategies to prevent or reverse atherosclerotic diseases.

  3. Lipoprotein-associated phospholipase A2 and coronary calcification - The Rotterdam coronary calcification study

    NARCIS (Netherlands)

    Kardys, Isabella; Oei, Hok-Hay S.; Hofman, Albert; Oudkerk, Matthijs; Witteman, Jacqueline C. M.

    2007-01-01

    Objectives: Although several studies have recently suggested that lipoprotein-associated phospholipase A2 (Lp-PLA2) is an independent predictor of coronary events, only one study has examined the association between Lp-PLA2 and coronary calcification, using young adults. We investigated the associat

  4. A Comparison of Mortality Rates in a Large Population of Smokers and Non-smokers: based on the Presence or Absence of Coronary Artery Calcification

    Science.gov (United States)

    McEvoy, John W; Blaha, Michael J; Rivera, Juan J; Budoff, Matthew J; Khan, Atif N; Shaw, Leslee J; Berman, Daniel S; Raggi, Paolo; Min, James K; Rumberger, John A; Callister, Tracy Q; Blumenthal, Roger S.; Nasir, Khurram

    2015-01-01

    Objectives To further study the interplay between smoking status, Coronary Artery Calcium (CAC) and all-cause mortality. Background Prior studies have not directly compared the relative prognostic impact of CAC in smokers versus non-smokers. In particular, while zero CAC is a known favorable prognostic-marker, whether smokers without CAC have as good a prognosis as non-smokers without CAC is unknown. Given computed tomography (CT) screening for lung cancer appears effective in smokers, the relative prognostic implications of visualizing any CAC versus no CAC on such screening also deserve study. Methods Our study cohort consisted of 44,042 asymptomatic individuals referred for non-contrast cardiac CT (age 54±11 years, 54% males). Subjects were followed for a mean of 5.6 years. The primary endpoint was all-cause mortality. Results Approximately 14% (n=6020) of subjects were active smokers at enrollment. There were 901 deaths (2.05%) overall, with increased mortality in smokers vs. non-smokers (4.3% vs. 1.7%, p400). In multivariable analysis within these strata, we found mortality hazard ratios (HRs) of 3.8 (95% CI, 2.8-5.2), 3.5 (2.6-4.9), and 2.7 (2.1-3.5), respectively, in smokers compared to nonsmokers. At each stratum of elevated CAC score, mortality in smokers was consistently higher than mortality in non-smokers from the CAC stratum above. However, among the 19,898 individuals with CAC=0, the mortality HR for smokers without CAC was 3.6 (95% CI, 2.3-5.7), compared to non-smokers without CAC. Conclusion Smoking is a risk factor for death across the entire spectrum of subclinical coronary atherosclerosis. Smokers with any coronary calcification are at significantly increased future mortality risk than smokers without CAC. However, the absence of CAC may not be as useful a “negative risk factor” in active smokers; as this group has mortality rates similar to non-smokers with mild to moderate atherosclerosis. PMID:23058072

  5. Medial arterial calcification, calcific aortic stenosis and mitral annular calcification in a diabetic patient with severe autonomic neuropathy.

    LENUS (Irish Health Repository)

    Cronin, C C

    2012-02-03

    Medial arterial calcification (Monckeberg\\'s arteriosclerosis) is well described in diabetic patients with autonomic neuropathy. There is also a high prevalence of diabetes mellitus among subjects with calcific aortic stenosis and mitral annular calcification. We describe a diabetic patient with autonomic neuropathy and extensive medial arterial calcification who also had calcification of the aortic valve and of the mitral valve annulus. We propose that autonomic neuropathy may play a role in calcification of these structures at the base of the heart.

  6. Coronary artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Koischwitz, D.; Harder, T.; Schuppan, U.; Thurn, P.

    1982-04-01

    Seven saccular coronary artery aneurysms have been demonstrated in the course of 1452 selective coronary artery angiograms. In six patients they were arterio-sclerotic; in one patient the aneurysm must have been congenital or of mycotic-embolic origin. The differential diagnosis between true aneurysms and other causes of vascular dilatation is discussed. Coronary artery aneurysms have a poor prognosis because of the possibility of rupture with resultant cardiac tamponade, or the development of thrombo-embolic myocardial infarction. These aneurysms can only be diagnosed by means of coronary angiography and require appropriate treatment.

  7. Progression of coronary calcification in healthy postmenopausal women

    Directory of Open Access Journals (Sweden)

    Burt Jeremy

    2004-12-01

    Full Text Available Abstract Background Coronary artery calcium score incrementally improves coronary risk prediction beyond that provided by conventional risk factors. Limited information is available regarding rates of progression of coronary calcification in women, particularly those with baseline scores above zero. Further, determinants of progression of coronary artery calcification in women are not well understood. This study prospectively evaluated rates and determinants of progression of coronary artery calcium score in a group of healthy postmenopausal women. Methods We determined coronary calcium score by computed tomography and recorded demographic, lifestyle and health characteristics of 914 postmenopausal women, a subset of those enrolled in the Women's Health Initiative Observational Study. The 305 women with calcium score ≥10 Agatston units at baseline were invited for repeat scan. This analysis includes the 94 women who underwent second scans. Results Mean age of study participants was 65 ± 9 years (mean ± SD, body mass index was 26.1 ± 6.1 kg/m2, and baseline calcium score was 162 ± 220 Agatston units. Mean interval between scans was 3.3 ± 0.7 years. A wide range of changes in coronary calcium score was observed, from -53 to +452 Agatston units/year. Women with lower scores at baseline had smaller annual increases in absolute calcium score. Coronary calcium scores increased 11, 31 and 79 Agatston units/year among women with baseline calcium score in the lowest, middle and highest tertiles. In multivariate analysis, age was not an independent predictor of absolute change in coronary calcium score. Hydroxymethylglutaryl coenzyme A reductase inhibitor (statin use at baseline was a negative predictor (p = 0.015, whereas baseline calcium score was a strong, positive predictor (p Conclusion Among postmenopausal women with coronary calcium score ≥ 10 Agatston units, rates of change of coronary calcium score varied widely. In multivariate analysis

  8. Arterial calcification: Conscripted by collagen

    Science.gov (United States)

    Miller, Jordan D.

    2016-03-01

    In atherosclerotic plaques, patterns of calcification -- which have profound implications for plaque stability and vulnerability to rupture -- are determined by the collagen's content and patterning throughout the plaque.

  9. Reliable categorisation of visual scoring of coronary artery calcification on low-dose CT for lung cancer screening: validation with the standard Agatston score

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Yi-Luan; Wu, Fu-Zong; Wang, Yen-Chi [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung 813 (China); National Yang Ming University, Faculty of Medicine, School of Medicine, Taipei (China); Ju, Yu-Jeng [National Taiwan University, Department of Psychology, Taipei (China); Mar, Guang-Yuan [Kaohsiung Veterans General Hospital, Division of Cardiology, Department of Medicine, Kaohsiung 813 (China); Chuo, Chiung-Chen [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung 813 (China); Lin, Huey-Shyan [Fooyin University, School of Nursing, Kaohsiung (China); Wu, Ming-Ting [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung 813 (China); National Yang Ming University, Faculty of Medicine, School of Medicine, Taipei (China); National Yang Ming University, Institute of Clinical Medicine, Taipei (China)

    2013-05-15

    To validate the reliability of the visual coronary artery calcification score (VCACS) on low-dose CT (LDCT) for concurrent screening of CAC and lung cancer. We enrolled 401 subjects receiving LDCT for lung cancer screening and ECG-gated CT for the Agatston score (AS). LDCT was reconstructed with 3- and 5-mm slice thickness (LDCT-3mm and LDCT-5mm respectively) for VCACS to obtain VCACS-3mm and VCACS-5mm respectively. After a training session comprising 32 cases, two observers performed four-scale VCACS (absent, mild, moderate, severe) of 369 data sets independently, the results were compared with four-scale AS (0, 1-100, 101-400, >400). CACs were present in 39.6 % (146/369) of subjects. The sensitivity of VCACS-3mm was higher than for VCACS-5mm (83.6 % versus 74.0 %). The median of AS of the 24 false-negative cases in VCACS-3mm was 2.3 (range 1.1-21.1). The false-negative rate for detecting AS {>=} 10 on LDCT-3mm was 1.9 %. VCACS-3mm had higher concordance with AS than VCACS-5mm (k = 0.813 versus k = 0.685). An extended test of VCACS-3mm for four junior observers showed high inter-observer reliability (intra-class correlation = 0.90) and good concordance with AS (k = 0.662-0.747). This study validated the reliability of VCACS on LDCT for lung cancer screening and showed that LDCT-3mm was more feasible than LDCT-5mm for CAD risk stratification. (orig.)

  10. Thyrotrophin levels and coronary artery calcification: Cross-sectional results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Peixoto de Miranda, Érique José F; Bittencourt, Márcio Sommer; Staniak, Henrique Lane; Pereira, Alexandre C; Foppa, Murilo; Santos, Itamar S; Lotufo, Paulo A; Benseñor, Isabela M

    2017-06-13

    There is little information about the association between thyrotrophin (TSH) levels and coronary artery calcification (CAC). Our aim was to analyse the association between TSH quintiles and subclinical atherosclerosis measured by CAC, using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Cross-sectional study. We excluded individuals using medications that affect thyroid function and who self-reported cardiovascular disease. We included euthyroid subjects and individuals with subclinical hypothyroidism (SCHypo) and subclinical hyperthyroidism (SCHyper). Logistic regression models evaluated CAC >100 Agatston units as the dependent variable, and increasing quintiles of TSH as the independent variable, adjusted for demographic and cardiovascular risk factors. Our sample included 3836 subjects, mean age 49 years (interquartile range 44-56); 1999 (52.1%) were female, 3551 (92.6%) were euthyroid, 239 (6.2%) had SCHypo and 46 (1.2%) had SCHyper. The frequency of women, White people and never smokers as well as body mass index and insulin resistance increased according to quintiles. The 1st quintile for TSH (0-0.99 mIU/L) was associated with CAC >100, using the 3rd quintile (1.39-1.85 mIU/L) as reference (adjusted OR=1.57, 95% CI: 1.05-2.35, P=.027), but no association was shown for the 5th quintile (2.68-35.5 mIU/L) compared to the 3rd. Restricting the analysis to euthyroid subjects did not change the results. For women, but not for men, we observed a U-shaped curve with 1st and 5th TSH quintiles associated with CAC>100. Low and low-normal (1st quintile) TSH levels were associated with CAC>100 Agatston units in a sample with subclinical thyroid disorders and euthyroid subjects. © 2017 John Wiley & Sons Ltd.

  11. Increased Risk of Progression of Coronary Artery Calcification in Male Subjects with High Baseline Waist-to-Height Ratio: The Kangbuk Samsung Health Study.

    Science.gov (United States)

    Oh, Hyung Geun; Nallamshetty, Shriram; Rhee, Eun Jung

    2016-02-01

    The waist-to-height ratio (WHtR) is an easy and inexpensive adiposity index that reflects central obesity. In this study, we examined the association of baseline WHtR and progression of coronary artery calcification (CAC) over 4 years of follow-up in apparently healthy Korean men. A total of 1,048 male participants (mean age, 40.9 years) in a health-screening program in Kangbuk Samsung Hospital, Seoul, Korea who repeated a medical check-up in 2010 and 2014 were recruited. Baseline WHtR was calculated using the value for the waist in 2010 divided by the value for height in 2010. The CAC score (CACS) of each subject was measured by multi-detector computed tomography in both 2010 and 2014. Progression of CAC was defined as a CACS change over 4 years greater than 0. During the follow-up period, progression of CAC occurred in 278 subjects (26.5%). The subjects with CAC progression had slightly higher but significant baseline WHtR compared to those who did not show CAC progression (0.51±0.04 vs. 0.50±0.04, P<0.01). The proportion of subjects with CAC progression significantly increased as the baseline WHtR increased from the 1st quartile to 4th quartile groups (18.3%, 18.7%, 28.8%, and 34.2%; P<0.01). The risk for CAC progression was elevated with an odds ratio of 1.602 in the 4th quartile group of baseline WHtR even after adjustment for confounding variables (95% confidence interval, 1.040 to 2.466). Increased baseline WHtR was associated with increased risk for CAC progression. WHtR might be a useful screening tool to identify individuals at high risk for subclinical atherosclerosis.

  12. Relationship of Insulin Resistance to Prevalence and Progression of Coronary Artery Calcification Beyond Metabolic Syndrome Components: Shiga Epidemiological Study of Subclinical Atherosclerosis.

    Science.gov (United States)

    Yamazoe, Masahiro; Hisamatsu, Takashi; Miura, Katsuyuki; Kadowaki, Sayaka; Zaid, Maryam; Kadota, Aya; Torii, Sayuki; Miyazawa, Itsuko; Fujiyoshi, Akira; Arima, Hisatomi; Sekikawa, Akira; Maegawa, Hiroshi; Horie, Minoru; Ueshima, Hirotsugu

    2016-08-01

    The association between insulin resistance (IR) and coronary artery calcification (CAC) has been uncertain after adjustment for metabolic syndrome components. We aimed to evaluate whether IR is associated with CAC prevalence or progression independently of metabolic syndrome components. We conducted a population-based study in a random sample of Japanese men aged 40 to 79 years and determined IR using the homeostasis model assessment of insulin resistance (HOMA-IR). The associations of HOMA-IR and other diabetic parameters per 1-SD increase with CAC prevalence and progression were evaluated using multivariable logistic regression. Of 1006 total participants at baseline (mean age, 64±10 years), CAC prevalence was observed in 646 (64.2%), and of 789 participants at follow-up (mean duration, 4.9±1.3 years), CAC progression was observed in 365 (46.3%). After adjustment for covariates including metabolic syndrome components, higher HOMA-IR was independently associated with CAC prevalence (adjusted odds ratio 1.34, 95% confidence interval 1.10-1.63; P=0.003) and progression (odds ratio 1.32, 95% confidence interval 1.09-1.60; P=0.004). In participants without diabetes mellitus, positive associations were similarly observed (prevalence: odds ratio 1.29, 95% confidence interval 1.04-1.60; P=0.022; and progression: odds ratio 1.25, 95% confidence interval 1.01-1.55; P=0.042), whereas glucose and hemoglobin A1c were not associated with CAC prevalence and progression. Higher IR was associated with CAC prevalence and progression independently of metabolic syndrome components in Japanese men and also in those without diabetes mellitus. Among diabetic measures, IR and fasting insulin, but not glucose and hemoglobin A1c, predicted CAC progression in men without diabetes mellitus. © 2016 American Heart Association, Inc.

  13. Coronary Artery Bypass

    Directory of Open Access Journals (Sweden)

    Kadri Ceberut

    2011-01-01

    Full Text Available Ancient schwannoma is a rare variant of neural tumors though rarely seen in the thorax. The combination with coronary artery diseases is also rare. Here we describe a 66 year-old male who had undergone one-stage combined surgery for thoracic ancient schwannomas removal and coronary artery disease. The masses were, respectively, 13 cm in the middle mediastinum and 5 cm in diameter originating from the intercostal nerve. The tumors were successfully removed using sternotomy, and then a coronary artery bypass grafting was performed. Here we discuss this rare tumor in relation to the relevant literature.

  14. Transradial artery coronary angioplasty.

    Science.gov (United States)

    Kiemeneij, F; Laarman, G J; de Melker, E

    1995-01-01

    This study explored the feasibility and safety of percutaneous coronary balloon angioplasty (PTCA) with miniaturized PTCA equipment via the radial artery. Coronary angioplasty (PTCA) via the femoral or brachial arteries may be associated with rare vascular complications such as bleeding and damage to the artery and adjacent structures. It was postulated that PTCA via the radial artery with miniaturized angioplasty equipment is feasible and that no major puncture site-related complications occur because hemostasis is obtained easily and because no major structures are near the radial artery. With double blood supply to the hand, radial artery occlusion is well tolerated. In 100 patients with collateral blood supply to the right hand, PTCA was attempted with 6F guiding catheters and rapid-exchange balloon catheters for exertional angina (87 patients) or nonexertional angina (13 patients). Angioplasty was attempted in 122 lesions (type A n = 67 [55%], Type B n = 37 [30%], and type C n = 18 [15%]). Pre- and post-PTCA computerized quantitative coronary analysis was performed. Radial artery function and structure were assessed clinically and with Doppler and two-dimensional ultrasound on the day of discharge. Coronary catheterization via the radial artery was successful in 94 patients (94%). The 6 remaining patients had successful PTCA via the femoral artery (n = 5) or the brachial artery (n = 1). Procedural success (120 of 122 lesions) was achieved in 92 patients (98%) via the radial artery and in 98 patients of the total study population.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Coronary calcification improves cardiovascular risk prediction in the elderly

    NARCIS (Netherlands)

    Vliegenthart, R; Oudkerk, M; Hofman, A; Oei, HHS; van Dijck, W; van Rooij, FJA; Witteman, JCM

    2005-01-01

    Background - Coronary calcification detected by electron beam tomography may improve cardiovascular risk prediction. The technique is particularly promising in the elderly because the predictive power of cardiovascular risk factors weakens with age. We investigated the prognostic value of coronary c

  16. [Detection of coronary calcifications by electron beam tomography and multislice spiral CT: clinical relevance].

    Science.gov (United States)

    Achenbach, S; Schmermund, A; Erbel, R; Silber, S; Haberl, R; Moshage, W; Daniel, W G

    2003-11-01

    Coronary calcifications can be detected and quantified using electron beam tomography (EBT) or newer generation multi-slice spiral CT (MSCT) scanners. An abundance of data has been acquired by EBT. It could be shown that the amount of coronary calcium correlates to the coronary plaque burden. The detection of coronary calcium with CT imaging methods therefore provides a unique opportunity to detect and quantify coronary atherosclerosis in a subclinical stage. Consequently, the presence and amount of coronary calcium has been shown to be indicative for an increased coronary event risk in symptomatic and asymptomatic individuals. Several clinical studies found a predictive value that was superior to conventional risk factors. Clinically, the use of coronary calcification assessment may therefore be beneficial in patients who, based on traditional risk factors, seem to be at "intermediate risk" for coronary events (10-year event risk 10-20%) in order to decide on the aggressiveness of risk factor modification. The role of coronary calcium quantification to monitor the progression of disease has not been clarified yet. Large, ongoing trials will provide further data as to the relative merit of coronary calcium assessment for risk stratification and will help to more clearly define its clinical role. The relationship between coronary calcium and coronary stenoses is more complex. While the absence of coronary calcifications makes significant coronary stenoses unlikely, even large amounts of coronary calcium do not necessarily indicate the presence of coronary artery stenoses. Pronounced coronary calcifications as an isolated finding should therefore not be the motivation for invasive diagnostic procedures in the absence of other evidence of ischemic heart disease.

  17. Coronary Artery Imaging in Children

    Science.gov (United States)

    2015-01-01

    Coronary artery problems in children usually have a significant impact on both short-term and long-term outcomes. Early and accurate diagnosis, therefore, is crucial but technically challenging due to the small size of the coronary artery, high heart rates, and limited cooperation of children. Coronary artery visibility on CT and MRI in children is considerably improved with recent technical advancements. Consequently, CT and MRI are increasingly used for evaluating various congenital and acquired coronary artery abnormalities in children, such as coronary artery anomalies, aberrant coronary artery anatomy specific to congenital heart disease, Kawasaki disease, Williams syndrome, and cardiac allograft vasculopathy. PMID:25741188

  18. Coronary Artery Disease

    DEFF Research Database (Denmark)

    Christiansen, Morten Krogh

    2017-01-01

    A family history of coronary artery disease (CAD) is an important risk factor for adverse coronary events, in particular if the disease has an early onset. The risk of CAD is influenced by genetic and environmental factors with a greater genetic contribution earlier in life. Through recent years...... Registry and risk factor control was evaluated. The study revealed that risk factors are common in early-onset CAD and that a large room for risk factor improvement remains. In study II, we used coronary computed tomography angiography to compare the coronary plaque burden and characteristics between 88...... first-degree relatives of patients with early-onset CAD and 88 controls with no familial predisposition. Relatives had a significantly increased coronary plaque burden, which displayed characteristics associated with myocardial ischemia and adverse coronary events. In study III, 134 patients with early...

  19. Genome-wide association study of coronary and aortic calcification in lung cancer screening CT

    Science.gov (United States)

    de Vos, Bob D.; van Setten, Jessica; de Jong, Pim A.; Mali, Willem P.; Oudkerk, Matthijs; Viergever, Max A.; Išgum, Ivana

    2016-03-01

    Arterial calcification has been related to cardiovascular disease (CVD) and osteoporosis. However, little is known about the role of genetics and exact pathways leading to arterial calcification and its relation to bone density changes indicating osteoporosis. In this study, we conducted a genome-wide association study of arterial calcification burden, followed by a look-up of known single nucleotide polymorphisms (SNPs) for coronary artery disease (CAD) and myocardial infarction (MI), and bone mineral density (BMD) to test for a shared genetic basis between the traits. The study included a subcohort of the Dutch-Belgian lung cancer screening trial comprised of 2,561 participants. Participants underwent baseline CT screening in one of two hospitals participating in the trial. Low-dose chest CT images were acquired without contrast enhancement and without ECG-synchronization. In these images coronary and aortic calcifications were identified automatically. Subsequently, the detected calcifications were quantified using coronary artery calcium Agatston and volume scores. Genotype data was available for these participants. A genome-wide association study was conducted on 10,220,814 SNPs using a linear regression model. To reduce multiple testing burden, known CAD/MI and BMD SNPs were specifically tested (45 SNPs from the CARDIoGRAMplusC4D consortium and 60 SNPS from the GEFOS consortium). No novel significant SNPs were found. Significant enrichment for CAD/MI SNPs was observed in testing Agatston and coronary artery calcium volume scores. Moreover, a significant enrichment of BMD SNPs was shown in aortic calcium volume scores. This may indicate genetic relation of BMD SNPs and arterial calcification burden.

  20. Sudden death in a captive meerkat (Suricata suricatta with arterial medial and myocardial calcification

    Directory of Open Access Journals (Sweden)

    Laura Bongiovann

    2016-04-01

    Full Text Available A 1-year-old male meerkat was found dead by the owner. The animal was clinically healthy and was regularly vaccinated for distemper virus. Necropsy revealed multifocal to confluent dry white areas in the myocardium, pneumonia and congestive hepatopathy. All the other organs, including gross vessels, were macroscopically normal. The heart showed histologically large, multifocal to confluent areas of mineralization of the myocardium and the wall of small coronary artery. Vascular calcifications were also observed in the hepatic portal tracts and kidneys arteries of small/medium sizes. The arterial lumen appeared narrowed and the wall thickened due to the calcification of the tunica media. In veterinary medicine, arterial mineralization is regarded as a metastatic calcification, as the result of hypercalcemia and/or hyperphosphatemia. However, today, the pathogenesis of medial artery calcification in humans seems to be the results of an active process resembling embryonic osteogenesis, rather than a mere passive process.

  1. Electrocardiogram Abnormalities and Coronary Calcification in Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Michiel Bots

    2010-02-01

    Full Text Available Background: An electrocardiogram (ECG can provide information on subclinical myocardial damage. The presence,and more importantly, the quantity of coronary artery calcification (CAC, relates well with the overall severity of the atherosclerotic process. A strong relation has been demonstrated between coronary calcium burden and the incidence of myocardial infarction, a relation independent of age. The aim of this study was to assess the relation of left ventricular hypertrophy (LVH and ECG abnormalities with CAC.Methods: The study population comprised 566 postmenopausal women selected from a population-based cohort study.Information on LVH and repolarization abnormalities (T-axis and QRS-T angle was obtained using electrocardiography.Modular ECG Analysis System (MEANS was used to assess ECG abnormalities. The women underwent a multi detectorrow computed tomography (MDCT scan (Philips Mx 8000 IDT 16 to assess CAC. The Agatston score was used to quantifyCAC; scores greater than zero were considered as the presence of coronary calcium. Logistic regression was used to assessthe relation of ECG abnormality with coronary calcification.Results: LVH was found in 2.7% (n = 15 of the women. The prevalence of T-axis abnormality was 6% (n = 34, whereas 8.5% (n = 48 had a QRS-T angle abnormality. CAC was found in 62% of the women. Compared to women with a normal T-axis, women with borderline or abnormal T-axes were 3.8 fold more likely to have CAC (95% CI: 1.4-10.2. Similarly,compared to women with a normal QRS-T angle, in women with borderline or abnormal QRS-T angle, CAC was 2.0 fold more likely to be present (95% CI: 1.0-4.1.Conclusion: Among women with ECG abnormalities reflecting subclinical ischemia, CAC is commonly found and may in part explain the increased coronary heart disease risk associated with these ECG abnormalities.

  2. Coronary Artery Anomalies in Animals

    Directory of Open Access Journals (Sweden)

    Brian A. Scansen

    2017-04-01

    Full Text Available Coronary artery anomalies represent a disease spectrum from incidental to life-threatening. Anomalies of coronary artery origin and course are well-recognized in human medicine, but have received limited attention in veterinary medicine. Coronary artery anomalies are best described in the dog, hamster, and cow though reports also exist in the horse and pig. The most well-known anomaly in veterinary medicine is anomalous coronary artery origin with a prepulmonary course in dogs, which limits treatment of pulmonary valve stenosis. A categorization scheme for coronary artery anomalies in animals is suggested, dividing these anomalies into those of major or minor clinical significance. A review of coronary artery development, anatomy, and reported anomalies in domesticated species is provided and four novel canine examples of anomalous coronary artery origin are described: an English bulldog with single left coronary ostium and a retroaortic right coronary artery; an English bulldog with single right coronary ostium and transseptal left coronary artery; an English bulldog with single right coronary ostium and absent left coronary artery with a prepulmonary paraconal interventricular branch and an interarterial circumflex branch; and a mixed-breed dog with tetralogy of Fallot and anomalous origin of all coronary branches from the brachiocephalic trunk. Coronary arterial fistulae are also described including a coronary cameral fistula in a llama cria and an English bulldog with coronary artery aneurysm and anomalous shunting vessels from the right coronary artery to the pulmonary trunk. These examples are provided with the intent to raise awareness and improve understanding of such defects.

  3. Arterial ageing: from endothelial dysfunction to vascular calcification.

    Science.gov (United States)

    Tesauro, M; Mauriello, A; Rovella, V; Annicchiarico-Petruzzelli, M; Cardillo, C; Melino, G; Di Daniele, N

    2017-05-01

    Complex structural and functional changes occur in the arterial system with advancing age. The aged artery is characterized by changes in microRNA expression patterns, autophagy, smooth muscle cell migration and proliferation, and arterial calcification with progressively increased mechanical vessel rigidity and stiffness. With age the vascular smooth muscle cells modify their phenotype from contractile to 'synthetic' determining the development of intimal thickening as early as the second decade of life as an adaptive response to forces acting on the arterial wall. The increased permeability observed in intimal thickening could represent the substrate on which low-level atherosclerotic stimuli can promote the development of advanced atherosclerotic lesions. In elderly patients the atherosclerotic plaques tend to be larger with increased vascular stenosis. In these plaques there is a progressive accumulation of both lipids and collagen and a decrease of inflammation. Similarly the plaques from elderly patients show more calcification as compared with those from younger patients. The coronary artery calcium score is a well-established marker of adverse cardiovascular outcomes. The presence of diffuse calcification in a severely stenotic segment probably induces changes in mechanical properties and shear stress of the arterial wall favouring the rupture of a vulnerable lesion in a less stenotic adjacent segment. Oxidative stress and inflammation appear to be the two primary pathological mechanisms of ageing-related endothelial dysfunction even in the absence of clinical disease. Arterial ageing is no longer considered an inexorable process. Only a better understanding of the link between ageing and vascular dysfunction can lead to significant advances in both preventative and therapeutic treatments with the aim that in the future vascular ageing may be halted or even reversed. © 2017 The Association for the Publication of the Journal of Internal Medicine.

  4. Evaluation of coronary arterial lesions due to Kawasaki disease using optical coherence tomography.

    Science.gov (United States)

    Kakimoto, Nobuyuki; Suzuki, Hiroyuki; Kubo, Takashi; Suenaga, Tomohiro; Takeuchi, Takashi; Shibuta, Shoichi; Ino, Yasushi; Akasaka, Takashi; Yoshikawa, Norishige

    2014-08-01

    Optical coherence tomography (OCT) is a high-resolution intracoronary arterial imaging modality. We describe 2 patients who were admitted to undergo coronary angiography and OCT for follow-up of Kawasaki disease with coronary artery aneurysms. OCT clearly demonstrated thrombus, stenosis, fibrotic intimal thickening with lamellar calcification, and partial disappearance of the tunica media at the aneurysm site. In addition, focal calcification, intimal thickening, and medial irregularity were observed even in regions of coronary arterial walls that appeared to be normal using coronary angiography. OCT is useful for evaluating coronary arterial sequelae of Kawasaki disease. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  5. Case Report: Coronary arterial spasm in single right coronary artery

    Institute of Scientific and Technical Information of China (English)

    En-zhi JIA; Qi-jun SHAN; Zhi-jian YANG; Tie-bing ZHU; Lian-sheng WANG; Ke-jiang CAO; Wen-zhu MA

    2009-01-01

    We presented a case of anomalous single-coronary artery detected incidentally during routine coronary angiography. A 32-year-old male Chinese patient presented with recurrent pre-syncope and six episodes of syncope. Coronary angiography and coronary-computed tomography (CT)-angiography performed by a dual-source computed tomography (DSCT) revealed that the patient had a single large right coronary artery. A moderately large branch originated from the proximal part of the single right coronary artery and extended to the left, passing the anterior to the pulmonary artery, and divided into the anterior descending artery branch and circumflex branch at the base of the left auricular appendage. The episodes of the syncope were suspected to be caused by coronary arterial spasm, so this patient was on a regimen of 30 mg of diltiazem every 6 h and had no recurrence of syncope during follow-up.

  6. Dual anterior descending coronary artery associated with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Siqueira Luciane da L. V.

    2003-01-01

    Full Text Available The patient is a male with risk factors for coronary artery disease, who was referred for cardiac catheterization after acute myocardial infarction in the inferior wall. The patient underwent transluminal coronary angioplasty in the right coronary artery with successful stent implantation.

  7. Application value of coronary artery calcification score with 16 slice spiral CT in the diagnosis of coronary heart disease%16层螺旋 CT 冠状动脉钙化积分在冠心病诊断中的应用价值研究

    Institute of Scientific and Technical Information of China (English)

    杨德胜

    2016-01-01

    Objective To investigate the value of coronary artery calcification score with16 slice spiral CT in the diagnosis of coronary heart disease .Methods A total of 35 cases patients with coronary heart disease admitted to our hospital from August 2013 to August 2015 were selected as the observation group ,and 35 patients with non-coronary heart disease were selected as con-trol group .Two groups of patients were performed of coronary artery calcification score with 16 slice spiral CT ,and coronary artery calcification score and total score of the two groups were compared .Results The scores of right coronary artery ,left anterior de-scending branch ,left anterior descending artery ,left anterior descending artery ,left main stem and total calcification score in the ob-servation group were significantly higher than those in the control group (P< 0 .05) .Condition of vascular calcification was as fol-lowing :the rate of patients with severe calcification was the highest in the observation group (88 .57% ) ,and the rate of patients without calcification in control group was the highest (77 .14% ) .Meanwhile ,the rates of patients without calcification and patients with a little calcification of the observation group were significantly lower than that of the control group (P< 0 .05) .The rate of pa-tients with severe calcification in the observation group was significantly higher than that in the control group (P< 0 .05) .Conclu-sion Coronary artery calcification score with 16 slice spiral CT can help to clarify the degree of calcification in patients with coro-nary heart disease ,which has higher clinical value and could be used for screening and diagnosis of coronary heart disease .%目的:探讨16层螺旋 CT 冠状动脉钙化积分对于冠心病诊断的应用价值。方法选择2013年8月至2015年8月在该院收治的35例冠心病患者作为观察组,另选择同期收治的35例非冠心病患者作为对照组。两组患者均行16层螺旋 CT 冠状

  8. ADVANCE: Study to Evaluate Cinacalcet Plus Low Dose Vitamin D on Vascular Calcification in Subjects With Chronic Kidney Disease Receiving Hemodialysis

    Science.gov (United States)

    2014-07-14

    Chronic Kidney Disease; End Stage Renal Disease; Coronary Artery Calcification; Vascular Calcification; Calcification; Cardiovascular Disease; Chronic Renal Failure; Hyperparathyroidism; Kidney Disease; Nephrology; Secondary Hyperparathyroidism

  9. Coronary calcification with no flow limiting lesions: A potential cause for ischaemic dysfunction in syndrome X patients

    Directory of Open Access Journals (Sweden)

    Elisabetta Palmerini

    2015-12-01

    Conclusion: In symptomatic patients with no obstructive coronary lesions and with more than mild CAC, long axis disturbances and wall motion score index rise occur with stress, at the time of symptom development and correlate with severity of arterial calcification. These findings suggest CAC as a potential mechanism for coronary wall stiffness and consequently exertional ischaemic changes as a result of limited flow reserve.

  10. Using Coronary Artery Calcification Combined with Pretest Clinical Risk Assessment as a Means of Determining Investigation and Treatment in Patients Presenting with Chest Pain in a Rural Setting

    Directory of Open Access Journals (Sweden)

    Baskar Sekar

    2015-01-01

    Full Text Available 462 patients presenting with chest pain to a rural district general hospital underwent calcium scoring and pretest clinical risk assessment in order to stratify subsequent investigations and treatment was retrospectively reviewed. The patients were followed up for two years and further investigations and outcomes recorded. Of the 206 patients with zero calcium score, 132 patients were immediately discharged from cardiac follow-up with no further investigation on the basis of their calcium score, low pretest risk of coronary artery disease, and no significant incidental findings. After further tests, 267 patients were discharged with no further cardiac therapy, 88 patients were discharged with additional medical therapy, and 19 patients underwent coronary artery by-pass grafting or percutaneous intervention. 164 patients with incidental findings on the chest CT (computed tomography accompanying calcium scoring were reviewed, of which 88 patients underwent further tests and follow-up for noncardiac causes of chest pain. The correlations between all major risk factors and calcium scores were weak except for a combination of diabetes and hypertension in the male gender (P=0.012, The use of calcium scoring and pretest risk appeared to reduce the number of unnecessary cardiac investigations in our patients: however, the calcium scoring test produced a high number of incidental findings on the associated CT scans.

  11. Medial arterial calcification in diabetes and its relationship to neuropathy

    DEFF Research Database (Denmark)

    Jeffcoate, W J; Rasmussen, Lars Melholt; Hofbauer, L C

    2009-01-01

    Calcification of the media of arterial walls is common in diabetes and is particularly associated with distal symmetrical neuropathy. Arterial calcification also complicates chronic kidney disease and is an independent risk factor for cardiovascular and all-cause mortality. The term calcification...... factor linked to the development of arterial calcification is distal symmetrical neuropathy; indeed, it has been suggested that neuropathy explains the distal distribution of arterial calcification in diabetes. It has also been suggested that the link with neuropathy results from loss of neuropeptides......, such as calcitonin gene-related peptide, which are inherently protective. The association between distal symmetrical neuropathy and calcification of the arterial wall highlights the fact that neuropathy may be an independent risk factor for cardiovascular mortality....

  12. Cardiac Calcification

    Directory of Open Access Journals (Sweden)

    Morteza Joorabian

    2011-05-01

    Full Text Available There is a spectrum of different types of cardiac"ncalcifications with the importance and significance"nof each type of cardiac calcification, especially"ncoronary artery calcification. Radiologic detection of"ncalcifications within the heart is quite common. The"namount of coronary artery calcification correlates"nwith the severity of coronary artery disease (CAD."nCalcification of the aortic or mitral valve may indicate"nhemodynamically significant valvular stenosis."nMyocardial calcification is a sign of prior infarction,"nwhile pericardial calcification is strongly associated"nwith constrictive pericarditis. A spectrum of different"ntypes of cardiac calcifications (linear, annular,"ncurvilinear,... could be seen in chest radiography and"nother imaging modalities. So a carful inspection for"ndetection and reorganization of these calcifications"nshould be necessary. Numerous modalities exist for"nidentifying coronary calcification, including plain"nradiography, fluoroscopy, intravascular ultrasound,"nMRI, echocardiography, and conventional, helical and"nelectron-beam CT (EBCT. Coronary calcifications"ndetected on EBCT or helical CT can be quantifie,"nand a total calcification score (Cardiac Calcification"nScoring may be calculated. In an asymptomatic"npopulation and/or patients with concomitant risk"nfactors like diabetes mellitus, determination of the"npresence of coronary calcifications identifies the"npatients at risk for future myocardial infarction and"ncoronary artery disease. In patients without coronary"ncalcifications, future cardiovascular events could"nbe excluded. Therefore, detecting and recognizing"ncalcification related to the heart on chest radiography"nand other imaging modalities such as fluoroscopy, CT"nand echocardiography may have important clinical"nimplications.

  13. Coronary artery anatomy and variants

    Energy Technology Data Exchange (ETDEWEB)

    Malago, Roberto; Pezzato, Andrea; Barbiani, Camilla; Alfonsi, Ugolino; Nicoli, Lisa; Caliari, Giuliana; Pozzi Mucelli, Roberto [Policlinico G.B. Rossi, University of Verona, Department of Radiology, Verona (Italy)

    2011-12-15

    Variants and congenital anomalies of the coronary arteries are usually asymptomatic, but may present with severe chest pain or cardiac arrest. The introduction of multidetector CT coronary angiography (MDCT-CA) allows the detection of significant coronary artery stenosis. Improved performance with isotropic spatial resolution and higher temporal resolution provides a valid alternative to conventional coronary angiography (CCA) in many patients. MDCT-CA is now considered the ideal tool for three-dimensional visualization of the complex and tortuous anatomy of the coronary arteries. With multiplanar and volume-rendered reconstructions, MDCT-CA may even outperform CCA in determining the relative position of vessels, thus providing a better view of the coronary vascular anatomy. The purpose of this review is to describe the normal anatomy of the coronary arteries and their main variants based on MDCT-CA with appropriate reconstructions. (orig.)

  14. Spontaneous Coronary Artery Dissection.

    Science.gov (United States)

    Tweet, Marysia S; Gulati, Rajiv; Hayes, Sharonne N

    2016-07-01

    Spontaneous coronary artery dissection is an important etiology of nonatherosclerotic acute coronary syndrome, myocardial infarction, and sudden death. Innovations in the catheterization laboratory including optical coherence tomography and intravascular ultrasound have enhanced the ability to visualize intimal disruption and intramural hematoma associated with SCAD. Formerly considered "rare," these technological advances and heightened awareness suggest that SCAD is more prevalent than prior estimates. SCAD is associated with female sex, young age, extreme emotional stress, or extreme exertion, pregnancy, and fibromuscular dysplasia. The clinical characteristics and management strategies of SCAD patients are different than for atherosclerotic heart disease and deserve specific consideration. This review will highlight recent discoveries about SCAD as well as describe current efforts to elucidate remaining gaps in knowledge.

  15. [The hemodynamic characterization of the diabetic patient with arterial calcifications].

    Science.gov (United States)

    Vega Gómez, M E; Ley Pozo, J; Aldama Figueroa, A; Lima Santana, B; Montalvo Diago, J; Bustillo, C; Fernández Boloña, A; Gutiérrez Jiménez, O; Ramirez Muñoz, O; Martínez Hernández, R

    1993-01-01

    This study was designed to describe the presence of calcifications according to the clinical features of the diabetic patient and the hemodynamics of the calcified arteries. With this purpose, 197 lower limbs from diabetic patients (type I and II) and carbon-hydrate intolerant patients, were studied. In all of the patients, the pressure ratio leg/arm was measured. On the same way, the arterial flow velocity was recorded using the Doppler ultrasonography on the pedia and postero-tibial arteries. The arterial calcifications, evident on the radiography of the foot, were more frequent between the type I patients and the neuro-infections diabetic foot. According to the hemodynamics point of view, we found a trend of association of more pathologic arterial flow velocity curves with the presence of calcifications (specially on the intima layer). It was also remarkable that an arterial incomprensibility was always associated with arterial calcifications.

  16. Coronary Artery Disease - Coronary Heart Disease

    Science.gov (United States)

    ... result of coronary artery disease, or CAD, said Edward A. Fisher, M.D., Ph.D., M.P. ... Problems and Disease • High Blood Pressure (HBP) • Metabolic Syndrome • Pericarditis • Peripheral Artery Disease (PAD) • Stroke • Vascular Health • ...

  17. Reliability analysis of visual ranking of coronary artery calcification on low-dose CT of the thorax for lung cancer screening: comparison with ECG-gated calcium scoring CT.

    Science.gov (United States)

    Kim, Yoon Kyung; Sung, Yon Mi; Cho, So Hyun; Park, Young Nam; Choi, Hye-Young

    2014-12-01

    Coronary artery calcification (CAC) is frequently detected on low-dose CT (LDCT) of the thorax. Concurrent assessment of CAC and lung cancer screening using LDCT is beneficial in terms of cost and radiation dose reduction. The aim of our study was to evaluate the reliability of visual ranking of positive CAC on LDCT compared to Agatston score (AS) on electrocardiogram (ECG)-gated calcium scoring CT. We studied 576 patients who were consecutively registered for health screening and undergoing both LDCT and ECG-gated calcium scoring CT. We excluded subjects with an AS of zero. The final study cohort included 117 patients with CAC (97 men; mean age, 53.4 ± 8.5). AS was used as the gold standard (mean score 166.0; range 0.4-3,719.3). Two board-certified radiologists and two radiology residents participated in an observer performance study. Visual ranking of CAC was performed according to four categories (1-10, 11-100, 101-400, and 401 or higher) for coronary artery disease risk stratification. Weighted kappa statistics were used to measure the degree of reliability on visual ranking of CAC on LDCT. The degree of reliability on visual ranking of CAC on LDCT compared to ECG-gated calcium scoring CT was excellent for board-certified radiologists and good for radiology residents. A high degree of association was observed with 71.6% of visual rankings in the same category as the Agatston category and 98.9% varying by no more than one category. Visual ranking of positive CAC on LDCT is reliable for predicting AS rank categorization.

  18. 冠状动脉钙化的机制与缺血性心脏病%Mechanism of the calcification in coronary arteries and ischemic heart disease

    Institute of Scientific and Technical Information of China (English)

    Masahiko Kurabayashi

    2010-01-01

    @@ Vascular calcification is a common problem a-mong the elderly and the patients with diabetes and chronic kidney disease(CKD),and may be associated with increased morbidity and mortality of cardiovas-cular disease.

  19. 老年患者慢性肾功能不全与冠状动脉钙化积分的相关性%Association between chronic kidney dysfunction and coronary artery calcification score in elderly patients

    Institute of Scientific and Technical Information of China (English)

    颜利求; 曹绪芬; 郑晔; 郭楠; 熊立新; 曹艳超; 赵世龙; 郭艳芬; 韩立宪

    2014-01-01

    Objective To investigate the association between chronic kidney dysfunction and coronary artery calcification score(CACS) in the elderly.Methods We prospectively studied 795 consecutive elderly patients with clinically suspected coronary artery disease who underwent 64-multidetector row computed tomography coronary angiography from January 2006 to December 2010.CACS was quantified using Agatston method.eGFR was calculated by the simplified modification of diet in renal disease(MDRD)equation.Patients were divided into four groups according to CACS as follows:No CACS(CACS =0),low CACS(0<CACS≤100),medium CACS(100<CACS≤400) and high CACS (CACS> 400).Ordinal logistic regression was used to analyze the association of chronic kidney dysfunction with CACS.Results Patients with higher CACS were older (F=4.99,P<0.01),had lower eGFR(F=10.16,P<0.001)and higher level of C-reactive protein(F=39.36,P <0.001),and were more likely to have a history of hypertension(x2 =18.59,P<0.001) and diabetes (x2=14.03,P<0.01)than patients without coronary artery calcification(CAC) or with lower CACS.Ordinal logistic regression showed that age,hypertension,diabetes,C-reactive protein and eGFR were independent risk factors for CAC.Conclusions Age,hypertension,diabetes mellitus,C-reactive protein and eGFR were independent risk factors for CAC in elderly patients.%目的 分析老年患者慢性肾功能不全与冠状动脉(冠脉)钙化积分(CACS)的相关性.方法 前瞻性连续性入选2006年1月至2010年12月因疑诊冠心病于我院行64层螺旋CT的老年患者795例,应用Agatston方法计算CACS,应用简化MDRD公式计算估算肾小球滤过率(eGFR).根据CACS将患者分为4组:无冠脉钙化组(CACS=0)、低冠脉钙化组(CACS 1~100)、中冠脉钙化组(CACS 101~400)以及高冠脉钙化组(CACS>400).通过有序Logistic回归分析慢性肾功能不全与冠状动脉钙化积分的相关性. 结果 高冠脉钙化组患者年龄大(F=4.99,P=0

  20. Robotics and coronary artery surgery.

    Science.gov (United States)

    Magee, Mitchell J; Mack, Michael J

    2002-11-01

    Significant progress in cardiac surgery, and specifically the surgical management of coronary artery disease, has been due in large part to enabling technology. Robotic systems have been recently developed and refined for use in cardiac surgery to facilitate, among other procedures, a totally endoscopic approach to coronary artery bypass surgery. These systems enhance precision through endoscopic approaches by specifically addressing the inherent limitations of conventional endoscopic coronary microsurgical instrumentation via computerized, digital interface, telemanipulation technology. With a combined experience of 125 patients, several groups have independently demonstrated the clinical feasibility of totally endoscopic coronary artery bypass with two commercially available robotic telemanipulation systems. Additional enabling technology is needed to overcome the challenges currently limiting development and widespread application of totally endoscopic off-pump multivessel coronary artery bypass surgery.

  1. Coronary CT angiography in coronary artery disease: Opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Zhonghua Sun

    2016-06-01

    Full Text Available Coronary CT angiography is widely recognised as a reliable imaging modality for the diagnosis of coronary artery disease. Coronary CT angiography not only provides excellent visualisation of anatomical changes in the coronary artery with high diagnostic value in the detection of lumen stenosis or occlusion, but also offers quantitative characterisation of coronary plaque components. Furthermore, coronary CT angiography allows myocardial perfusion imaging with diagnostic value comparable to the reference standard method. Coronary CT angiography-derived haemodynamic analysis has the potential to evaluate functional significance of coronary lesions. This review article aims to provide an overview of clinical applications of coronary CT angiography in coronary artery disease.

  2. The effect of intensive glycemic treatment on coronary artery calcification in type 1 diabetic participants of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study.

    Science.gov (United States)

    Cleary, Patricia A; Orchard, Trevor J; Genuth, Saul; Wong, Nathan D; Detrano, Robert; Backlund, Jye-Yu C; Zinman, Bernard; Jacobson, Alan; Sun, Wanjie; Lachin, John M; Nathan, David M

    2006-12-01

    The Epidemiology of Diabetes Interventions and Complications (EDIC) study, an observational follow-up of the Diabetes Control and Complications Trial (DCCT) type 1 diabetes cohort, measured coronary artery calcification (CAC), an index of atherosclerosis, with computed tomography (CT) in 1,205 EDIC patients at approximately 7-9 years after the end of the DCCT. We examined the influence of the 6.5 years of prior conventional versus intensive diabetes treatment during the DCCT, as well as the effects of cardiovascular disease risk factors, on CAC. The prevalences of CAC >0 and >200 Agatston units were 31.0 and 8.5%, respectively. Compared with the conventional treatment group, the intensive group had significantly lower geometric mean CAC scores and a lower prevalence of CAC >0 in the primary retinopathy prevention cohort, but not in the secondary intervention cohort, and a lower prevalence of CAC >200 in the combined cohorts. Waist-to-hip ratio, smoking, hypertension, and hypercholesterolemia, before or at the time of CT, were significantly associated with CAC in univariate and multivariate analyses. CAC was associated with mean HbA(1c) (A1C) levels before enrollment, during the DCCT, and during the EDIC study. Prior intensive diabetes treatment during the DCCT was associated with less atherosclerosis, largely because of reduced levels of A1C during the DCCT.

  3. Association of low baseline free thyroxin levels with progression of coronary artery calcification over 4 years in euthyroid subjects: the Kangbuk Samsung Health Study.

    Science.gov (United States)

    Park, Hye-Jeong; Kim, Jihyun; Han, Eun Jin; Park, Se Eun; Park, Cheol-Young; Lee, Won-Young; Oh, Ki-Won; Park, Sung-Woo; Rhee, Eun-Jung

    2016-06-01

    Overt and subclinical hypothyroidism are risk factors for atherosclerosis and cardiovascular diseases. It is unclear whether thyroid hormone levels within the normal range are also associated with atherosclerosis measured by coronary artery calcium (CAC). This study aimed to examine the relationship between normal variations in thyroid function and changes in CAC. We conducted a 4-year retrospective study of 2173 apparently healthy men and women with normal thyroid hormone levels. Their free thyroxin (FT4), free triiodothyronin (FT3) and thyroid-stimulating hormone (TSH) levels were measured by electrochemiluminescent immunoassay. The CAC score (CACS) of each subject was measured by multidetector computed tomography in both 2010 and 2014. Progression of CAC was defined as a CACS change over 4 years > 0. The mean CACS changes over 4 years by quartiles of baseline FT4 level (lowest to highest) were 12·9, 8·43, 7·82 and 7·81 (P = 0·028). CAC progression was not significantly associated with either the baseline FT3 or TSH levels. The odds ratios (OR) for CAC progression over 4 years (highest vs lowest quartile for baseline FT4) were 0·647 (95% confidence interval (CI) 0·472-0·886) after adjustment for confounding factor, which were attenuated with further adjustment for lipid profiles, homoeostasis model assessment of insulin resistance, high-sensitivity C-reactive protein and hypertension [0·747 (95% CI 0·537-1·038)]. Quartiles of baseline FT3 or TSH level did not show any increased OR for CAC progression after adjustment for confounding factors. In this cohort of euthyroid men and women, a low baseline FT4 level was associated with a high risk of CACS progression over 4 years. © 2015 John Wiley & Sons Ltd.

  4. Self-reported menopausal symptoms, coronary artery calcification, and carotid intima-media thickness in recently menopausal women screened for the Kronos early estrogen prevention study (KEEPS).

    Science.gov (United States)

    Wolff, Erin Foran; He, Yunxiao; Black, Dennis M; Brinton, Eliot A; Budoff, Mathew J; Cedars, Marcelle I; Hodis, Howard N; Lobo, Rogerio A; Manson, Joann E; Merriam, George R; Miller, Virginia M; Naftolin, Fredrick; Pal, Lubna; Santoro, Nanette; Zhang, Heping; Harman, S Mitchell; Taylor, Hugh S

    2013-04-01

    To determine whether self-reported menopausal symptoms are associated with measures of subclinical atherosclerosis. Cross-sectional analysis. Multicenter, randomized controlled trial. Recently menopausal women (n = 868) screened for the Kronos Early Estrogen Prevention Study (KEEPS). None. Baseline menopausal symptoms (hot flashes, dyspareunia, vaginal dryness, night sweats, palpitations, mood swings, depression, insomnia, irritability), serum E2 levels, and measures of atherosclerosis were assessed. Atherosclerosis was quantified using coronary artery calcium (CAC) Agatston scores (n = 771) and carotid intima-media thickness (CIMT). Logistic regression model of menopausal symptoms and E2 was used to predict CAC. Linear regression model of menopausal symptoms and E2 was used to predict CIMT. Correlation between length of time in menopause with menopausal symptoms, E2, CAC, and CIMT were assessed. In early menopausal women screened for KEEPS, neither E2 nor climacteric symptoms predicted the extent of subclinical atherosclerosis. Palpitations and depression approached significance as predictors of CAC. Other symptoms of insomnia, irritability, dyspareunia, hot flashes, mood swings, night sweats, and vaginal dryness were not associated with CAC. Women with significantly elevated CAC scores were excluded from further participation in KEEPS; in women meeting inclusion criteria, neither baseline menopausal symptoms nor E2 predicted CIMT. Years since menopause onset correlated with CIMT, dyspareunia, vaginal dryness, and E2. Self-reported symptoms in recently menopausal women are not strong predictors of subclinical atherosclerosis. Continued follow-up of this population will be performed to determine whether baseline or persistent symptoms in the early menopause are associated with progression of cardiovascular disease. NCT00154180. Published by Elsevier Inc.

  5. Abnormal lipoprotein(a) levels predict coronary artery calcification in Southeast Asians but not in Caucasians: use of noninvasive imaging for evaluation of an emerging risk factor.

    Science.gov (United States)

    Sharma, Abhinav; Kasim, Manoefris; Joshi, Parag H; Qian, Zhen; Krivitsky, Eric; Akram, Kamran; Rinehart, Sarah; Vazquez, Gustavo; Miller, Joseph; Rohman, Mohammad Saifur; Voros, Szilard

    2011-08-01

    Subclinical atherosclerosis can be quantified by coronary artery calcium (CAC) scoring. Due to its high specificity for atherosclerosis, CAC is an excellent phenotypic tool for the evaluation of emerging risk markers. Lipoprotein(a) [Lp(a)] is atherogenic due to the presence of apoB and may be thrombogenic through its apo(a) component. Lp(a) has been linked to cardiovascular events in Caucasians; however, its link to atherosclerosis in various ethnicities remains unclear. We evaluated the ability of Lp(a) mass to predict subclinical atherosclerosis in Southeast Asians and Caucasians, as measured by CAC. Traditional lipid measurements, Lp(a) measurements, and CAC by 64-slice multidetector computed tomography was performed in 103 consecutive patients in the USA and in 104 consecutive patients in Jakarta, Indonesia. Proportion of positive CAC and median CAC in Southeast Asians and in Caucasians was 61.5% and 63.1%, and 23.5 (interquartile range, 0-270) and 13 (interquartile range, 0-388), respectively. Significantly higher proportion of Southeast Asians had elevated Lp(a) levels, compared to Caucasians (51.0% vs. 29.2%; p = 0.005). In Southeast Asians, Lp(a) remained an independent predictor of CAC with an odds ratio of 4.97 (95% confidence interval, 1.56-15.88; p Southeast Asians. This translated to 7% of Southeast Asians reclassified to correct CAC status. Lp(a) measurements may have a role in risk stratification of Southeast Asians. Ethnic variation should be taken into account when considering the use of Lp(a) measurements in risk assessment.

  6. High dietary menaquinone intake is associated with reduces coronary calcification

    NARCIS (Netherlands)

    Beulens, J.W.J.; Bots, M.L.; Atsma, F.; Bartelink, M.L.; Prokop, M.; Geleijnse, J.M.; Witteman, J.C.; Grobbee, D.E.; Schouw, van der Y.T.

    2009-01-01

    Background Dietary vitamin K is thought to decrease risk of cardiovascular disease by reducing coronary calcification, but inconsistent results are reported. This may be due to different effects of vitamin K1 (phylloquinone) and vitamin K2 (menaquinone, MK), but few studies included both. Methods We

  7. Assessment of coronary artery disease using coronary computed tomography angiography and biochemical markers

    Institute of Scientific and Technical Information of China (English)

    Gitsios; Gitsioudis; Hugo; A; Katus; Grigorios; Korosoglou

    2014-01-01

    Chronic inflammatory mechanisms in the arterial wall lead to atherosclerosis,and include endothelial cell damage,inflammation,apoptosis,lipoprotein deposition,calcification and fibrosis.Cardiac computed tomography angiography(CCTA)has been shown to be a promising tool for non-invasive assessment of theses specific compositional and structural changes in coronary arteries.This review focuses on the technical background of CCTA-based quantitative plaque characterization.Furthermore,we discuss the available evidence for CCTA-based plaque characterization and the potential role of CCTA for risk stratification of patients with coronary artery disease.

  8. 应用冠状动脉钙化积分诊断老年人冠心病的研究%Clinical study on coronary artery calcification score combined with carotid intima-media thickness measure in elderly patients with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    林萍; 谢晓林; 胡芸

    2009-01-01

    Objective To evaluate the clinical diagnostic value of coronary artery calcification score(CACS)of multi-slice spiral computed tomography(MSCT)combined with carotid intima-media thickness(IMT)measure in elderly patients with coronary artery disease(CAD). Methods CACS of MSCT,carotid IMT measure,and coronary angiography were performed in 68 patients,including 36 cases with CAD(CAD group)diagnosed by coronary angiography and 32 cases(control group)with coronary arterial stenosis(<50% stenosis).CACS and carotid IMT were compared between two groups. Results The coronary artery calcification score was significantly increased in CAD group compared with the control group[(349.5±86.3)vs.(74.7±25.2),t=13.670,P<0.01],and it was increased with the severity of coronary arterial stenosis.The carotid intima-media thickness in CAD group showed significant difference with that in control group[(1.11±0.05)mm vs(0.69±0.13)mm,t=13.587,P<0.01].In CAD group,CACS exhibited a significant positive correlation with carotid IMT(r=0.950,P<0.01).The positive rates of CACS and carotid IMT were both 77.8% (28 cases)in CAD group and both 12.5%(4 cases)in control group,which showed significant difference between two groups(X2=28.976,P<0.01). Conclusions CACS of MSCT combined with carotid IMT have high sensitivity and specificity in evaluating coronary arteriaI stenosis.It can be used as a non-invasive examination to diagnose CAD in the elderly.%目的 探讨多层螺旋CT冠状动脉钙化积分(CACS)结合测量颈动脉内膜-中膜厚度(IMT)在老年人冠心病诊断中的价值. 方法 68例患者均行多层螺旋CT测定CACS、测量颈动脉IMT及冠状动脉造影检查,冠心病组36例患者行冠状动脉造影诊断为冠心病;非冠心病组32例,为冠状动脉造影证实冠状动脉狭窄<50%者.比较冠心病组与非冠心病组CACS值及颈动脉IMT.结果冠心病组CACS较非冠心病组明显升高[分别为(349.5±86.3)分和(74.7±25.2)分,t=13

  9. Anomalous origin of right coronary artery from pulmonary artery

    Directory of Open Access Journals (Sweden)

    Rajat Gupta

    2012-01-01

    Full Text Available Anomalous origin of coronary artery from the pulmonary artery is a rare anomaly that most frequently involves the left coronary artery and very rarely the right coronary artery. These lesions can be missed on echocardiography unless carefully looked for. We describe a case of isolated anomalous origin of right coronary artery from pulmonary artery diagnosed on echocardiography and confirmed by computed tomography (CT angiography.

  10. The association between coronary calcification assessed by electron beam computed tomography and measures of extracoronary atherosclerosis - The Rotterdam Coronary Calcification Study

    NARCIS (Netherlands)

    Oei, HHS; Vliegenthart, R; Hak, AE; del Sol, AI; Hofman, A; Oudkerk, M; Witteman, JCM

    2002-01-01

    OBJECTIVES The present study was designed to examine the associations of coronary calcification assessed by electron beam computed tomography (CT) with measures of extracoronary atherosclerosis. BACKGROUND Although measures of extracoronary atherosclerosis have been used to predict coronary events,

  11. Ectopic Origin of Coronary Arteries Diagnozed by Coronary Angiography

    Science.gov (United States)

    Krasniqi, Xhevdet; Gorani, Daut; Sejdiu, Basri; Citaku, Hajdin

    2016-01-01

    Introduction: Anomalous origin of coronary arteries from opposite sinus of Valsalva is rare finding. The incidence of anomalous origination of the left coronary artery from right sinus is 0.15% and the right coronary artery from the left sinus is 0.92%. The ectopic origin of left coronary artery or right coronary artery from opposite sinus depending on pathways and considering atherosclerotic changes are manifested with different clinical significance. Case report: We report two cases, the first case the coronary angiography showed the left coronary artery arising from the right coronary sinus, presenting with proximally and distally stenosed left anterior descending artery (LAD), associated with medial and distal stenosed right coronary artery (RCA). The second case the coronary angiography revealed the right coronary artery arising from the left coronary sinus, associated with tortuous medial and distal segments of left anterior descending artery (LAD), without atherosclerotic changes. The first case successfully underwent treatment procedures based on guidelines for revascularization. Conclusion: The coronary angiography of patients with coronary ischemia determines atherosclerotic disease with possibility of the presence of coronary artery anomalies that in cases with ectopic origin from opposite sinus continues to exist as a challenge during treatment in interventional cardiology. PMID:27482140

  12. Predictive value of coronary calcifications for future cardiac events in asymptomatic patients with diabetes mellitus: A prospective study in 716 patients over 8 years

    Directory of Open Access Journals (Sweden)

    Tittus Janine

    2008-10-01

    Full Text Available Abstract Background To establish an efficient prophylaxis of coronary artery disease reliable risk stratification is crucial, especially in the high risk population of patients suffering from diabetes mellitus. This prospective study determined the predictive value of coronary calcifications for future cardiovascular events in asymptomatic patients with diabetes mellitus. Methods We included 716 patients suffering from diabetes mellitus (430 men, 286 women, age 55.2 ± 15.2 years in this study. On study entry all patients were asymptomatic and had no history of coronary artery disease. In addition, all patients showed no signs of coronary artery disease in ECG, stress ECG or echocardiography. Coronary calcifications were determined with the Imatron C 150 XP electron beam computed tomograph. For quantification of coronary calcifications we calculated the Agatston score. After a mean observation period of 8.1 ± 1.1 years patients were contacted and the event rate of cardiac death (CD and myocardial infarction (MI was determined. Results During the observation period 40 patients suffered from MI, 36 patients died from acute CD. The initial Agatston score in patients that suffered from MI or died from CD (475 ± 208 was significantly higher compared to those without cardiac events (236 ± 199, p Conclusion By determination of coronary calcifications patients at risk for future MI and CD could be identified within an asymptomatic high risk group of patients suffering from diabetes mellitus. On the other hand future events could be excluded in patients without coronary calcifications.

  13. Feasibility of spectral shaping for detection and quantification of coronary calcifications in ultra-low dose CT

    Energy Technology Data Exchange (ETDEWEB)

    Vonder, Marleen; Pelgrim, Gert Jan; Vliegenthart, Rozemarijn [University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen (Netherlands); University of Groningen, University Medical Center Groningen, Center for Medical Imaging North-East Netherlands (CMI-NEN), Groningen (Netherlands); Huijsse, Sevrin E.M.; Greuter, Marcel J.W. [University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen (Netherlands); Meyer, Mathias; Henzler, Thomas [Heidelberg University, Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg (Germany); Flohr, Thomas G. [Siemens Healthcare GmbH, Computed Tomography, Forchheim (Germany); Oudkerk, Matthijs [University of Groningen, University Medical Center Groningen, Center for Medical Imaging North-East Netherlands (CMI-NEN), Groningen (Netherlands)

    2017-05-15

    To evaluate detectability and quantification of coronary calcifications for CT with a tin filter for spectral shaping. Phantom inserts with 100 small and 9 large calcifications, and a moving artificial artery with 3 calcifications (speed 0-30 mm/s) were placed in a thorax phantom simulating different patient sizes. The phantom was scanned in high-pitch spiral mode at 100 kVp with tin filter (Sn100 kVp), and at a reference of 120 kVp, with electrocardiographic (ECG) gating. Detectability and quantification of calcifications were analyzed for standard (130 HU) and adapted thresholds. Sn100 kVp yielded lower detectability of calcifications (9 % versus 12 %, p = 0.027) and lower Agatston scores (p < 0.008), irrespective of calcification, patient size and speed. Volume scores of the moving calcifications for Sn100 kVp at speed 10-30 mm/s were lower (p < 0.001), while mass scores were similar (p = 0.131). For Sn100 kVp with adapted threshold of 117 HU, detectability (p = 1.000) and Agatston score (p > 0.206) were similar to 120 kVp. Spectral shaping resulted in median dose reduction of 62.3 % (range 59.0-73.4 %). Coronary calcium scanning with spectral shaping yields lower detectability of calcifications and lower Agatston scores compared to 120 kVp scanning, for which a HU threshold correction should be developed. (orig.)

  14. Sudden death in a captive meerkat(Suricata suricatta) with arterial medial and myocardial calcification

    Institute of Scientific and Technical Information of China (English)

    Laura Bongiovann; Nicola Di Girolamo; Leonardo Della Salda; Marcella Massimi; Mariarita Romanucci; Paolo Selleri

    2016-01-01

    A 1-year-old male meerkat was found dead by the owner.The animal was clinically healthy and was regularly vaccinated for distemper virus.Necropsy revealed multifocal to confluent dry white areas in the myocardium,pneumonia and congestive hepatopathy.All the other organs,including gross vessels,were macroscopically normal.The heart showed histologically large,multifocal to confluent areas of mineralization of the myocardium and the wall of small coronary artery.Vascular calcifications were also observed in the hepatic portal tracts and kidneys arteries of small/medium sizes.The arterial lumen appeared narrowed and the wall thickened due to the calcification of the tunica media.In veterinary medicine,arterial mineralization is regarded as a metastatic calcification,as the result of hypercalcemia and/or hyperphosphatemia.However,today,the pathogenesis of medial artery calcification in humans seems to be the results of an active process resembling embryonic osteogenesis,rather than a mere passive process.

  15. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease

    NARCIS (Netherlands)

    P.W.J.C. Serruys (Patrick); M-C. Morice (Marie-Claude); A.P. Kappetein (Arie Pieter); A. Colombo (Antonio); D.R. Holmes Jr (David); M.J. Mack (Michael); E. Stahle (Elisabeth); T.E. Feldman (Ted); M.J.B.M. van den Brand (Marcel); E.J. Bass (Eric); N. van Dyck (Nic); K. Leadly (Katrin); K.D. Dawkins (Keith); F.W. Mohr (Friedrich)

    2009-01-01

    textabstractBACKGROUND Percutaneous coronary intervention (PCI) involving drug-eluting stents is increasingly used to treat complex coronary artery disease, although coronary-artery bypass grafting (CABG) has been the treatment of choice historically. Our trial compared PCI and CABG for treating pat

  16. Clinical significance of intramammary arterial calcifications in diabetic women

    Directory of Open Access Journals (Sweden)

    Milošević Zorica

    2004-01-01

    Full Text Available Background. It is well known that intramammary arterial calcifications diagnosed by mammography as a part of generalized diabetic macroangiopathy may be an indirect sign of diabetes mellitus. Hence, the aim of this study was to determine the incidence of intramammary arterial calcifications, the patient’s age when the calcifications occur, as well as to observe the influence of diabetic polineuropathy, type, and the duration of diabetes on the onset of calcifications, in comparison with nondiabetic women. Methods. Mammographic findings of 113 diabetic female patients (21 with type 1 diabetes and 92 with type 2, as well as of 208 nondiabetic women (the control group were analyzed in the prospective study. The data about the type of diabetes, its duration, and polineuropathy were obtained using the questionnaire. Statistical differences were determined by Mann-Whitney test. Results. Intramammary arterial calcifications were identified in 33.3% of the women with type 1 diabetes, in 40.2% with type 2, and in 8.2% of the women from the control group, respectively. The differences comparing the women with type 1, as well as type 2 diabetes and the controls were statistically significant (p=0.0001. Women with intramammary arterial calcifications and type 1 diabetes were younger comparing to the control group (median age 52 years, comparing to 67 years of age, p=0.001, while there was no statistically significant difference in age between the women with calcifications and type 2 diabetes (61 years of age in relation to the control group (p=0.176. The incidence of polineuropathy in diabetic women was higher in the group with intramammary arterial calcifications (52.3% in comparison to the group without calcifications (26.1%, (p=0.005. The association between intramammary arterial calcifications and the duration of diabetes was not found. Conclusion. The obtained results supported the theory that intramammary arterial calcifications, detected by

  17. The association of breast arterial calcification and metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Seyma Yildiz

    2014-01-01

    Full Text Available OBJECTIVES: We investigated the relationship between metabolic syndrome and breast arterial calcification detected via mammography in a cohort of postmenopausal subjects. METHODS: Among 837 patients referred to our radiology department for mammographic screening, 310 postmenopausal females (105 patients with and 205 patients without breast arterial calcification aged 40 to 73 (mean 55.9±8.4 years were included in this study. The groups were compared with respect to clinical characteristics and metabolic syndrome criteria. Univariate and multivariate analyses identified the factors related to breast arterial calcification. RESULTS: Age, postmenopausal duration and the frequencies of diabetes mellitus, hypertension and metabolic syndrome were significantly higher in the subjects with breast arterial calcification than in those without (p<0.05. Multivariate analysis indicated that age (OR = 1.3, 95% CI = 1.1-1.6, p = 0.001 and metabolic syndrome (OR = 4.0, 95% CI = 1.5−10.4, p = 0.005 were independent predictors of breast arterial calcification detected via mammography. The independent predictors among the features of metabolic syndrome were low levels of high-density lipoproteins (OR = 8.1, 95% CI = 1.0−64.0, p = 0.047 and high blood pressure (OR = 8.7, 95% CI = 1.5−49.7, p = 0.014. CONCLUSIONS: The likelihood of mammographic detection of breast arterial calcification increases with age and in the presence of hypertension or metabolic syndrome. For patients undergoing screening mammography who present with breast arterial calcification, the possibility of metabolic syndrome should be considered. These patients should be informed of their cardiovascular risk factors and counseled on appropriate lifestyle changes.

  18. 血清骨钙素水平与老年骨质疏松及冠状动脉病变的相关性%Relations between serum levels of osteocalcin and the diseases of osteoporosis and coronary artery calcification in elderly men

    Institute of Scientific and Technical Information of China (English)

    卢维晟; 张江蓉; 高艳虹; 袁惠敏; 王一尘

    2013-01-01

    目的 探讨血清骨钙素水平与老年骨质疏松及冠状动脉病变的相关性.方法 选取183例年龄在60 ~ 85岁的患者,根据骨密度测定结果分为2组:非骨质疏松组86例,骨质疏松组97例;根据冠状动脉螺旋CT检查结果分为3组:轻度钙化组(积分<200)68例;中度钙化组(200≤积分<300)43例;重度钙化组(积分≥300)72例.比较各组患者的冠状动脉狭窄病变和钙化程度.应用酶联免疫吸附试验者测定各组患者血清骨钙素水平.结果 骨质疏松组患者合并肥胖、高血压、高血脂和糖尿病的比例分别为56.7%(55/97)、80.4%(78/97)、78.4%(76/97)、71.1% (69/97),高于非骨质疏松组的37.2% (32/86)、54.7%(47/86)、44.2%(38/86)、31.4%(27/86)(P<0.05);骨质疏松组患者血清骨钙素水平明显低于非骨质疏松组患者[(14±3)ng/L比(42±6)ng/L(P <0.05)];骨质疏松组患者任意冠状动脉分支的钙化程度均高于非骨质疏松组,2组比较差异有统计学意义(P<0.05).骨质疏松组冠状动脉单支病变超过50%狭窄者比例明显高于非骨质疏松组,冠状动脉2支以上病变者占比更高[20.6% (20/97)比3.5% (3/86)],差异均有统计学意义(均P<0.05).冠状动脉血清骨钙素水平分别为(45.6±8.3)、(26.2±4.8)、(15.5±10.2) ng/L,任意两两比较差异均有统计学意义(均P<0.01).结论 骨钙流失与钙质在冠状动脉的沉积存在共同的发病机制.该机制与血清骨钙素水平有关,血清骨钙素对老年男性骨质疏松与冠状动脉钙化有保护作用.%Objective To determine osteocalcin in serum in elderly man; to discuss the effects of abnormal calcium metabolism between osteoporosis and coronary artery calcification in elderly men.Methods According to the results of the bone density,183 patients with an age from 60 to 85 (72 ± 8.8),were divided into two groups:non-osteoporosis group(n =86) and osteoporosis group(n =97).According to the

  19. Distal arterial occlusive disease in diabetes is related to medial arterial calcification.

    Science.gov (United States)

    Chantelau, E; Lee, K M; Jungblut, R

    1997-01-01

    In diabetes mellitus, peripheral arterial occlusive disease predominantly affects the lower leg (tibial and peroneal vessel disease). Our study suggests that this feature is related to the presence of forefoot medial arterial calcification.

  20. Physiologic assessment of coronary artery fistula

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, N.C.; Beauvais, J. (Creighton Univ., Omaha, NE (USA))

    1991-01-01

    Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery.

  1. Coronary Artery Bypass in Octogenarians

    Directory of Open Access Journals (Sweden)

    Chen-Yen Chien

    2012-09-01

    Full Text Available Prevalence of coronary artery disease (CAD has increased with the expansion of life span among the elderly population in the world. Hence, the issue of the coronary artery bypass in octogenarians has attracted more attention. Recent literature about the topic revealed nearly the same excellent results as those in the younger population under the newly developed operative techniques and improving concept in perioperative management and postoperative care. In this article, we review the current status of the procedure that was thought to be dangerous in the earlier era, including its risk factors, result, and benefit.

  2. Breast Arterial Calcifications and Heart Disease Risk in women

    NARCIS (Netherlands)

    Maas, A.H.E.M.

    2006-01-01

    Imaging of vascular calcification is increasingly used for cardiovascular screening purposes in asymptomatic patients. Coronary and aortic calcium deposits in the vascular wall have been shown to be related to atherosclerotic plaque burden. New imaging techniques with electron beam computed tomograp

  3. Anomalous origin of right coronary artery from left coronary sinus.

    Science.gov (United States)

    Hamzeh, Gadah; Crespo, Alex; Estarán, Rafael; Rodríguez, Miguel A; Voces, Roberto; Aramendi, José I

    2008-08-01

    Anomalous aortic origin of the coronary arteries is uncommon but clinically significant. Manifestations vary from asymptomatic patients to those who present with angina pectoris, myocardial infarction, heart failure, syncope, arrhythmias, and sudden death. We describe 4 patients, aged 34 to 59 years, who were diagnosed with right coronary artery arising from the left sinus of Valsalva, confirmed by coronary angiography, which was surgically repaired. Three patients presented dyspnea and angina, and one with acute myocardial infarction. At operation, the right coronary artery was dissected at the take-off from the intramural course, and reimplanted into the right sinus of Valsalva. There was no mortality. One patient had associated coronary artery disease that required stent placement postoperatively. This reimplantation technique provides a good physiological and anatomical repair, eliminates a slit-like ostium, avoids compression of the coronary artery between the aorta and the pulmonary artery, and gives superior results to coronary artery bypass grafting or the unroofing technique.

  4. Coronary artery spasm

    Science.gov (United States)

    ... Saunders; 2016:chap 71. Giugliano RP, Cannon CP, Braunwald E. Non-ST elevation acute coronary syndromes In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  5. Effect of High-Calcium Diet on Coronary Artery Disease in Ossabaw Miniature Swine With Metabolic Syndrome

    OpenAIRE

    Phillips-Eakley, Alyssa K; McKenney-Drake, Mikaela L; Bahls, Martin; Newcomer, Sean C; Radcliffe, John S.; Wastney, Meryl E; Van Alstine, William G; Jackson, George; Alloosh, Mouhamad; Martin, Berdine R.; Sturek, Michael; Weaver, Connie M.

    2015-01-01

    Background Calcium is a shortfall essential nutrient that has been a mainstay of osteoporosis management. Recent and limited findings have prompted concern about the contribution of calcium supplementation to cardiovascular risk. A proposed mechanism is through the acceleration of coronary artery calcification. Determining causality between calcium intake and coronary artery calcification has been hindered by a lack of sensitive methodology to monitor early vascular calcium accumulation. The ...

  6. 256层ICT探测冠状动脉钙化在不稳定心绞痛与稳定心绞痛患者中的对比%Detection of Coronary Artery Calcification Score and Compare it in Patients Diagnosed Clinically as Stable and Unstable Angina by 256 ICT

    Institute of Scientific and Technical Information of China (English)

    朱大光

    2013-01-01

    目的:探讨256层ICT在探测冠状动脉钙化积分中的意义。方法:采用256层ICT对2组患者进行冠状动脉钙化积分扫描,钙化积分由工作站软件自动获得,132例患者分为2组,55例稳定心绞痛,77不例稳定心绞痛。结果:不稳定心绞痛患者的钙化积分要显著大于稳定心绞痛患者(p<0.05),不稳定心绞痛患者的血管钙化数目要明显多于稳定心绞痛组。结论:不稳定心绞痛患者的钙化更明显,因此预测冠状动脉情况冠状动脉钙化积分可以作为重要指标。%Objective:To detect Coronary calcification score and compare it in patients diagnosed clinically of having stable and unsta -ble angina and they being more prone for cardiovascular risk .Methods:Coronary artery calcification was scanned and its scores ( CACS) were measured through 256-slice ICT in 132 patients diagnosed of having stable and unstable angina .(55 stable and 77 unstable angi-na).the result were analyzed statistically by 2-grouped test.Also some associated risk factors were also taken into concideraton (HTN, total cholesterol ,Triglycerides etc ) .Results:The calcification scores in patients with unstable angina were comparatively more than those with patients having stable angina (p<0.05).Also it found that 3-vesssel calcification was more significant with unstable angina ,where as 1-vesssel calcification was more significant with stable angina cases .Conclusion:Coronary artery calcification scores is of great value in predicting cardiovascular enets .

  7. Left Coronary Artery-Pulmonary Artery Fistula in Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Orhan Veli Doğan

    2012-08-01

    Full Text Available Coroner artery fistula which is rare and congenital or acquired arise from whole coroner artery drainage all of cardiac chamber and great artery. Although coroner artery fistula is uncommon, it can cause significant mortality and morbidity rates. The article is presented which coroner artery disease and coroner-pulmonary artery fistula was accomplishment committed. Sixty three year-old male patient admitted to the hospital with chest pain. Non-ST myocardial infarction was diagnosed in the examinations. After coroner angiography, it was found coronary artery disease in addition between LAD proximal portion and main pulmonary artery fistula. Fistula repair and coronary bypass were performed successfully under cardiopulmonary bypass. Without hemodynamic problem in intensive care and service follow-up, the patient was discharged from the hospital in the seventh postoperative day. We think that surgical treatment of coronary fistulas in patients with coronary artery lesion is done at the earliest time would enable improvement in mortality and morbidity rates.

  8. Giant calcific pericardial cyst: certainly unexpected during primary percutaneous coronary intervention.

    Science.gov (United States)

    Güvenç, Tolga Sinan; Hayıroğlu, Mert İlker; Gümüşdağ, Ayça; Ekmekçi, Ahmet; Erer, Hatice Betül; Keskin, Muhammed; Eren, Mehmet

    2016-12-01

    Pericardial cyst is a rare congenital anomaly that is usually diagnosed during evaluation for right-sided heart failure. We report a 50-year-old man with a primary diagnosis of ST-segment elevation myocardial infarction at admission, whose emergent angiography revealed a calcific mass close to right coronary artery. Further analysis of the mass with computed tomography and three-dimensional echocardiography revealed a giant pericardial cyst causing partial obstruction of superior vena cava. Unlike previous cases reported, the patient had no symptoms compatible with right-sided heart failure. © 2016, Wiley Periodicals, Inc.

  9. Arterial calcifications at the hand: Normal development and its course in patients on maintenance dialysis

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, E.

    1987-03-01

    Normally, the arterial calcifications at the hand progress form proximal to distal and do not reach the fingers in the 8th decade. In patients on maintenance dialysis the arterial calcifications begin earlier and do not progress with age. The most severe arterial calcifications occur in patients with renal failure caused by diabetic nephropathy. Prognostically arterial calcifications in the finger-metacarpal region are an unfavourable sign.

  10. Aneurysm of the left main coronary artery

    Directory of Open Access Journals (Sweden)

    Ênio E. Guérios

    2000-12-01

    Full Text Available Aneurysm of the left main coronary artery is a rare angiographic finding, with few cases described in the international literature. We report the case of a 42-year-old male with a previous history of acute myocardial infarction, whose coronariography indicated triple vessel coronary disease and an aneurysm of the left main coronary artery. A review of the etiology, clinical aspects, and surgical management of coronary arterial aneurysm is presented.

  11. Minimally invasive coronary artery bypass grafting versus coronary angioplasty for isolated type C stenosis of the left anterior descending artery

    NARCIS (Netherlands)

    Mariani, MA; Boonstra, PW; Grandjean, JG; Monnink, SHJ; denHeijer, P; Crijns, HJGM

    Background: Isolated stenosis of the left anterior descending coronary artery can be treated with medication, percutaneous transluminal coronary angioplasty, or coronary artery bypass grafting. Recently a new treatment has been developed, which is called minimally invasive direct coronary artery

  12. Exercised-Induced Coronary Spasm in Near Normal Coronary Arteries

    Directory of Open Access Journals (Sweden)

    Damian Franzen

    2010-01-01

    Full Text Available In contrast to effort-induced symptoms in obstructive coronary disease, spasm in normal coronary arteries is characterized by angina at rest. We describe a 44-year-old patient with minor coronary plaques and pure exercised-induced coronary spasm. The case questions the differential pathogenic considerations of variant of the variant as opposed to Prinzmetal's variant angina.

  13. [A case of primary coronary artery dissection].

    Science.gov (United States)

    Nishino, M; Kato, J; Ezumi, A; Nozaki, S; Nishino, Y; Tanahashi, H; Yasuno, M; Kobayashi, K; Yamada, Y; Abe, H

    1990-06-01

    Primary coronary artery dissection occurring as a spontaneous event and not associated with trauma due to catheter manipulation is rare. We recently experienced (a case of) a 52-year-old man with primary artery dissection. He was admitted to our hospital with severe chest pain as his chief complaint on September 6, 1988. Electrocardiography and laboratory data showed acute inferior myocardial infarction. He was treated with medication and underwent coronary angiograms on October 3, 1988. Right coronary angiogram revealed an intimal flap and false lumen. But right coronary angiograms 6 months after the onset of myocardial infarction revealed progression of stenosis but no intimal flap, and coronary spasm was not evoked after acetylcholine administration. Primary coronary artery dissection has been reported since Pretty's first description of it in 1931. The majority of earlier cases were diagnosed at autopsy, but recently reports of survivors have been increasing due to the progress in and popularization of coronary angiographic technics. This case is the 46th case of primary coronary dissection found by coronary angiography. So it is not extremely rare. In our case the involved artery was the right coronary artery. In survivors, right coronary artery dissection is more frequent than left, because the area supplied by the right coronary artery is smaller than the area supplied by the left one. Although in our case coronary artery stenosis progressed, after a long term resolution of dissection may occur. There are a few cases in which resolution of dissection occurred naturally.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Coronary Artery and Pulmonary Artery Fistula Originated from Significant Stenosis in the Left Anterior Descending Artery

    Directory of Open Access Journals (Sweden)

    Alper Sami Kunt

    2013-01-01

    Full Text Available Coronary artery fistula (CAF is defined as a rare anomalous connection between a coronary artery and a major vessel or a cardiac chamber. We report a case of a left anterior descending coronary (LAD stenosis and coronary artery fistula between the LAD coronary artery and the pulmonary artery (PA. CAF is often diagnosed by coronary angiogram. We describe our diagnostic approach and review the literature on the epidemiology, the pathophysiology, the diagnostic modalities, and the treatment options.

  15. Stationary digital chest tomosynthesis for coronary artery calcium scoring

    Science.gov (United States)

    Wu, Gongting; Wang, Jiong; Potuzko, Marci; Harman, Allison; Pearce, Caleb; Shan, Jing; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping

    2016-03-01

    The coronary artery calcium score (CACS) measures the buildup of calcium on the coronary artery wall and has been shown to be an important predictor of the risk of coronary artery diseases (CAD). Currently CACS is measured using CT, though the relatively high cost and high radiation dose has limited its adoption as a routine screening procedure. Digital Chest Tomosynthesis (DCT), a low dose and low cost alternative to CT, and has been shown to achieve 90% of sensitivity of CT in lung disease screening. However commercial DCT requires long scanning time and cannot be adapted for high resolution gated cardiac imaging, necessary for CACS. The stationary DCT system (s- DCT), developed in our lab, has the potential to significantly shorten the scanning time and enables high resolution cardiac gated imaging. Here we report the preliminary results of using s-DCT to estimate the CACS. A phantom heart model was developed and scanned by the s-DCT system and a clinical CT in a phantom model with realistic coronary calcifications. The adapted fan-beam volume reconstruction (AFVR) method, developed specifically for stationary tomosynthesis systems, is used to obtain high resolution tomosynthesis images. A trained cardiologist segmented out the calcifications and the CACS was obtained. We observed a strong correlation between the tomosynthesis derived CACS and CT CACS (r2 = 0.88). Our results shows s-DCT imaging has the potential to estimate CACS, thus providing a possible low cost and low dose imaging protocol for screening and monitoring CAD.

  16. Anomalous Coronary Artery: Run of a Lifetime.

    Science.gov (United States)

    Green, Michael Stuart; Sehgal, Sankalp; Smukler, Naomi; Suber, LaDouglas Jarod; Saththasivam, Pooven

    2016-09-01

    The anatomy of the coronary circulation is well described with incidence of congenital anomalies of approximately 0.3% to 1.0%. Although often incidental, 20% are life-threatening. A 25-year-old woman with syncopal episodes collapsed following a 10-km run. Coronary anatomy evaluation showed an anomalous left main coronary artery originating from the right sinus of valsalva and following a course between the aorta and the pulmonary outflow tract. Percutaneous coronary intervention was followed by eventual surgical revascularization. Abnormal course of coronary arteries plays a role in the pathogenesis of sudden death on exertion. Origin of the left main coronary from the right sinus of valsalva is a rare congenital anomaly. The expansion of the roots of the aorta and pulmonary trunk with exertion lead to compression of the coronary artery and syncope. Our patient raises awareness of a potentially fatal coronary artery path. Intraoperative identification of anomalous coronaries by utilizing intraoperative transesophageal echocardiography was critical.

  17. A Rare Case of Triple Coronary Artery Fistulae Originating from Left Main and Right Coronary Arteries

    Directory of Open Access Journals (Sweden)

    Mehmet Ali Elbey

    2012-10-01

    Full Text Available ABSTRACTDual coronary artery fistulae (CAF involving both right and left coronary trees are uncommon; accounting for only 5% of all CAFs. A 48-year-old male patient was admitted to our institution for evaluation of chest pain. The coronary angiography revealed fistulae from left main coronary artery (LMCA and right coronary artery (RCA to the pulmonary artery. We concluded that angina pectoris was caused by a steal phenomenon and the patient was recommended surgical intervention. To our knowledge, this is the first paper reporting three fistulae associated with multiple aneurysms originating from proximal coronary arteries, which were connected to the pulmonary artery.

  18. Assessment of coronary artery lesions in children with Kawasaki disease: evaluation of MSCT in comparison with 2-D echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Xing, Yanlin; Wang, Hong; Yu, Xianyi; Chen, Rui [Shengjing Hospital of China Medical University, Department of Pediatrics, Shenyang (China); Hou, Yang [Shengjing Hospital of China Medical University, Department of Radiology, Shenyang (China)

    2009-11-15

    Transthoracic two-dimensional echocardiography is an effective method for detecting coronary arterial injury in Kawasaki disease. However, its accuracy in the diagnosis of coronary arterial lesions is limited. To investigate the value of multislice spiral CT for coronary angiography for observing the coronary arterial injury caused by infantile Kawasaki disease. Coronary angiography, using a 64-slice spiral CT scanner, and 2-D echocardiography were performed in 48 children with Kawasaki disease in whom the position, internal diameter, and length of each coronary artery were measured. MSCT showed coronary artery injury in 15 of the 48 children. Among these 15 children, 20 coronary artery branches showed complications, including the left coronary artery branches in 15 (31.2%) and the right coronary artery branches in 5 (10.4%). Complications in the left coronary artery branches included dilation in 12 (25.0%) and stenosis, calcification and the combination of the two in one each, and the right coronary artery branches showed dilation; two branches also showed beaded changes. MSCT also showed dilation in the left anterior descending arteries in two children. These children showed no abnormality on 2-D echocardiography. MSCT is a valuable examination method for detecting coronary artery injury in Kawasaki disease. (orig.)

  19. Clinical and imaging features associated with intracranial internal carotid artery calcifications in patients with ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, Arda [Mersin University, Department of Neurology, Faculty of Medicine, Mersin (Turkey); Akpinar, Erhan [Hacettepe University, Department of Radiology, Faculty of Medicine, Ankara (Turkey); Topcuoglu, Mehmet Akif; Arsava, Ethem Murat [Hacettepe University, Department of Neurology, Faculty of Medicine, Ankara (Turkey)

    2015-05-01

    Intracranial internal carotid artery calcifications (ICAC), a frequent finding on imaging studies, are predictive of future stroke risk in population-based studies. The clinical significance of this observation among ischemic stroke patients is however less clear. In this study, we analyzed ICAC burden in relation to vascular risk factor profile, stroke etiology, and extent of craniocervical vascular calcifications in a consecutive series of ischemic stroke patients. The burden of ICAC was determined both on non-contrast CT and CT-angiography source images by semiquantitative scoring algorithms. The distribution of vascular risk factors, etiologic stroke subtype, and calcification burden in other craniocervical arteries was assessed among patients with no ICAC, mild-moderate ICAC, and severe ICAC. Of 319 patients included into the study, 28 % had no ICAC, 35 % had mild-moderate ICAC, and 37 % had severe ICAC on CT angiography. Independent factors associated with ICAC burden in multivariate analysis included age (p < 0.001), diabetes mellitus (p = 0.006), and coronary artery disease (p < 0.001). Furthermore, a stroke etiology of large artery atherosclerosis or cardioaortic embolism was significantly related to higher ICAC burden (p = 0.006). Patients with severe ICAC were more likely to harbor calcifications in other vascular beds (p < 0.001). All of these findings persisted when analyses were repeated with CT-based ICAC burden assessments. ICAC burden reflects a continuum of atherosclerotic disease involving carotid arteries together with other craniocervical vascular beds. ICAC is significantly associated with stroke of large vessel or cardioembolic origin. This information might help the clinician in prioritizing etiologic work-up in the acute period. (orig.)

  20. New Technologies in Coronary Artery Surgery

    Directory of Open Access Journals (Sweden)

    David Taggart

    2013-07-01

    Full Text Available Coronary artery disease remains the leading cause of death in developed countries. Major recent studies such as SYNTAX and FREEDOM have confirmed that coronary artery bypass grafting (CABG remains the gold standard treatment in terms of survival and freedom from myocardial infarction and the need for repeat revascularization. The current review explores the use of new technologies and future directions in coronary artery surgery, through 1 stressing the importance of multiple arterial conduits and especially the use of bilateral mammary artery; 2 discussing the advantages and disadvantages of off-pump coronary artery bypass; 3 presenting additional techniques, e.g. minimally invasive direct coronary artery bypass grafting, hybrid, and robotic-assisted CABG; and, finally, 4 debating a novel external stenting technique for saphenous vein grafts.

  1. Medial arterial calcification: novel insights into its determinants and cardiovascular implications

    NARCIS (Netherlands)

    Hendriks, EJE

    2017-01-01

    Background Arterial calcification is associated with an increased cardiovascular disease risk. Different layers of the arterial wall can become calcified. Calcification of the arterial intima occurs as an advanced stage of the atherosclerotic disease process. The arterial media and internal elastic

  2. Emergency off-pump coronary artery surgery

    Institute of Scientific and Technical Information of China (English)

    Shahzad G Raja; Zulfiqar Haider; Haider Zaman

    2004-01-01

    Background Off-pump coronary artery bypass grafting is fast-becoming a procedure of choice for elective revascularization in high-risk patients with multi-vessel coronary artery disease. However, the role of off-pump coronary artery bypass grafting for patients with acute coronary syndromes requiring emergency revascularization still requires validation. We present our experience to show the feasibility of off-pump coronary artery surgery as an emergency revascularization technique. Methods From April 2001 to September 2003, emergency (operation within 24 hours after hospitalization) coronary artery bypass grafting without cardiopulmonary bypass (CPB) was performed in 66 patients with a mean age of (66.9±5.4) years (range 49-72 years). They presented acute coronary syndromes with 38 patients on platelet glycoprotein Ⅱb/Ⅲa receptor antagonists. All patients underwent off-pump coronary artery bypass surgery via sternotomy with the intention of complete coronary revascularization.Results An average of 2.9 grafts per patient were performed and the posterior descending artery and marginal branches of the circumflex artery were grafted in 83.3% of the patients. There were 4 events of intraoperative cardiac instability, precipitated by occlusion of right coronary artery or positioning of a cardiomegaly heart, leading to immediate conversion to CPB. The mortality rate was 3% (2/66). Two patients suffered postoperative stroke while three needed hemofiltration for acute renal failure. Post surgery elective coronary angiography (n=46) showed no significant stenosis.Conclusion Emergency off-pump coronary artery surgery with complete revascularization is feasible in patients with acute coronary syndrome with low morbidity and mortality and excellent early results.

  3. Breast arterial calcification on mammogram: correlation with carotid arterial atherosclerosis on ultrasonogram

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nam Ju; Suh, Jung Ho [School of Medicine, Ajou Univ., Suwon (Korea, Republic of); Kim, Ji Hyung [College of Medicine, KonYang Univ., Nonsan (Korea, Republic of)

    2002-01-01

    To investigate the incidence of breast arterial calcification in Korean women, and to determine its association with systemic diseases and carotid arterial atherosclerosis. One thousand seven hundred and thirteen female subjects who underwent mammography at a health care center between May 1999 and May 2000 were included in this study. Of the total, 172 were found to have breast arterial calcification, and were classified according to age. The coincidence of hypertension, diabetes mellitus and hyperlipidemia was examined in both the subject group and the control group selected on the same age basis. To investigate the presence and degree of carotid atherosclerosis, sonographic imaging was performed and the findings were compared between the two groups. The incidence of breast arterial calcification showed statistically significant differences according to age, with a higher incidence in older patients (p<0.05). However, there was no statistical difference in the incidence of hypertension, hyperlipidemia, and diabetes mellitus between groups. Carotid atherosclerosis was subjects more prevalent among subjects than in the control group (p<0.05), though there was no statistically significant difference in the degree of luminal stenosis. The most common pathologic cause of breast arterial calcification is arteriosclerosis. Breast arterial calcification is demonstrated at mammography, along with other clinical risk factors for atherosclerosis or coincidental neurologic symptoms. We stress that further evaluation of the carotid artery is necessary.

  4. Clinical investigation of coronary artery calcification detected by 64-slice spiral computed tomography in diagnosis of coronary heart disease%64层螺旋CT量化冠状动脉钙化在冠心病中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    苏瑞瑛; 肖文良; 申艳霞; 田帅

    2006-01-01

    目的 探讨64层螺旋CT(64-slice spiral computed tomography,64SCT)量化冠状动脉钙化(coronary artery calcification,CAC)对诊断冠心病(coronary heart disease,CHD)的价值.方法 对56例临床诊断及可疑冠心病患者,进行64SCT冠脉成像及其钙化的量化分析,并同期进行选择性经皮冠状动脉造影(coronary angiography,CAG)检查,CAG采用经典插管法,冠状动脉钙化积分(coronary artery calcification score,CACS)采用Agatston方法完成,64SCT结果与CAG结果做双盲对照研究;根据CAG结果将患者分为冠心病组34例(冠状动脉至少有1支血管狭窄≥50%)和非冠心病组22例;进一步将224支血管按狭窄程度分为A组(狭窄<50%)、B组(狭窄50%~75%)和C组(狭窄>75%),记录其CACS分别进行统计分析;按照年龄分为<60岁组和≥60岁组,分别分析CAC率和CACS与年龄的关系.结果 64SCT冠状动脉三维成像对冠状动脉钙化显示清晰,对冠状动脉各分支显示良好,冠心病组的CACS与非冠心病组比较,差异有统计学意义(P<0.01),且A组与B、C组比较CACS差异有统计学意义(P<0.01),但B组、C组两组之间CACS差异无统计学意义(P>0.05);随着年龄的增长,CAC率和CACS逐渐增高,<60岁组与≥60岁组CAC率和CACS比较差异有统计学意义(P<0.01);<60岁组冠心病患者CAC率和CACS明显高于非冠心病组(P<0.05),≥60岁组冠心病患者CAC率与非冠心病组比较差异无统计学意义(P>0.05),但CACS差异有统计学意义(P<0.01).结论 应用64SCT量化冠状动脉钙化,可以对可疑冠心病患者提供早期诊断依据,CACS与相应血管管腔狭窄的对照分析显示,CACS与冠状动脉狭窄程度之间有一定关系;年龄对CAC有影响.

  5. 终末期肾病患者心脏瓣膜钙化与冠状动脉钙化进展的关系研究%The correction of cardiac valve calcification and the progression of coronary artery calcium in end stage re-nal disease patients

    Institute of Scientific and Technical Information of China (English)

    王晓春; 王泓; 戴云; 孙晖; 李娟; 杨斌

    2015-01-01

    Objective To investigate the relationship between cardiac valve calcification and the progression of coronary ar-tery calcium scores( CACS) in end stage renal disease patients.Methods We collected 127 end stage renal disease patients.Statisti-cal methods were used to analyze the relation between cardiac valve calcification and the progression of coronary calcium.Results In-cidence of the CACS progression in no valve calcification, aortic valve or mitral valve calcification and both valve calcification were 43.1%, 71.4%and 76.5%(P<0.05).Cardiac valve calcification was independent risk factor for CAC progression.Patients with aortic valve or mitral valve calcification and both valve calcification had a significantly greater likelihood of increase of CACS ( relative ratios were 1.30,1.35;P<0.01).Conclusion The cardiac valve calcification in end stage renal disease patients was strongly asso-ciated with the progression of CACS.CACS progressed rapidly in patients with cardiac valve calcification.%目的:探讨终末期肾病患者心脏瓣膜钙化与冠状动脉钙化进展之间的关系。方法选取127例终末期肾病患者,分析心脏瓣膜钙化与冠状动脉钙化进展的关系。结果终末期肾病患者冠脉钙化在无瓣膜钙化组、主动脉瓣或二尖瓣钙化组、主动脉瓣和二尖瓣同时钙化组中进展的发生率分别为43.1%、71.4%、76.5%(P<0.05)。心脏瓣膜钙化是冠脉钙化进展的独立危险因子。与无瓣膜钙化患者相比,主动脉瓣或二尖瓣钙化患者与主动脉瓣和二尖瓣钙化的终末期肾病患者冠脉钙化积分进展的危险比分别为1.30、1.35( P<0.01)。结论终末期肾病患者心脏瓣膜钙化与冠状动脉的钙化进程密切相关,瓣膜钙化患者冠状动脉钙化的进展更快。

  6. 64-multyslice computed tomography: detection of coronary artery disease in patients with ischemic heart disease

    Directory of Open Access Journals (Sweden)

    A. S. Nikonenko

    2015-02-01

    Full Text Available At present time, the death rate from cardiovascular disease occupies leading position in the structure of total mortality worldwide. The opportunity to conduct non-invasive studies of the coronary arteries has appeared through the development and implementation of multislice computed tomography (MSCT into medical practice, which carry 64 or more sections. Aim. The purpose of this research is the identification of diagnostic capabilities of 64-slice MSCT in the verification of the severity of coronary artery lesions in patients with proven coronary artery disease. Methods and results. The study has been conducted on a 64-slice CT scanner Optima 660 (GE, USA. The degree of stenosis and calcification of the coronary arteries and also central hemodynamics have been studied. The analysis of survey results of 65 patients with coronary heart disease (30.8% of patients had a history of myocardial infarction has been carried out. The average age of patients in observation group was 60.2 ± 10.56 years. Male patients were dominated (75.4%. According to the 64-slice MSCT it has been found that coronary artery stenosis occurs ≥ 50% in 90.0% of patients with myocardial infarction, and in 32.5% of patients with symptomatic coronary artery disease. Conclusion. Therefore, MSCT has sufficient specificity in the diagnosis of occlusive and stenotic lesions of the coronary arteries, and can be used for screening patients with suspected coronary artery disease.

  7. 甲状旁腺切除术对血液透析患者冠状动脉钙化进展的影响%Impact of parathyroidectomy on the progression of coronary artery calcification in maintenance hemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    阚森; 张倩; 王梦婧; 丁旻雯; 张敏敏; 黄碧红; 袁立; 陈靖

    2015-01-01

    目的 观察甲状旁腺切除术(parathyroidectomy,PTX)对伴有继发性甲状旁腺功能亢进症(Secondary Hyperparathyroidism,SHPT)的血液透析患者冠状动脉钙化(Coronary artery calcification,CAC)进展的影响,并分析CAC进展的相关因素.方法 37例维持性血液透析(maintenance hemodialysis,MHD)患者,其中9例因难治性SHPT行甲状旁腺切除术,另外28例未做手术.基线以及随访时均应用多层螺旋CT检测CAC积分,比较2组CAC积分进展情况以及血钙、血磷、iPTH等指标,采用单因素和多因素回归分析CAC进展和临床参数的相关性. 结果 手术组患者随访血钙、血磷、iPTH水平分别为(2.1±0.3) mmol/L、(1.3±0.5) mmol/L和(82.1±96.6)mmol/L,较基线(2.5±0.4)mmol/L、(1.8±0.4) mmol/L和(846.6±588.4)mmol/L均明显降低,差异有统计学意义(P均<0.05).与基线CAC积分比较,患者随访CAC积分有明显升高,但2组患者CAC进展速度(128.9±169.9)分/年和(137.5±143.3)分/年无显著性差异;单因素与多因素回归分析显示CAC进展与iPTH水平改变、平均血钙磷水平等均无相关性,与糖尿病和基线CAC积分水平存在相关性(P分别为0.002和0.001). 结论 甲状旁腺切除术可以显著改善血液透析患者的钙磷代谢紊乱,但并未改善CAC进展情况,糖尿病和基线CAC积分可能影响CAC的进展.

  8. Do neighborhood socioeconomic deprivation and low social cohesion predict coronary calcification?: the CARDIA study.

    Science.gov (United States)

    Kim, Daniel; Diez Roux, Ana V; Kiefe, Catarina I; Kawachi, Ichiro; Liu, Kiang

    2010-08-01

    Growing evidence suggests that neighborhood characteristics may influence the risk of coronary heart disease. No studies have yet explored associations of neighborhood attributes with subclinical atherosclerosis in younger adult populations. Using data on 2,974 adults (1,699 women, 1,275 men) aged 32-50 years in 2000 from the Coronary Artery Disease Risk Development in Young Adults (CARDIA) Study and 2000 US Census block-group-level data, the authors estimated multivariable-adjusted associations of neighborhood socioeconomic deprivation and perceived neighborhood cohesion with odds of coronary artery calcification (CAC) 5 years later. Among women, the quartiles of highest neighborhood deprivation and lowest cohesion were associated with higher odds of CAC after adjustment for individual-level demographic and socioeconomic factors (for deprivation, odds ratio = 2.49, 95% confidence interval: 1.22, 5.08 (P for trend = 0.03); for cohesion, odds ratio = 1.87, 95% confidence interval: 1.10, 3.16 (P for trend = 0.02)). Associations changed only slightly after adjustment for behavioral, psychosocial, and biologic factors. Among men, neither neighborhood deprivation nor cohesion was related to CAC. However, among men in deprived neighborhoods, low cohesion predicted higher CAC odds (for interaction between neighborhood deprivation and cohesion, P = 0.03). This study provides evidence on associations of neighborhood deprivation and cohesion with CAC in younger, asymptomatic adults. Neighborhood attributes may contribute to subclinical atherosclerosis.

  9. Early results of coronary artery bypass grafting with coronary endarterectomy for severe coronary artery disease

    Directory of Open Access Journals (Sweden)

    Toischer Karl

    2009-09-01

    Full Text Available Abstract Background Despite the existence of controversial debates on the efficiency of coronary endarterectomy (CE, it is still used as an adjunct to coronary artery bypass grafting (CABG. This is particularly true in patients with endstage coronary artery disease. Given the improvements in cardiac surgery and postoperative care, as well as the rising number of elderly patient with numerous co-morbidities, re-evaluating the pros and cons of this technique is needed. Methods Patient demographic information, operative details and outcome data of 104 patients with diffuse calcified coronary artery disease were retrospectively analyzed with respect to functional capacity (NYHA, angina pectoris (CCS and mortality. Actuarial survival was reported using a Kaplan-Meyer analysis. Results Between August 2001 and March 2005, 104 patients underwent coronary artery bypass grafting (CABG with adjunctive coronary endarterectomy (CE in the Department of Thoracic-, Cardiac- and Vascular Surgery, University of Goettingen. Four patients were lost during follow-up. Data were gained from 88 male and 12 female patients; mean age was 65.5 ± 9 years. A total of 396 vessels were bypassed (4 ± 0.9 vessels per patient. In 98% left internal thoracic artery (LITA was used as arterial bypass graft and a total of 114 vessels were endarterectomized. CE was performed on right coronary artery (RCA (n = 55, on left anterior descending artery (LAD (n = 52 and circumflex artery (RCX (n = 7. Ninety-five patients suffered from 3-vessel-disease, 3 from 2-vessel- and 2 from 1-vessel-disease. Closed technique was used in 18%, open technique in 79% and in 3% a combination of both. The most frequent endarterectomized localization was right coronary artery (RCA = 55%. Despite the severity of endstage atherosclerosis, hospital mortality was only 5% (n = 5. During follow-up (24.5 ± 13.4 months, which is 96% complete (4 patients were lost caused by unknown address 8 patients died (cardiac

  10. Early results of coronary artery bypass grafting with coronary endarterectomy for severe coronary artery disease

    Science.gov (United States)

    Schmitto, Jan D; Kolat, Philipp; Ortmann, Philipp; Popov, Aron F; Coskun, Kasim O; Friedrich, Martin; Sossalla, Samuel; Toischer, Karl; Mokashi, Suyog A; Tirilomis, Theodor; Baryalei, Mersa M; Schoendube, Friedrich A

    2009-01-01

    Background Despite the existence of controversial debates on the efficiency of coronary endarterectomy (CE), it is still used as an adjunct to coronary artery bypass grafting (CABG). This is particularly true in patients with endstage coronary artery disease. Given the improvements in cardiac surgery and postoperative care, as well as the rising number of elderly patient with numerous co-morbidities, re-evaluating the pros and cons of this technique is needed. Methods Patient demographic information, operative details and outcome data of 104 patients with diffuse calcified coronary artery disease were retrospectively analyzed with respect to functional capacity (NYHA), angina pectoris (CCS) and mortality. Actuarial survival was reported using a Kaplan-Meyer analysis. Results Between August 2001 and March 2005, 104 patients underwent coronary artery bypass grafting (CABG) with adjunctive coronary endarterectomy (CE) in the Department of Thoracic-, Cardiac- and Vascular Surgery, University of Goettingen. Four patients were lost during follow-up. Data were gained from 88 male and 12 female patients; mean age was 65.5 ± 9 years. A total of 396 vessels were bypassed (4 ± 0.9 vessels per patient). In 98% left internal thoracic artery (LITA) was used as arterial bypass graft and a total of 114 vessels were endarterectomized. CE was performed on right coronary artery (RCA) (n = 55), on left anterior descending artery (LAD) (n = 52) and circumflex artery (RCX) (n = 7). Ninety-five patients suffered from 3-vessel-disease, 3 from 2-vessel- and 2 from 1-vessel-disease. Closed technique was used in 18%, open technique in 79% and in 3% a combination of both. The most frequent endarterectomized localization was right coronary artery (RCA = 55%). Despite the severity of endstage atherosclerosis, hospital mortality was only 5% (n = 5). During follow-up (24.5 ± 13.4 months), which is 96% complete (4 patients were lost caused by unknown address) 8 patients died (cardiac failure: 3

  11. Choice PTTM guidewire for recanalization of total occlusive coronary arteries

    Institute of Scientific and Technical Information of China (English)

    OUYANG Ping; HE Shi-hua; CHEN Wei-Kang; WOO Carrie

    2002-01-01

    Objective: To evaluate the therapeutic effects of 0. 014″Choice PTTM wire in chronic total occlusion angioplasty. Methods: Balloon angioplasty was attempted in 25 arteries with chronic total occlusion,with the mean time of occlusion of 17±13 months (ranging from 2 to 84 months) and mean length of 14±6mm (ranging from 5 to 25 mm). The morphology of the lesions included bridging collaterals (4 cases), calcification (3 cases) and major side branch at the lesion (4 cases) . Choice PTTM wire was used electively in all the cases. Results: Lesion was crossed successfully in 92% (23/25) cases, without incidences of dissection of the coronary artery with subintimal entry. Balloon angioplasy and stenting (n=21) were performed with good immediate angiograghic results. Acute myocardial infarction or death occurred in none of the patients.Conclusion Successful recanalization of chronic coronary total occlusions using Choice PTTM wire can be achieved with good safety.

  12. Does the quantitative assessment of coronary artery dimensions predict the physiologic significance of a coronary stenosis?

    NARCIS (Netherlands)

    F. Zijlstra (Felix); J.C.W. van Ommeren (Jan-Kees); J.H.C. Reiber (Johan); P.W.J.C. Serruys (Patrick)

    1987-01-01

    textabstractTo study the relationship between the quantitatively assessed coronary artery dimensions and the regional coronary flow reserve as measured by digital subtraction cineangiography, we investigated 17 coronary arteries with a single discrete proximal stenosis and 12 normal coronary

  13. Multimodality imaging of coronary artery bypass grafts

    NARCIS (Netherlands)

    Salm, Liesbeth Pauline

    2006-01-01

    This thesis describes multiple imaging modalities to examine coronary artery bypass grafts, and the research which was performed to further develop noninvasive imaging techniques to detect stenoses in native coronary arteries and bypass grafts in patients who experienced recurrent chest pain after

  14. Multimodality imaging of coronary artery bypass grafts

    NARCIS (Netherlands)

    Salm, Liesbeth Pauline

    2006-01-01

    This thesis describes multiple imaging modalities to examine coronary artery bypass grafts, and the research which was performed to further develop noninvasive imaging techniques to detect stenoses in native coronary arteries and bypass grafts in patients who experienced recurrent chest pain after c

  15. Coronary artery calcium score: current status

    Science.gov (United States)

    Neves, Priscilla Ornellas; Andrade, Joalbo; Monção, Henry

    2017-01-01

    The coronary artery calcium score plays an Important role In cardiovascular risk stratification, showing a significant association with the medium- or long-term occurrence of major cardiovascular events. Here, we discuss the following: protocols for the acquisition and quantification of the coronary artery calcium score by multidetector computed tomography; the role of the coronary artery calcium score in coronary risk stratification and its comparison with other clinical scores; its indications, interpretation, and prognosis in asymptomatic patients; and its use in patients who are symptomatic or have diabetes. PMID:28670030

  16. Spontaneous Coronary Artery Dissection with Cardiac Tamponade.

    Science.gov (United States)

    Goh, Anne C H; Lundstrom, Robert J

    2015-10-01

    Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome. Clinical presentation ranges from chest pain alone to ST-segment-elevation myocardial infarction, ventricular fibrillation, and sudden death. The treatment of patients with spontaneous coronary artery dissection is challenging because the disease pathophysiology is unclear, optimal treatment is unknown, and short- and long-term prognostic data are minimal. We report the case of a 70-year-old woman who presented with an acute ST-segment-elevation myocardial infarction secondary to a spontaneous dissection of the left anterior descending coronary artery. She was treated conservatively. Cardiac tamponade developed 16 hours after presentation. Repeat coronary angiography revealed extension of the dissection. Medical therapy was continued after the hemopericardium was aspirated. The patient remained asymptomatic 3 years after hospital discharge. To our knowledge, this is the first reported case of spontaneous coronary artery dissection in association with cardiac tamponade that was treated conservatively and had a successful outcome.

  17. Coronary artery anomalies in Turner Syndrome

    DEFF Research Database (Denmark)

    Viuff, Mette H; Trolle, Christian; Wen, Jan;

    2016-01-01

    BACKGROUND: Congenital heart disease, primarily involving the left-sided structures, is often seen in patients with Turner Syndrome. Moreover, a few case reports have indicated that coronary anomalies may be more prevalent in Turner Syndrome than in the normal population. We therefore set out...... to systematically investigate coronary arterial anatomy by computed tomographic coronary angiography (coronary CTA) in Turner Syndrome patients. METHODS: Fifty consecutive women with Turner Syndrome (mean age 47 years [17-71]) underwent coronary CTA. Patients were compared with 25 gender-matched controls. RESULTS......: Coronary anomaly was more frequent in patients with Turner Syndrome than in healthy controls [20% vs. 4% (p = 0.043)]. Nine out of ten abnormal cases had an anomalous left coronary artery anatomy (absent left main trunk, n = 7; circumflex artery originating from the right aortic sinus, n = 2). One case had...

  18. Structural and functional changes of the coronary arteries in elderly senile patients with essential hypertension.

    Science.gov (United States)

    Hu, Jun; Zhu, Fu; Xie, Jun; Cheng, Xinhai; Chen, Guiyu; Tai, Haifen; Fan, Shaohua

    2013-11-01

    The aim of this study was to evaluate the effect of aging on the changes to the structure and function of coronary arteries in senile elderly patients with essential hypertension. Patients (aged 60-80 years) were divided into three groups. The 195 hypertensive patients were divided into four sub-groups according to the duration of hypertension. The changes to the coronary arteries (left and right) of all those patients were tested using the following index by 64 coronary computed tomography (CT) scans. The 24 h systolic blood pressure (SBP) and other blood biochemical parameters were assayed for all patients. We found that the value of the body mass index (BMI), total cholesterol (TC) and low density lipoproteins (LDL) were lower, but age and high density lipoproteins (HDL) were higher in the group of very elderly patients with hypertension (Group I; Phypertension (Group III). The left anterior descending branch calcification score (CSLAD), total calcification score (CST), pulse pressure (PP), the left main branch calcification score (CSLM), the left circumflex branch calcification score (CSLCX) were significantly increased in Group I compared with Group III (Phypertension' group (Group II). Hence, in elderly patients, a decrease in the levels of BMI, HDL, TC and LDL accompanies aging. Furthermore, the decline of arterial compliance and increase in arterial stiffness develops with age. Aging is more likely to lead to atherosclerosis in the coronary arteries, particularly in the left main coronary artery and its main branches. Aging is an uncontrollable risk factor, which plays a crucial role in coronary artery atherosclerosis.

  19. Vitamin K Supplementation and the Progression of Coronary Artery Calcium in Older Men and Women

    Science.gov (United States)

    Coronary artery calcium (CAC) is an independent predictor of cardiovascular disease. A preventive role for vitamin K in CAC progression has been proposed based on the properties of matrix Gla protein (MGP) as a vitamin K-dependent calcification inhibitor. The objective of this study was to determine...

  20. Discrepancy between coronary artery calcium score and HeartScore in middle-aged Danes

    DEFF Research Database (Denmark)

    Diederichsen, Axel Cosmus Pyndt; Sand, Niels Peter; Nørgaard, Bjarne;

    2012-01-01

    Background: Coronary artery calcification (CAC) is an independent and incremental risk marker. This marker has previously not been compared to the HeartScore risk model. Design: A random sample of 1825 citizens (men and women, 50 or 60 years of age) was invited for screening. Methods: Using...

  1. Spontaneous Coronary Artery Dissection: Case Report Review of the Literature

    Directory of Open Access Journals (Sweden)

    Kemal Karaağaç

    2013-03-01

    Full Text Available Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome with a high risk of mortality. The clinical presentation is similar to the atherosclerotic coronary artery disease. The diagnosis is usually made by coronary angiography. Spontaneous coronary artery dissection is more common in women than men. Fast and accurate diagnosis and treatment of spontaneous coronary artery dissection patients improves survival. Therapeutic options include surgery, percutaneous coronary intervention and medical therapy.

  2. Coronary artery anatomy of the goat.

    Science.gov (United States)

    Lipovetsky, G; Fenoglio, J J; Gieger, M; Srinivasan, M R; Dobelle, W H

    1983-05-01

    The coronary arteries of the goat heart were studied using angiographic techniques and molds of the coronary vessel trees. Blood supplies to the left and right ventricles, interventricular septum, atrioventricular node, and apex of the caprine heart were studied. The goat possesses a left dominant pattern of coronary supply with relatively uniform coronary anatomy and may provide a good large animal model for testing cardiovascular assist devices.

  3. Segmented Coronary Artery Aneurysms and Kawasaki Disease

    Directory of Open Access Journals (Sweden)

    Hamid Reza Ghaemi

    2011-05-01

    Full Text Available Kawasaki disease (KD is an acute vasculitis syndrome of unknown etiology. It occurs in infants and young children,affecting mainly small and medium-sized arteries, particularly the coronary arteries. Generalized microvasculitis occurs in the first 10 days, and the inflammation persists in the walls of medium and small arteries, especially the coronary arteries, and changes to coronary artery aneurysms.We report the case of a 10-month-old girl referred to our center three months after the onset of disease due to the aneurysmsof the coronary arteries. During the acute phase of her illness, she received 2 gr/kg intravenous gamma globulin; and afterher referral to us, the patient was treated by antiaggregant doses of acetylsalicylic acid (ASA (5 mg/kg and Warfarin (1 mg/daily. At three months’ follow-up, the aneurysms still persisted in the echocardiogram.

  4. Diagnostic value of serum osteopontin on coronary artery calcification evaluated by ROC curve%ROC曲线评价血清骨桥蛋白对冠脉钙化的诊断价值

    Institute of Scientific and Technical Information of China (English)

    贺兆发; 冯粉; 卢均坤; 张丽; 李奕红; 范蕾; 张洪亮

    2013-01-01

    目的:应用受试者工作特征曲线(ROC)评价血清骨桥蛋白(OPN)对冠状动脉钙化(CAC)的诊断价值,确定血清OPN诊断CAC的最佳临界值.方法:据64层螺旋CT冠脉造影结果将54例患者分为CAC组(32例)和非CAC组(UCAC组,22例),用酶联免疫吸附测定法(ELISA)检测血清OPN水平;应用ROC对血清OPN水平进行分析评价.按年龄受试者被分为<50岁组(16例)、50~60岁组(20例)、>60岁3组(18例),分别评价各年龄组血清OPN对CAC的诊断价值.结果:(1) CAC组血清OPN水平显著高于UCAC组[(40.281±11.997) μg/L比(23.682±5.760) μg/L],P<0.01;(2)按ROC曲线分析和Youden's指数最大的截断点作为临床诊断界点,血清OPN诊断CAC的ROC曲线下面积为0.947,最佳分界值为32μg /L,以血清OPN≥32μg /L来预测CAC,敏感度和特异性分别为81.3%和95.5%;(3)<50岁组、50~60岁组、>60岁组OPN诊断CAC的ROC曲线下面积分别为0.991、0.958和0.889;敏感度和特异性分别100%、90.9%,83.3%、100%,73.3%、100%;最佳分界值分别为31μg/L,33μg/L,34μg/L.结论:(1)血清OPN水平升高可作为CAC形成的标志之一;(2)血清OPN≥32ug/L对CAC的诊断有较高的敏感性和特异性;(3)各年龄组血清OPN对CAC诊断的特异性都较高,OPN的诊断价值在于对CAC的排除.%Objective: To evaluate diagnostic value of serum osteopontin (OPN) on coronary artery calcification (CAC) and determine the optimal threshold of serum OPN on diagnosis of CAC using receiver operator characteristic curve (ROC). Methods: According to the results of 64-slice spiral computed tomography (MSCT) coronary angiography, a total of 54 patients were divided into CAC group (n = 32) and un-CAC group (UCAC group, n = 22). Enzyme linked immunosorbent assay (ELISA) was used to measure serum OPN level; ROC was used to analyze and evaluate serum OPN level. According to age, subjects were divided into 60 years group (n= 18), and diagnostic value of

  5. Correlation among risk factors of coronary artery calcification and serum osteopontin level%冠脉钙化危险因素与血清骨桥蛋白相关性分析

    Institute of Scientific and Technical Information of China (English)

    贺兆发; 冯粉; 卢均坤; 张丽; 刘春辉; 范蕾; 李奕红; 张洪亮

    2012-01-01

    目的:探讨冠脉钙化(CAC)的独立危险因素,进一步分析血清骨桥蛋白(OPN)与CAC及其危险因素的相关性.方法:据64层螺旋CT冠脉造影结果连续入选65例患者,分为冠脉钙化(CAC)组(37例)和非冠脉钙化(UCAC)对照组(28例),用酶联免疫吸附法(ELISA)测定血清OPN水平.分别进行单因素和多因素Logistic回归分析研究冠脉钙化的危险因素,血清OPN与CAC危险因素的相关性采用Spearman's相关分析.结果:1、将单因素Logistic回归分析有统计学意义的年龄、高血压,糖尿病,饮食习惯不佳,缺乏运动,超重(OR=3.47~12.96,P=0.018~0.003)等变量引入多因素Logistic回归分析,结果多因素Logistic回归分析显示年龄、超重、睡眠质量差、饮食习惯不佳是CAC的独立危险因素,OR为35.31~5.17,P<0.01~<0.05;2、CAC组血清OPN水平显著高于UCAC组[(39.919±11.879) μg/L比(24.000±6.000) μg /L,P<0.01];3、Spearman's 直线相关分析显示血清OPN水平与CAC危险因素:LDL-C、超重、年龄、TC呈正相关(r=0.487~0.286,P<0.001~<0.05),与睡眠质量差、糖尿病、不良饮食习惯、缺乏运动呈正相关(r=4.10~2.24,P<0.01~<0.05);与HDL-C呈负相关(r=-0.250,P<0.05).结论:相关分析显示年龄、超重、睡眠质量差、不良饮食习惯等是CAC独立危险因素;血清OPN水平与LDL-C、超重、年龄、糖尿病、缺乏运动等相关.这说明应降低OPN水平,减少CAC危险因素,以减轻冠脉钙化、减慢其发展.%Objective:To explore independent risk factors of coronary artery calcification (CAC) and analyze correlation among risk factors of CAC and serum osteopontin (OPN) level.Methods:According to results of 64-slice spiral computed tomography (MSCT) coronary angiography,a total of 65 patients were continuously enrolled and divided into CAC group (n =37) and non-CAC control group (n =28).Enzyme linked immunosorbent assay (ELISA) was used to measure serum level of OPN

  6. Diagnostic Efficacy of Vessel Specific Coronary Calcium Score in Detection of Coronary Artery Stenosis

    Science.gov (United States)

    Motevalli, Marzieh; Ghanaati, Hossein; Firouznia, Kavous; Kargar, Jalal; Aliyari Ghasabeh, Mounes; Shahriari, Mona; Jalali, Amir Hosein; Shakiba, Madjid

    2014-01-01

    Background: Coronary artery calcification which is determined quantitatively by coronary calcium scoring has been known as a sign of coronary stenosis and thus future cardiac events; hence it has been noticed on spotlight of researchers in recent years. Developing different method for early and optimal detection of coronary artery disease (CAD) is really essential as CAD are the first cause of death in population. Objectives: To evaluate predictive value of vessel specific coronary artery calcium (CAC) score in predicting obstructive coronary artery disease. Patients and Methods: In this diagnostic test study we evaluated patients with coronary computed tomography angiography (CCTA) and CAC score which had been referred to two referral radiology center in Tehran, Iran and finally we selected 2525 patients in a single and sequential pattern to create a diagnostic study. The whole-heart CAC scores and vessel specific CAC scores were calculated individually for the 4 major epicardial coronary arteries in 2 distinct group; group A ( patients with previous history of CABG) and group B (patients without history of CABG). For evaluation of obstruction tree cut off points were described: 0 > ; at least 1 segment with any kind of stenosis, ≥ 50; at least 1 segment with stenosis ≥ 50, ≥ 70; at least 1 segment with stenosis ≥ 70. Results: Mean of coronary calcium scores in terms of each coronary artery vessel increase by increasing coronary stenosis grade in group B; LAD, RCA, LCX respectively have mean CAC score 6.06, 6.21 and 5.04 in normal patients and 221.6, 226.7 and 106.6 in patients with complete stenosis. As expected these findings don't work for group A. Also By increasing calcium score cutoff in all four vessels sensitivity decreased and specificity increased but steal LAD had higher sensitivity than other vessels and LM had higher specificity. Thus using calcium score method is useful for ruling out stenosis in LAD while calcium score of LM can predict

  7. Prognostic implications of coronary artery calcium in the absence of coronary artery luminal narrowing

    NARCIS (Netherlands)

    I. Cho (Iksung); Ó Hartaigh, B. (Bríain); H. Gransar (Heidi); V. Valenti (Valentina); F.Y. Lin (Fay); S. Achenbach (Stephan); D.S. Berman (Daniel); M.J. Budoff (Matthew); T.Q. Callister (Tracy); M. Al-Mallah (Mouaz); F. Cademartiri (Filippo); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); A.M. Dunning (Alison); A. Delago (Augustin); T.C. Villines (Todd); M. Hadamitzky (Martin); J. Hausleiter (Jörg); J. Leipsic (Jonathon); L.J. Shaw (Leslee); P.A. Kaufmann (Philipp); R.C. Cury (Ricardo); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); E. Maffei (Erica); G.L. Raff (Gilbert); G. Pontone (Gianluca); D. Andreini (Daniele); H.-J. Chang (Hyuk-Jae); J.K. Min (James)

    2017-01-01

    textabstractBackground and aims: Coronary artery calcium (CAC) scoring is a predictor of future adverse clinical events, and a surrogate measure of overall coronary artery plaque burden. Coronary computed tomographic angiography (CCTA) is a contrast-enhanced method that allows for visualization of p

  8. Phosphorus is associated with coronary artery disease in patients with preserved renal function.

    Directory of Open Access Journals (Sweden)

    Ana Ludimila Cancela

    Full Text Available High serum phosphorus levels have been associated with mortality and cardiovascular events in patients with chronic kidney disease and in the general population. In addition, high phosphorus levels have been shown to induce vascular calcification and endothelial dysfunction in vitro. The aim of this study was to evaluate the relation of phosphorus and coronary calcification and atherosclerosis in the setting of normal renal function. This was a cross-sectional study involving 290 patients with suspected coronary artery disease and undergoing elective coronary angiography, with a creatinine clearance >60 ml/min/1.73 m(2. Coronary artery obstruction was assessed by the Friesinger score and coronary artery calcification by multislice computed tomography. Serum phosphorus was higher in patients with an Agatston score >10 than in those with an Agatston score ≤ 10 (3.63 ± 0.55 versus 3.49 ± 0.52 mg/dl; p = 0.02. In the patients with Friesinger scores >4, serum phosphorus was higher (3.6 ± 0.5 versus 3.5 ± 0.6 mg/dl, p = 0.04 and median intact fibroblast growth factor 23 was lower (40.3 pg/ml versus 45.7 pg/ml, p = 0.01. Each 0.1-mg/dl higher serum phosphate was associated with a 7.4% higher odds of having a Friesinger score >4 (p = 0.03 and a 6.1% greater risk of having an Agatston score >10 (p = 0.01. Fibroblast growth factor 23 was a negative predictor of Friesinger score (p = 0.002. In conclusion, phosphorus is positively associated with coronary artery calcification and obstruction in patients with suspected coronary artery disease and preserved renal function.

  9. Cardiac CT: coronary arteries and beyond

    Energy Technology Data Exchange (ETDEWEB)

    Mahnken, Andreas H. [RWTH Aachen University, Department of Diagnostic Radiology, University Hospital, Aachen (Germany); RWTH Aachen University, Applied Medical Engineering, Aachen (Germany); Muehlenbruch, Georg; Guenther, Rolf W.; Wildberger, Joachim E. [RWTH Aachen University, Department of Diagnostic Radiology, University Hospital, Aachen (Germany)

    2007-04-15

    Multi-detector-row computed tomography (MDCT) has emerged as a rapidly developing method for non-invasive imaging of the heart. An understanding of ECG synchronization, contrast material administration, patient preparation and image post-processing is needed to optimize image quality. The basic technical principles and essentials of these technical basics are described here. Correctly applied cardiac MDCT allows imaging of the coronary arteries including coronary anatomy and stenosis detection. The same is true for evaluation of coronary artery bypass grafts and, to some extent, coronary artery stents. While quantification of total calcified plaque burden has been long established, coronary MDCT allows assessing plaque morphology and constitution. Recent approaches go beyond the coronaries and include evaluation of left ventricular function at rest and myocardial viability. In combination with experimental approaches for assessing aortic valve function and myocardial perfusion imaging, cardiac MDCT offers the potential for a comprehensive examination of the heart using a single breath-hold examination. (orig.)

  10. Hypophosphatemic rickets developed after treatment with etidronate disodium in a patient with generalized arterial calcification in infancy

    Directory of Open Access Journals (Sweden)

    Kentaro Miyai

    2015-12-01

    Full Text Available Ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1 was originally reported as a responsible gene for generalized arterial calcification in infancy (GACI. Though the prognosis of GACI patients is poor because of myocardial infarction and heart failure in relation to medial calcification of the coronary arteries, some patients rescued by bisphosphonate treatment have been reported. Recently, ENPP1 is also reported as responsible for autosomal recessive hypophosphatemic rickets type 2. We show here a boy with homozygous ENPP1 mutations diagnosed as having GACI in early infancy. After the diagnosis, he was treated with etidronate disodium (EHDP in combination with antihypertensive drugs. The calcification of major arteries was diminished and disappeared by the age of eight months. He also showed mild hypophosphatemia (2.6–3.7 mg/dl from the age of one year. After the treatment with EHDP for five years, he showed genu valgum with hypophosphatemia (2.6 mg/dl. He was diagnosed as having hypophosphatemic rickets at the age of seven years. The findings that hyper-mineralization of the arteries and hypo-mineralization of the bone observed in the same patient are noteworthy. ENPP1 could be regarded as a controller of the calcification of the whole body at least in part.

  11. Exertion and acute coronary artery injury.

    Science.gov (United States)

    Black, A; Black, M M; Gensini, G

    1975-12-01

    Twelve cases of myocardial infarction as related to strenuous exertion are presented with the pathological findings in several of these cases. Three cases with coronary arteriography are also presented. The pathology of coronary arteriosclerotic plaques and the vulnerability to acute injury is reviewed and discussed. It is concluded that strenuous exertion can cause acute injury to coronary artery plaques due to the unusual stressful whip-like action to which coronary arteries are subject. These injuries may initiate as cracks in the plaques or subintimal hemorrhages and proceed to coronary occlusion and ultimate myocardial infarction. With this concept in mind we use the term of "crack in the plaque" (Black's Crack in the Plaque) to account for the sudden appearance of clinical coronary artery disease appearing during or shortly after exertion, or other stressful situations in patients without previous existing evidence of clinical coronary artery disease. This could also account for exacerbation of symptoms or death occurring after exertion in previously quiescent asymptomatic known coronary artery disease subjects. This concept may explain some of the puzzling features of coronary disease.

  12. Progression from stenosis to occlusion in the proximal native coronary artery after coronary artery bypass grafting.

    Science.gov (United States)

    Tanaka, Akihito; Ishii, Hideki; Oshima, Hideki; Shibata, Yohei; Tatami, Yosuke; Osugi, Naohiro; Ota, Tomoyuki; Kawamura, Yoshihiro; Suzuki, Susumu; Usui, Akihiko; Murohara, Toyoaki

    2016-07-01

    Coronary artery bypass grafting (CABG) is an established treatment for multivessel coronary artery disease. However, problematic situations are occasionally encountered after CABG, such as disease progression in the native coronary artery with graft occlusion, which causes difficulty in revascularization. The purpose of this study was to evaluate changes in the native coronary artery after CABG. Between 2009 and 2012 in our institution, 351 patients underwent CABG, and 768 bypass grafts were anastomosed to non-occluded coronary arteries. Of these, 489 bypass grafts had available early postoperative angiographic results (≤6 months) suitable for assessment in this study. We defined malignant graft failure after CABG to be bypass graft occlusion and de novo complete occlusion of the target native coronary artery proximal to the graft anastomosis site. In the early angiographic results, 17 grafts were occluded (17/489; 3.5 %). Two of the grafts displayed malignant graft failure (a saphenous vein graft to the right coronary artery and a saphenous vein graft to the diagonal branch) (2 of 17 occluded grafts, and 2 of 489 studied grafts). Of the patent bypass grafts, 24 involved progression to occlusion in the proximal native coronary artery (19 saphenous vein grafts, 4 left internal thoracic artery grafts, and 1 right internal thoracic artery graft). Malignant graft failure was uncommon during short-term follow-up after CABG. At the same time, disease progression in the proximal native coronary artery from stenosis to occlusion following patent bypass grafting was relatively common, especially for vein grafts.

  13. Acoustic detection of coronary artery disease.

    Science.gov (United States)

    Semmlow, John; Rahalkar, Ketaki

    2007-01-01

    Coronary artery disease (CAD) occurs when the arteries to the heart (the coronary arteries) become blocked by deposition of plaque, depriving the heart of oxygen-bearing blood. This disease is arguably the most important fatal disease in industrialized countries, causing one-third to one-half of all deaths in persons between the ages of 35 and 64 in the United States. Despite the fact that early detection of CAD allows for successful and cost-effective treatment of the disease, only 20% of CAD cases are diagnosed prior to a heart attack. The development of a definitive, noninvasive test for detection of coronary blockages is one of the holy grails of diagnostic cardiology. One promising approach to detecting coronary blockages noninvasively is based on identifying acoustic signatures generated by turbulent blood flow through partially occluded coronary arteries. In fact, no other approach to the detection of CAD promises to be as inexpensive, simple to perform, and risk free as the acoustic-based approach. Although sounds associated with partially blocked arteries are easy to identify in more superficial vessels such as the carotids, sounds from coronary arteries are very faint and surrounded by noise such as the very loud valve sounds. To detect these very weak signals requires sophisticated signal processing techniques. This review describes the work that has been done in this area since the 1980s and discusses future directions that may fulfill the promise of the acoustic approach to detecting coronary artery disease.

  14. Coronary Artery Calcium Distribution and Interscan Measurement Variability in End-Stage Renal and Coronary Heart Disease Patients

    Energy Technology Data Exchange (ETDEWEB)

    Serafin, Z.; Laskowska, K.; Marzec, M.; Lasek, W. (Dept. of Radiology and Diagnostic Imaging, Nicolaus Copernicus Univ., Collegium Medicum, Bydgoszcz (Poland)); Sinjab, T.A.; Wlodarczyk, Z. (Dept. of Transplantology, Nicolaus Copernicus Univ., Collegium Medicum, Bydgoszcz (Poland))

    2009-04-15

    Background: Coronary heart disease patients and end-stage renal disease patients have been documented to have an increased amount of coronary artery calcifications (CAC). Purpose: To evaluate the distribution of CAC and its influence on interscan variability of measurement in end-stage renal disease and coronary heart disease patients, proven to have calcifications. Material and Methods: 69 patients having CAC, including 34 with coronary heart disease and 35 with end-stage renal disease, were scanned twice with multidetector-row computed tomography (MDCT). Amount of CAC was determined as the number of calcified lesions (CN), total calcium score (CS), calcium volume (CV), and calcium mass (CM). Distribution of CAC was evaluated on a per-patient basis as the median CS and CM of a single lesion. Density of the calcifications was calculated as the patient's CM divided by CV. Results: The overall median CS was 457.2, and the median CM was 75.6 mg. There were no significant differences in the number of calcified lesions, CS, or CM between the two groups. Both CS and CM of a single lesion, as well as the mean calcium density were lower in renal disease patients (P<0.05) than in coronary heart disease subjects. The relative interscan variability of coronary calcium measurement was higher in the renal disease group (P<0.05). There was a negative correlation between the calcium concentration and the relative interscan variability. Conclusion: The results indicate that the coronary calcium distribution influences the measurement interscan reproducibility, and the distribution may differ between end-stage renal disease patients and coronary heart disease patients, reflecting the dissimilar nature of coronary calcifications in those groups.

  15. [Pediatric case of congenital coronary artery fistula; surgical result and late changes in coronary artery aneurysm].

    Science.gov (United States)

    Sugawara, Masaaki; Oguma, Fumiaki; Hirahara, Hiroyuki

    2014-07-01

    Congenital coronary artery fistula is an uncommon heart anomaly involving the coronary arteries. We report here a case of a 4-year-old boy who had a coronary fistula from the right coronary artery to the right ventricle, with a coronary aneurysm. He was asymptomatic, but the calculated ratio of pulmonary blood flow to systemic blood flow was shown to be high [pulmonary flow (Qp)/systemic flow(Qs)=1.78]. The coronary angiography showed that the right coronary artery was dilated beginning at the ostium and had an aneurysm at the acute marginal portion. A large spherical aneurysm approximately 20 mm in diameter was found to have been connected with coronary fistula opening into the right ventricle. Surgical repair by closure of the fistula under direct vision, partial resection and suture closure of the aneurysm was performed. Plication of the proximal portion of the right coronary artery was not performed, and the diffusely dilated artery was left untouched. After this operation, he recovered well under anticoagulant treatment with warfarin and aspirin. Postoperative angiography was performed 17 months after the surgery to evaluate morphological changes in the coronary artery. The angiography confirmed the closure of the fistula and the regression of coronary artery dilatation.

  16. Effect of High-Calcium Diet on Coronary Artery Disease in Ossabaw Miniature Swine With Metabolic Syndrome.

    Science.gov (United States)

    Phillips-Eakley, Alyssa K; McKenney-Drake, Mikaela L; Bahls, Martin; Newcomer, Sean C; Radcliffe, John S; Wastney, Meryl E; Van Alstine, William G; Jackson, George; Alloosh, Mouhamad; Martin, Berdine R; Sturek, Michael; Weaver, Connie M

    2015-08-13

    Calcium is a shortfall essential nutrient that has been a mainstay of osteoporosis management. Recent and limited findings have prompted concern about the contribution of calcium supplementation to cardiovascular risk. A proposed mechanism is through the acceleration of coronary artery calcification. Determining causality between calcium intake and coronary artery calcification has been hindered by a lack of sensitive methodology to monitor early vascular calcium accumulation. The primary study aim was to assess the impact of high calcium intake on coronary artery calcification using innovative calcium tracer kinetic modeling in Ossabaw swine with diet-induced metabolic syndrome. Secondary end points (in vitro wire myography, histopathology, intravascular ultrasound) assessed coronary disease. Pigs (n=24; aged ≈15 months) were fed an atherogenic diet with adequate calcium (0.33% by weight) or high calcium (1.90% from calcium carbonate or dairy) for 6 months. Following 5 months of feeding, all pigs were dosed intravenously with (41)Ca, a rare isotope that can be measured in serum and tissues at a sensitivity of 10(-18) mol/L by accelerator mass spectrometry. Kinetic modeling evaluated early coronary artery calcification using (41)Ca values measured in serial blood samples (collected over 27 days) and coronary artery samples obtained at sacrifice. Serum disappearance of (41)Ca and total coronary artery (41)Ca accumulation did not differ among groups. Secondary end points demonstrated no treatment differences in coronary artery disease or function. There was no detectable effect of high calcium diets (from dairy or calcium carbonate) on coronary artery calcium deposition in metabolic syndrome swine. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  17. [Single coronary artery and right aortic arch].

    Science.gov (United States)

    Martínez-Quintana, Efrén; Rodríguez-González, Fayna

    2015-01-01

    Coronary anomalies are mostly asymptomatic and diagnosed incidentally during coronary angiography or echocardiography. However, they must be taken into account in the differential diagnosis of angina, dyspnea, syncope, acute myocardial infarction or sudden death in young patients. The case is presented of two rare anomalies, single coronary artery originating from right sinus of Valsalva and right aortic arch, in a 65 year-old patient with atherosclerotic coronary artery disease treated percutaneously. Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  18. Genetics of Coronary Artery Disease

    DEFF Research Database (Denmark)

    McPherson, Ruth; Tybjærg-Hansen, Anne

    2016-01-01

    Genetic factors contribute importantly to the risk of coronary artery disease (CAD), and in the past decade, there has been major progress in this area. The tools applied include genome-wide association studies encompassing >200,000 individuals complemented by bioinformatic approaches, including...... factors and identify those individuals who will benefit most from statin therapy. Such information also has important applications in clinical medicine and drug discovery by using a Mendelian randomization approach to interrogate the causal nature of many factors found to associate with CAD risk...... have led to a broader understanding of the genetic architecture of CAD and demonstrate that it largely derives from the cumulative effect of multiple common risk alleles individually of small effect size rather than rare variants with large effects on CAD risk. Despite this success, there has been...

  19. The Aberrant Coronary Artery - The Management Approach.

    Science.gov (United States)

    King, Nina-Marie; Tian, David D; Munkholm-Larsen, Stine; Buttar, Sana N; Chow, Vincent; Yan, Tristan

    2017-07-03

    An aberrant coronary artery is a rare clinical occurrence with an incidence of 0.05-1.2%. Often it is an incidental finding detected on coronary angiography or at autopsy. However, symptomatic patients can experience angina, arrhythmia, sudden death or non-specific symptoms such as dyspnoea and syncope. At present, there are no guidelines or dedicated studies assessing the treatment of an aberrant coronary artery leaving management options for these patients controversial. Selected international cardiothoracic surgeons were surveyed electronically in November 2016 to determine whether consensus exists on different management aspects for patients with an aberrant coronary artery arising from the contralateral sinus with an interarterial course. For asymptomatic patients with either an aberrant left main coronary artery (ALMCA) arising from the contralateral sinus or an aberrant right main coronary artery (ARMCA) arising from the contralateral sinus, there was no consensus on surgical correction of the anomaly. If myocardial ischaemia was demonstrated on either coronary angiography with fractional flow reserve measurements and/or stress myocardial perfusion scan, surgical correction was the consensus between the surveyed surgeons. If surgery was deemed appropriate, coronary artery bypass surgery utilising the internal mammary artery was marginally preferred by the respondents in patients with an ALMCA whilst unroofing of the coronary ostium was preferred in patients with an ARMCA. Although no consensus was reached, a large proportion of respondents would not treat a patient over the age of 30 years differently compared to those under 30 years old. For symptomatic patients or if myocardial ischaemia is demonstrated on either coronary angiography with fractional flow reserve measurements and/or stress myocardial perfusion scan, surgical correction is indicated. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the

  20. Warfarin-induced artery calcification is accelerated by growth and vitamin D.

    Science.gov (United States)

    Price, P A; Faus, S A; Williamson, M K

    2000-02-01

    The present studies demonstrate that growth and vitamin D treatment enhance the extent of artery calcification in rats given sufficient doses of Warfarin to inhibit gamma-carboxylation of matrix Gla protein, a calcification inhibitor known to be expressed by smooth muscle cells and macrophages in the artery wall. The first series of experiments examined the influence of age and growth status on artery calcification in Warfarin-treated rats. Treatment for 2 weeks with Warfarin caused massive focal calcification of the artery media in 20-day-old rats and less extensive focal calcification in 42-day-old rats. In contrast, no artery calcification could be detected in 10-month-old adult rats even after 4 weeks of Warfarin treatment. To directly examine the importance of growth to Warfarin-induced artery calcification in animals of the same age, 20-day-old rats were fed for 2 weeks either an ad libitum diet or a 6-g/d restricted diet that maintains weight but prevents growth. Concurrent treatment of both dietary groups with Warfarin produced massive focal calcification of the artery media in the ad libitum-fed rats but no detectable artery calcification in the restricted-diet, growth-inhibited group. Although the explanation for the association between artery calcification and growth status cannot be determined from the present study, there was a relationship between higher serum phosphate and susceptibility to artery calcification, with 30% higher levels of serum phosphate in young, ad libitum-fed rats compared with either of the groups that was resistant to Warfarin-induced artery calcification, ie, the 10-month-old rats and the restricted-diet, growth-inhibited young rats. This observation suggests that increased susceptibility to Warfarin-induced artery calcification could be related to higher serum phosphate levels. The second set of experiments examined the possible synergy between vitamin D and Warfarin in artery calcification. High doses of vitamin D are known to

  1. Spontaneous Coronary Artery Dissection: The Phantom Menace

    Science.gov (United States)

    Spinthakis, Nikolaos; Abdulkareem, Nada; Farag, Mohamed; Gorog, Diana A.

    2016-01-01

    We present a case of a 66-year-old lady with chest pain, without dynamic 12-lead electrocardiographic (ECG) changes and normal serial troponin. Coronary angiography revealed a linear filing defect in the first obtuse marginal branch of the circumflex artery indicating coronary artery dissection, with superadded thrombus. She was managed medically with dual antiplatelet therapy and has responded well. Spontaneous coronary artery dissection (SCAD) is a rare cause of cardiac chest pain, which can be missed without coronary angiography. Unlike most other lesions in patients with unstable symptoms, where coronary intervention with stenting is recommended, patients with SCAD generally fare better with conservative measures than with intervention, unless there is hemodynamic instability. PMID:28197295

  2. Characterization of blood borne microparticles as markers of premature coronary calcification in newly menopausal women.

    Science.gov (United States)

    Jayachandran, Muthuvel; Litwiller, Robert D; Owen, Whyte G; Heit, John A; Behrenbeck, Thomas; Mulvagh, Sharon L; Araoz, Philip A; Budoff, Matthew J; Harman, S Mitchell; Miller, Virginia M

    2008-09-01

    While the risk for symptomatic atherosclerotic disease increases after menopause, currently recognized risk factors do not identify ongoing disease processes in low-risk women. This study tested the hypothesis that circulating cell-derived microparticles may reflect disease processes in women defined as low risk by the Framingham risk score. The concentration and phenotype of circulating microparticles were evaluated in a cross-sectional study of apparently healthy menopausal women, screened for enrollment into the Kronos Early Estrogen Prevention Study. Microparticles were evaluated by flow cytometry, and coronary artery calcification (CAC) was scored using 64-slice computed tomography scanners. The procoagulant activity of isolated microparticles was determined with a sensitive fluorescent thrombin generation assay. Chronological age, body mass index, serum lipids, systolic blood pressure (Framingham risk score 50; range, 93-315 Agatston units) CAC compared with women without calcification. The total concentration and percentage of microparticles derived from platelets and endothelial cells were greatest in women with high CAC scores. The thrombin-generating capacity of the isolated microparticles correlated with phosphatidylserine expression, which also was greatest in women with high CAC scores. The percentages of microparticles expressing granulocyte and monocyte markers were not significantly different among groups. Therefore, the characterization of platelet and endothelial microparticles may identify early menopausal women with premature CAC who would not otherwise be identified by the usual risk factor analysis.

  3. Intravascular ultrasound for angiographically indeterminant left main coronary artery disease.

    Science.gov (United States)

    Parashara, D K; Jacobs, L E; Ledley, G S; Yazdanfar, S; Oline, J; Kotler, M N

    1994-01-01

    The precise diagnosis of the presence of significant left main coronary artery disease has profound prognostic and therapeutic implications. Coronary cineangiography has shown to be imprecise and inaccurate to determine the percent stenosis of the left main coronary artery. We report a case with significant left main coronary artery disease in whom coronary cineangiography was in discordance with the clinical data and intravascular ultrasonography. Based on the intravascular ultrasound findings, the patient underwent coronary artery bypass graft surgery. Therefore, the intravascular ultrasonography may be the procedure of choice for assessing indeterminant left main coronary artery lesions by coronary angiography.

  4. Left Circumflex Coronary Artery Fistula Connected to the Right Bronchial Artery Associated with Bronchiectasis: Multidetector CT and Coronary Angiography Findings

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Kyung Jin; Choo, Ki Seok [Dept. of Radiology, Medical Research Institute, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2013-04-15

    Coronary to bronchial artery fistula is a rare vascular anomaly secondary to enlargement of pre-existing vascular anastomosis between the coronary and bronchial arteries. This occurs when there is a constant disturbance of the pressure equilibrium involving either coronary or broncho-pulmonary disorder. Localized bronchiectasis is the most common related condition in patients with a coronary to bronchial artery fistula. Herein, we report on a case of a large left circumflex coronary artery to right bronchial artery fistula associated with bronchiectasis.

  5. Woven coronary artery: a case report and review of literature.

    Science.gov (United States)

    Kursaklioglu, Hurkan; Iyisoy, Atila; Celik, Turgay

    2006-10-26

    Woven coronary artery is an extremely rare and clearly undefined coronary malformation. Up to now, very few cases have been reported. In this anomaly, epicardial coronary artery are branched into thin channels at any segment of the coronary artery and then these longitudinal twisted thin channels merge again as the main coronary lumen. This anomaly is regarded as a benign condition since there is completely normal blood flow after the distal segment of the abnormal coronary artery. In this case report, we present a 48-year-old male patient with a woven coronary artery anomaly in the circumflex artery and who had been followed up for 5 years.

  6. The Fermi paradox and coronary artery disease

    National Research Council Canada - National Science Library

    Gottlieb, Ilan; Lima, Ronaldo Souza Leão

    2014-01-01

    ..., led Fermi to ask the famous question: "Where is everybody?" Fermi was confronted with a paradox that involved probability, scale, and evidence. Coronary artery disease (CAD) presents a similar challenge. The pathophysiological importance of nonobstructive CAD is well known, as two-thirds of acute coronary syndromes (ACS) originate...

  7. Arterial Calcification in Diabetes Mellitus: Preclinical Models and Translational Implications.

    Science.gov (United States)

    Stabley, John N; Towler, Dwight A

    2017-02-01

    Diabetes mellitus increasingly afflicts our aging and dysmetabolic population. Type 2 diabetes mellitus and the antecedent metabolic syndrome represent the vast majority of the disease burden-increasingly prevalent in children and older adults. However, type 1 diabetes mellitus is also advancing in preadolescent children. As such, a crushing wave of cardiometabolic disease burden now faces our society. Arteriosclerotic calcification is increased in metabolic syndrome, type 2 diabetes mellitus, and type 1 diabetes mellitus-impairing conduit vessel compliance and function, thereby increasing the risk for dementia, stroke, heart attack, limb ischemia, renal insufficiency, and lower extremity amputation. Preclinical models of these dysmetabolic settings have provided insights into the pathobiology of arterial calcification. Osteochondrogenic morphogens in the BMP-Wnt signaling relay and transcriptional regulatory programs driven by Msx and Runx gene families are entrained to innate immune responses-responses activated by the dysmetabolic state-to direct arterial matrix deposition and mineralization. Recent studies implicate the endothelial-mesenchymal transition in contributing to the phenotypic drift of mineralizing vascular progenitors. In this brief overview, we discuss preclinical disease models that provide mechanistic insights-and point to challenges and opportunities to translate these insights into new therapeutic strategies for our patients afflicted with diabetes mellitus and its arteriosclerotic complications. © 2016 American Heart Association, Inc.

  8. [Morphofunctional correlation in congenital anomalies of the coronary arteries. I. Coronary artery fistulas].

    Science.gov (United States)

    Rangel-Abundis, A; Muñoz-Castellanos, L; Marín, G; Chávez Pérez, E; Badui, E

    1994-01-01

    In order to explain the congenital coronary arteries malformations, the authors review the recent concepts on the coronary artery morphogenesis, based in the findings that in the human embryo, these arteries evolve from three sources: 1) endothelial aortic buds, 2) cavitary cellular groups from pericardial origin and with angiogenic character, which migrate to the cardiac zones where the coronary arteries will be distributed, and 3) the intramyocardial sinusoids. The anatomic and histologic cardiac alterations will be reflected in modifications of the coronary artery pattern. The coronary artery fistulae are formed by the persistence of the sponge structure of the myocardial wall, present in the early ontogenic steps of the cardiac development; such fistulae alter the normal functions of the coronary vascular tree and are capable to cause angina pectoris to the patient through diverse mechanisms: absence of capillarization, steal phenomenon aggravated by the altered coronary arteries properties when aneurysm or vascular channels are developed. The authors suggest a classification of the congenital coronary arteries anomalies: I. Anomalous origin in the sinus of Valsalva (anomalous and ectopic origin), II. Malformations of the coronary branches (in number, distribution and wall anomalies) and III. Anomalous connection of the coronary arteries: fistulae and persistence of the intramyocardial sinusoids isolated or communicated to left and right ventricles. The latter are frequently associated with aortic or pulmonary valve atresia. They do not cause myocardial ischemia and are formed secondary to the intracavitary elevated pressure which maintained the persistence, dilatation and communication of the ventricular chambers with such sinusoids and coronary arteries in the case of pulmonary valve atresia and with coronary veins in the case of aortic valve atresia.

  9. Influence of coronary calcification on the diagnostic accuracy of 64-slice computed tomography coronary angiography

    DEFF Research Database (Denmark)

    Abdulla, Jawdat; Pedersen, Kasper; Budoff, Matthew;

    2012-01-01

    To determine via meta-analysis the diagnostic accuracy of 64-slice computed tomography coronary angiography (CTA) for assessment of significant obstructive coronary artery stenosis at different coronary artery calcium score (CACS) levels. Data of 12,053 versus 5,890 segments, 906 versus 758...... arteries and 1,120 versus 514 patients in low versus high CACS subgroups from 19 eligible studies were compared. The per-patient prevalence of coronary artery disease was 48% versus 68%, respectively. Subgroups were stratified by different CACS thresholds ranging from 100 to 400. Meta-analyses of per......-patient data comparing overall low versus high CACS subgroups resulted in a sensitivity of 97.5 (95.5-99)% versus 97 (94.5-98.5)%, specificity of 85 (82-88)% versus 66.5 (58-74.5)%, diagnostic odds ratio of 153 (81-290) versus 40 (20-83), positive predictive value of 85 (82-87)% versus 86 (84-88)%, negative...

  10. Single coronary artery anomaly: the left main coronary artery originating from the proximal segment of right coronary artery

    Institute of Scientific and Technical Information of China (English)

    ZHU Jun; QIN Xu-guang; WU Qing-yu; XIONG Wei-guo; LU Chun-peng; WANG Rong-feng

    2011-01-01

    This case report we presented is that the anomalous left main coronary artery (LMCA) originates from the proximal segment of right coronary artery. In order to confirm the origin and course of the anomalous LMCA, a multi-slice computed tomography (MSCT) of the heart was performed on a 64-slice machine (Philips 64 Slice, Philips, USA) after 6 months of coronary angiography operation. The results showed that the anomalous LMCA originates from the proximal segment of right coronary artery, lies posteriorly to the aorta before taking acute sharply to go between the aorta and left atrium. It was classified as R-Ⅱ P subtype according to Lipton's classification. It is a rare case in the clinical practice.

  11. Can nontriggered thoracic CT be used for coronary artery calcium scoring? A phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Xueqian [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands and Center for Medical Imaging – North East Netherlands, Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen (Netherlands); Greuter, Marcel J. W. [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen (Netherlands); Groen, Jaap M. [Department of Radiology, Zaans Medical Center, 1500EE Zaandam (Netherlands); Bock, Geertruida H. de [Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen (Netherlands); Oudkerk, Matthijs [Center for Medical Imaging – North East Netherlands, Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen (Netherlands); Jong, Pim A. de [Department of Radiology, University Medical Center Utrecht, University of Utrecht, 3584CX Utrecht (Netherlands); Vliegenthart, Rozemarijn [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands and Center for Medical Imaging – North East Netherlands, Department of Radiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen (Netherlands)

    2013-08-15

    Purpose: Coronary artery calcium score, traditionally based on electrocardiography (ECG)-triggered computed tomography (CT), predicts cardiovascular risk. However, nontriggered CT is extensively utilized. The study-purpose is to evaluate the in vitro agreement in coronary calcium score between nontriggered thoracic CT and ECG-triggered cardiac CT.Methods: Three artificial coronary arteries containing calcifications of different densities (high, medium, and low), and sizes (large, medium, and small), were studied in a moving cardiac phantom. Two 64-detector CT systems were used. The phantom moved at 0–90 mm/s in nontriggered low-dose CT as index test, and at 0–30 mm/s in ECG-triggered CT as reference. Differences in calcium scores between nontriggered and ECG-triggered CT were analyzed by t-test and 95% confidence interval. The sensitivity to detect calcification was calculated as the percentage of positive calcium scores.Results: Overall, calcium scores in nontriggered CT were not significantly different to those in ECG-triggered CT (p > 0.05). Calcium scores in nontriggered CT were within the 95% confidence interval of calcium scores in ECG-triggered CT, except predominantly at higher velocities (≥50 mm/s) for the high-density and large-size calcifications. The sensitivity for a nonzero calcium score was 100% for large calcifications, but 46%± 11% for small calcifications in nontriggered CT.Conclusions: When performing multiple measurements, good agreement in positive calcium scores is found between nontriggered thoracic and ECG-triggered cardiac CT. Agreement decreases with increasing coronary velocity. From this phantom study, it can be concluded that a high calcium score can be detected by nontriggered CT, and thus, that nontriggered CT likely can identify individuals at high risk of cardiovascular disease. On the other hand, a zero calcium score in nontriggered CT does not reliably exclude coronary calcification.

  12. [Aortic valve calcification prevalence and association with coronary risk factors and atherosclerosis in Mexican population].

    Science.gov (United States)

    Acuña-Valerio, Jorge; Rodas-Díaz, Marco A; Macias-Garrido, Enrico; Posadas-Sánchez, Rosalinda; Juárez-Rojas, Juan G; Medina-Urrutia, Aida X; Cardoso-Saldaña, Guillermo C; Joge-Galarza, Esteban; Torres-Tamayo, Margarita; Vargas-Alarcón, Gilberto; Posadas-Romero, Carlos

    The prevalence of aortic valve calcification (AVC), strongly influenced by ethnicity, is unknown in Mexican population. The aim of this study was to investigate the prevalence of AVC and its associations with cardiovascular risk factors and coronary artery calcification (CAC), in Mexican subjects. In 1,267 subjects (53% women) without known coronary heart disease, aged 35 to 75 years, AVC and CAC were assessed by multidetector-computed tomography using the Agatston score. Cardiovascular risk factors were documented in all participants. The associations of AVC with CAC and risk factors were assessed by multivariable logistic regression analyses. The overall prevalence of AVC and CAC was 19.89% and 26.5%, respectively. AVC and CAC increased with age and were found more frequently in men (25.5% and 37.1%, respectively) than in women (14.9% and 13.0%, respectively). AVC was observed in only 8.5% of subjects without CAC, while those with CAC 1-99, 100-399, and >400 Agatston units had AVC prevalences of 36.8%, 56.8%, and 84.0%, respectively. The multivariable logistic regression analyses, adjusted for age, gender, obesity, physical inactivity, hypertension, dyslipidemia and high insulin levels, showed that the presence of CAC (OR [CI95%]: 3.23 [2.26-4.60]), obesity (1.94 [1.35-2.79]), male gender (1.44 [1.01-2.05]) and age (1.08 [1.03-1.10]), were significant independent predictors of AVC. Prevalence of AVC is high and significantly associated with atherosclerotic risk factors and CAC in this Mexican population. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  13. Effects of residual coronary artery disease on results of coronary artery bypass grafting.

    Science.gov (United States)

    Iskandrian, A S; Hakki, A H; Nestico, P F; DePace, N L; Goel, I P; Kane, S

    1984-10-01

    To assess the effects of residual coronary artery disease (non-revascularized coronary vessels) after coronary artery bypass grafting on symptoms and exercise left ventricular function, we categorized 77 patients into 3 groups according to the extent of residual coronary artery disease: group I (n = 17) had no residual coronary artery disease (residual score = 0); group II (n = 30) had light residual coronary artery disease (score of 1 to 9, mean 4.7); and group III (n = 30) had moderate residual coronary artery disease (score greater than or equal to 10, mean 23). Sixty patients were asymptomatic after coronary artery bypass grafting (14 in group I, 24 in group II, and 22 in group III), but the remaining patients had occasional angina pectoris. The resting left ventricular ejection fraction was significantly higher in group I than in the remaining 2 groups (56 +/- 18% in group I, 47 +/- 19% in group II, and 43 +/- 16% in group III, P less than 0.05). The exercise left ventricular ejection fraction was also significantly higher in group I (61 +/- 16% in group I, 51 +/- 18% in group II and 45 +/- 18% in group III, P less than 0.01). The ejection fraction response to exercise was abnormal in 5 patients in group I, 15 patients in group II, and 19 patients in group III. Thus, coronary artery bypass grafting results in symptomatic improvement, even in patients with residual coronary artery disease. The presence of residual coronary artery disease, however, may be a determinant of exercise left ventricular function in these patients.

  14. Comparison of CT and CMR for detection and quantification of carotid artery calcification

    DEFF Research Database (Denmark)

    Mujaj, Blerim; Lorza, Andrés M. Arias; van Engelen, Arna

    2017-01-01

    BACKGROUND: Carotid artery atherosclerosis is an important risk factor for stroke. As such, quantitative imaging of carotid artery calcification, as a proxy of atherosclerosis, has become a cornerstone of current stroke research. Yet, population-based data comparing the computed tomography (CT......) and cardiovascular magnetic resonance (CMR) for the detection and quantification of calcification remain scarce. METHODS: A total of 684 participants from the population-based Rotterdam Study underwent both a CT and CMR of the carotid artery bifurcation to quantify the amount of carotid artery calcification (mean...

  15. Noninvasive Detection of Coronary Artery Stenosis Using 16-slice Spiral CT: a Comparison with Selective X-ray Coronary Angiography

    Institute of Scientific and Technical Information of China (English)

    SHI Heshui; HAN Ping; KONG Xiangquan; FENG Gansheng; Martin HK Hoffmann

    2006-01-01

    The role of 16-slice spiral CT was evaluated in the diagnosis of coronary stenosis, with selective X-ray coronary angiography (SCA) serving as the reference standard. Sixty-five patients who were suspected of having coronary heart disease, without percutaneous transluminal coronary angioplasty or coronary bypass-grafting, were investigated using 16-slice CT. Eight patients with pre-scan heart rate of more than 80 beats/min were given β-blockers. After the retrospectively ECG-gated axial imaging reconstruction, volume redering (VR), multi-planar reconstruction (MPR), curved MPR and maximum intensity projection (MIP) were used to reconstruct. Every segment of coronary artery with a diameter ≥1.5 mm was assessed, and the presence on CT with a stenosis exceeding 50% diameter reduction was compared with that on SCA. The reasons which lead to some segments unevaluable were analysed. Compared with SCA, 93% coronary segments and 94 % main branches were evaluable. Residual cardiac motion artifacts, severe calcification and poor opacification made 58%, 28% and 14% of the remaining 60 segments unevaluable respectively. Without routine administration of β-blockers, good coronary imaging quality can be acquired using 16-slice spiral CT. It is a reliable noninvasive method for detection of obstructive coronary artery disease.

  16. Assessment of coronary artery disease and calcified coronary plaque burden by computed tomography in patients with and without diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Maffei, Erica; Seitun, Sara [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Nieman, Koen; Weustink, Annick C.; Mollet, Nico R. [Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Martini, Chiara [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Guaricci, Andrea Igoren [Azienda Ospedaliero-Universitaria di Foggia, Department of Cardiology, Foggia (Italy); Tedeschi, Carlo [Ospedale San Gennaro, Department of Cardiology, Naples (Italy); Berti, Elena; Grilli, Roberto [Regione Emilia-Romagna, Healthcare and Social Agency, Bologna (Italy); Messalli, Giancarlo [SDN Foundation, IRCCS, Naples (Italy); Cademartiri, Filippo [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Azienda Ospedaliero-Universitaria - Parma, Department of Radiology, Parma (Italy)

    2011-05-15

    To compare the coronary atherosclerotic burden in patients with and without type-2 diabetes using CT Coronary Angiography (CTCA). 147 diabetic (mean age: 65 {+-} 10 years; male: 89) and 979 nondiabetic patients (mean age: 61 {+-} 13 years; male: 567) without a history of coronary artery disease (CAD) underwent CTCA. The per-patient number of diseased coronary segments was determined and each diseased segment was classified as showing obstructive lesion (luminal narrowing >50%) or not. Coronary calcium scoring (CCS) was assessed too. Diabetics showed a higher number of diseased segments (4.1 {+-} 4.2 vs. 2.1 {+-} 3.0; p < 0.0001); a higher rate of CCS > 400 (p < 0.001), obstructive CAD (37% vs. 18% of patients; p < 0.0001), and fewer normal coronary arteries (20% vs. 42%; p < 0.0001), as compared to nondiabetics. The percentage of patients with obstructive CAD paralleled increasing CCS in both groups. Diabetics with CCS {<=} 10 had a higher prevalence of coronary plaque (39.6% vs. 24.5%, p = 0.003) and obstructive CAD (12.5% vs. 3.8%, p = 0.01). Among patients with CCS {<=} 10 all diabetics with obstructive CAD had a zero CCS and one patient was asymptomatic. Diabetes was associated with higher coronary plaque burden. The present study demonstrates that the absence of coronary calcification does not exclude obstructive CAD especially in diabetics. (orig.)

  17. Updates in management of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Dong Heon; Chae, Shung Chull [Kyungpook National University Medical School, Daegu (Korea, Republic of)

    2005-02-15

    Coronary artery disease (CAD) has been increasing during the last decade and is the one of major causes of death. The management of patients with coronary artery disease has evolved considerably. There are two main strategies in the management of CAD, complementary, not competitive, each other; the pharmacologic therapy to prevent and treat CAD and the percutaneous coronary intervention (PCI) to restore coronary flow. Antiplatelet drugs and cholesterol lowering drugs have central roles in pharmacotherapy. Drug eluting stent (DES) bring about revolutional changes in PCL in the management of patients with ST segment elevation acute myocardial infarction (AMI), there has been a debate on the better strategy for the restoration of coronary flow. Thrombolytic therapy is widely available and easy to administer, whereas primary PCI is less available and more complex, but more complete. Recently published evidences in the pharmacologic therapy including antiplatelet and statin, and PCI including DES and reperfusion therapy in patients with ST segment elevation AMI were reviewed.

  18. Left main coronary artery compression in pulmonary arterial hypertension

    DEFF Research Database (Denmark)

    Al-Badri, Kadhem Helo Abbas; Jensen, Jesper Møller; Christiansen, Evald H

    2015-01-01

    In patients with pulmonary arterial hypertension (PAH), chest pain is most likely due to right ventricular demand ischemia. We report a patient with idiopathic PAH who developed severe angina due to extrinsic compression of the left main coronary artery (LMCA) from a dilated pulmonary artery trunk....... The diagnosis was verified by electrocardiogram after exercise, coronary angiography including intravascular ultrasound, and cardiac multidetector computed tomography (MDCT). The origin of the LMCA was high in the left coronary sinus, facilitating extrinsic compression. The patient was successfully treated...... by percutaneous coronary intervention with stent implantation in the LMCA. Extrinsic compression of the LMCA is a severe and potentially fatal complication that should be considered in all patients with PAH and angina. MDCT is the method of choice for first-line diagnosis....

  19. [Pregnancy and coronary artery dissection].

    Science.gov (United States)

    Martínez-Quintana, Efrén; Rodríguez-González, Fayna

    2015-01-01

    Acute myocardial infarction during pregnancy is associated with high maternal and fetal mortality. Coronary atherosclerosis is the most common cause due to an increase in the age of the patients and the association with cardiovascular risk factors such as smoking, hypertension, diabetes mellitus, preeclampsia, and the existence of family history of coronary disease. However, thrombosis, coronary dissection or coronary vasospasms are other causes that may justify it. We report the case of a 33 weeks pregnant first-time mother, without cardiovascular risk factors, who presented an acute coronary event in the context of atherosclerotic disease and coronary dissection after percutaneous coronary intervention. Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  20. secondary Prevention of Coronary Events by Coronary Artery Bypass Surgery

    OpenAIRE

    2003-01-01

    Coronary artery bypass surgery has shown its superiority on other therapeutic options in specific but frequent indications such as left main lesions, multivessel disease with alteration of ventricular function, proximal lesions of the LAD, and multivessel diseases in diabetic patients. After reviewing the epidemiology of coronary artherosclerosis, we emphasize the efficacy of the surgical treatment compared to medical or interventional therapy for preventing ischemic events. The results deriv...

  1. Relationship between intracranial internal carotid artery calcification and enlarged cerebral perivascular space

    Energy Technology Data Exchange (ETDEWEB)

    Tao, Xiao-Xiao [Shanghai Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Department of Neurology, Shanghai (China); The First People' s Hospital of Wenling, Department of Neurology, Wenling (China); Li, Ge-Fei; Wu, Yi-Lan; Liu, Yi-Sheng; Zhao, Ying; Shi, Yan-Hui; Zhuang, Mei-Ting; Hou, Tian-Yu; Zhao, Rong; Liu, Feng-Di; Wang, Xue-Mei; Shen, Ying; Cui, Guo-Hong; Su, Jing-Jing; Chen, Wei [Shanghai Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Department of Neurology, Shanghai (China); Tang, Xue-Mei; Sun, Ji; Liu, Jian-Ren [Shanghai Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Department of Neurology, Shanghai (China); Shanghai Jiao Tong University School of Medicine, Clinical Research Center, Shanghai (China)

    2017-06-15

    The association between intracranial internal carotid artery (IICA) calcification and lacunes, white matter hyperintensity (WMH), and cerebral microbleeds (CMBs) has been well researched. However, enlarged cerebral perivascular space (PVS) has not yet been reported to correlate with intracranial internal carotid artery calcification. Therefore, the primary aim of this study was to investigate the relationship between IICA calcification and enlarged PVS. A total of 189 patients with ischemic stroke in the middle cerebral artery territory who presented within 7 days of ictus from 2012 to 2015 were enrolled respectively. All patients were required to have undergone head computed tomography, magnetic resonance imaging, susceptibility-weighted magnetic resonance imaging, magnetic resonance angiography, or computed tomography angiography. Clinical characteristics were recorded. IICA calcification and enlarged PVS were semi-quantitatively evaluated, and the presence of lacunes, WMH, and CMBs was recorded. Of the 189 patients, 63.5% were male. Mean age of the patients was 68.6 ± 12.2 years. There were 104 patients with IICA calcification. Age, diabetes mellitus, lacunes, and white matter hyperintensity were significantly associated with IICA calcification (P < 0.05). Multivariate logistic regression analysis showed that age, diabetes mellitus, and lacunes were independent predictors of IICA calcification (P < 0.05). A lower risk of IICA calcification was found in patients with a higher enlarged PVS score (P = 0.004). Higher enlarged PVS scores were associated with a lesser degree of IICA calcification. There appears to be a relationship between reduced risk of IICA calcification and enlarged PVS. (orig.)

  2. Intramural location and size of arterial calcification are associated with stenosis at carotid bifurcation

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Shigeki, E-mail: shigekiyamada3@gmail.com [Department of Neurosurgery and Stroke Center, Rakuwakai Otowa Hospital, Otowachinji-cho 2, Yamashina-ku, Kyoto 607-8602 (Japan); Department of Neurosurgery, Hamamatsu Rosai Hospital, 25 Shogen-cho, Higashi-ku, Hamamatsu city, Shizuoka 430-8525 (Japan); Interfaculty Initiative in Information Studies/Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo 153-8505 (Japan); Oshima, Marie, E-mail: marie@iis.u-tokyo.ac.jp [Interfaculty Initiative in Information Studies/Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo 153-8505 (Japan); Watanabe, Yoshihiko, E-mail: ynabe@magic.odn.ne.jp [Department of Neurosurgery, Hamamatsu Rosai Hospital, 25 Shogen-cho, Higashi-ku, Hamamatsu city, Shizuoka 430-8525 (Japan); Ogata, Hideki, E-mail: hidogata@gmail.com [Department of Neurosurgery, Hamamatsu Rosai Hospital, 25 Shogen-cho, Higashi-ku, Hamamatsu city, Shizuoka 430-8525 (Japan); Hashimoto, Kenji, E-mail: hashiken8022@yahoo.co.jp [Department of Neurosurgery, Kishiwada Municipal Hospital, 1001 Gakuhara-cho, Kishiwada city, Osaka 596-8501 (Japan); Miyake, Hidenori, E-mail: hi-miyake@hamamatsuh.rofuku.go.jp [Department of Neurosurgery, Hamamatsu Rosai Hospital, 25 Shogen-cho, Higashi-ku, Hamamatsu city, Shizuoka 430-8525 (Japan)

    2014-06-15

    Purpose: The purpose of this study was to investigate the association between internal carotid artery (ICA) stenosis and intramural location and size of calcification at the ICA origins and the origins of the cervical arteries proximal to the ICA. Method: A total of 1139 ICAs were evaluated stenosis and calcification on the multi-detector row CT angiography. The intramural location was categorized into none, outside and inside location. The calcification size was evaluated on the 4-point grading scale. The multivariate analyses were adjusted for age, serum creatinine level, hypertension, hyperlipidemia, diabetes mellitus, smoking and alcohol habits. Results: Outside calcification at the ICA origins showed the highest multivariate odds ratio (OR) for the presence of ICA stenosis (30.0) and severe calcification (a semicircle or more of calcification at the arterial cross-sectional surfaces) did the second (14.3). In the subgroups of >70% ICA stenosis, the multivariate OR of outside location increased to 44.8 and that of severe calcification also increased to 32.7. Four of 5 calcified carotid plaque specimens extracted by carotid endarterectomy were histologically confirmed to be calcified burdens located outside the internal elastic lamia which were defined as arterial medial calcification. Conclusions: ICA stenosis was strongly associated with severe calcification located mainly outside the carotid plaque. Outside calcification at the ICA origins should be evaluated separately from inside calcification, as a marker for the ICA stenosis. Additionally, we found that calcification at the origins of the cervical arteries proximal to the ICA was significantly associated with the ICA stenosis.

  3. 云南农村自然人群冠状动脉钙化与脉压差的关系%Relationship Between Coronary Artery Calcification and Pulse Pressure Difference in the Rural Population of Yunnan Province

    Institute of Scientific and Technical Information of China (English)

    王议; 曹慧丽; Robert Detrano; 吴新华; 杨瑛; 陈章荣; 欧阳天昭; 匡时权; 董瑜; 李利华; 吕滨

    2014-01-01

    目的:在了解云南农村自然人群冠状动脉钙化及冠状动脉钙化积分(CACS)的分布情况的基础上,进一步探讨冠状动脉钙化及CACS与脉压差的关系。  方法:对云南农村自然人群进行随机分层整群抽样,采用16排螺旋计算机断层摄影术(CT)对212名受试者进行冠状动脉扫描,评估冠状动脉钙化程度,并应用Agatston积分法计算冠状动脉钙化积分,按性别、年龄、钙化积分等分组,比较各组间脉压差,探讨冠状动脉钙化及CACS与脉压差相关性。  结果:51~60岁组的平均脉压差为(44.67±13.87)mmHg(1 mmHg=0.133 kPa),61~71岁年龄组平均脉压差为(50.00±17.44) mmHg,差异有统计学意义(P=0.015),且发现脉压差与年龄呈正相关(rs=0.202,P=0.003)。按CACS分组,CACS≥100组的平均脉压差[(55.22±18.79) mmHg]大于CACS  结论:云南省农村自然人群的冠心病危险因素脉压差与CACS有关,在冠状动脉钙化者中CACS随脉压差的增大而增大。%Objective: Based on coronary artery calciifcation (CAC) distribution in the rural population of Yunnan province, we further explored the relationship between coronary artery calciifcation score (CACS) and the pulse pressure difference (PPD). Methods: A randomly stratiifed cluster sampling method was used to study the rural population of Yunnan province and 16-MDCT scan was performed in 212 subjects for evaluating their CAC and calculating CACS. The subjects were divided into 2 sets of groups according to the age and CACS value. Age (51-60) years group,n=108 and Age (61-71) years group,n=104; CACS Results: The average PPD level in Age (61-71) years group was (44.67±13.87) mmHg and in Age (61-71) years group was (50.00±17.44) mmHg,P=0.015, PPD was positively related to age, rs=0.202,P=0.003. The average PPD level in CACS≥100 group, CACS Conclusion: PPD as a risk factor of coronary artery disease is related

  4. Coronary artery to left ventricle fistula

    Directory of Open Access Journals (Sweden)

    Kumar Vivek

    2005-11-01

    Full Text Available Abstract Background Coronary cameral fistulas are an uncommon entity, the etiology of which may be congenital or traumatic. They involve abnormal termination of a coronary artery, usually the right coronary, into a cardiac chamber, usually the right ventricle. Case Presentation We describe a case of female patient with severe aortic stenosis and interventricular septal hypertrophy that underwent bioprosthetic aortic valve replacement with concomitant septal myectomy. On subsequent follow-up an abnormal flow traversing the septum into the left ventricle was identified and Doppler interrogation demonstrated a continuous flow, with a predominantly diastolic component, consistent with coronary arterial flow. Conclusion The literature on coronary cameral fistulas is reviewed and the etiology of the diagnostic findings discussed. In our patient, a coronary artery to left ventricle fistula was the most likely explanation secondary to trauma to the septal perforator artery during myectomy. Since the patient was asymptomatic at the time of diagnosis no intervention was recommended and has done well on follow-up.

  5. Spontaneous healing of spontaneous coronary artery dissection.

    Science.gov (United States)

    Almafragi, Amar; Convens, Carl; Heuvel, Paul Van Den

    2010-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome and sudden cardiac death. It should be suspected in every healthy young woman without cardiac risk factors, especially during the peripartum or postpartum periods. It is important to check for a history of drug abuse, collagen vascular disease or blunt trauma of the chest. Coronary angiography is essential for diagnosis and early management. We wonder whether thrombolysis might aggravate coronary dissection. All types of treatment (medical therapy, percutaneous intervention or surgery) improve the prognosis without affecting survival times if used appropriately according to the clinical stability and the angiographic features of the involved coronary arteries. Prompt recognition and targeted treatment improve outcomes. We report a case of SCAD in a young female free of traditional cardiovascular risk factors, who presented six hours after thrombolysis for ST elevation myocardial infarction. Coronary angiography showed a dissection of the left anterior descending and immediate branch. She had successful coronary artery bypass grafting, with complete healing of left anterior descending dissection.

  6. Initial research on coronary artery calcification of the community population in Beijing with MDCT%北京社区自然人群冠状动脉钙化的多排螺旋CT初步研究

    Institute of Scientific and Technical Information of China (English)

    陈雄彪; 吕滨; 鲁锦国; 唐翔; 侯志辉; 孙明利; 李莹; 陈祚

    2010-01-01

    目的 利用64排螺旋CT(64 multi-detector computed tomography,64-MDCT)初步评价北京社区人群的冠状动脉钙化(coronary artery calcium,CAC)情况.方法 对北京地区社区人群进行抽样研究,利用64-MDCT(GE,LightSpeed VCT)对1 480例研究对象进行冠状动脉钙化扫描,应用 Agatston积分法分别计算其冠状动脉钙化积分(coronary artery calcium score,CACS),观察CAC分布特征,以性别及年龄分组比较组间的CAC差别.结果 总样本CAC阳性率为29.9%;男性组的CAC阳性率为37.6%,明显高于女性组的23.1%(P<0.01).同一性别各年龄组的CACS均呈正偏态分布,CAC阳性率和CACS均随年龄增加而显著增高(P<0.01);40~、50~岁组的CAC阳性率以及40~、50~、60~岁组的CACS存在性别间的显著性差异.1 480例研究对象有206例(13.9%)为单支钙化,237例(16.0%)为多支钙化;总样本共5 920支冠状动脉中以前降支(26.8%)及右冠状动脉(13.5%)钙化阳性率为高(P<0.01).结论 64-MDCT能够方便、快速地量化检测社区人群的CAC的发病情况,评价人群中的CAC分布特征及规律,从而初步判定人群中的冠状动脉粥样硬化病变的流行病学特征.

  7. 慢性肾脏病患者血清脂联素与冠状动脉钙化积分关系的研究%Study of the relation between serum adiponectin and coronary artery calcification score in patients with chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    王英; 孙懿; 程浩; 贾艳丽

    2015-01-01

    Objective To investigate the relation between serum adiponectin and coronary artery calcification score (CACS), and find the risk factors for CACS in patients with chronic kidney disease (CKD). Methods Twenty-nine patients with 3-5 stage CKD were selected. The serum adiponectin was measured by enzyme linked immunosorbent assay. The heart was scanned by 64-row spiral CT, and the CACS was calculated. The blood calcium, phosphorus, intact parathyroid hormone, total cholesterol, low density lipoprotein cholesterol, albumin, urea nitrogen, creatinine, uric acid and high sensitive C reactive protein levels were measured, and the calcium-phosphorus product and estimation glomerular filtration rate were calculated. Results In 29 patients with CKD, 24 cases (83%) had coronary artery calcification with different degree (CACS>0 score), and the average CACS was 508 (0-3 363) scores. There were statistical differences in systolic blood pressure, urea nitrogen and estimation glomerular filtration rate between CKD patients with CACS≥100 scores (15 cases) and CKD patients with CACS0分),CACS平均508(0~3 363)分.CACS≥100分(15例)与CACS<100分(14例)的慢性肾脏病患者的收缩压[(146.00±13.00)、(123.00±9.00)mmHg(1 mmHg=0.133 kPa)]、血尿素氮[(15.44±8.36)、(9.71±2.52)mmol/L]、估计肾小球滤过率[(21.77±11.81)、(38.71±11.56) ml/(min·1.73 m2)]比较差异有统计学意义(P<0.01或<0.05).Pearson相关分析显示,CACS与收缩压、肌酐和尿酸呈正相关,与白蛋白和估计肾小球滤过率呈负相关.多元逐步回归分析显示收缩压和估计肾小球滤过率是CACS的独立危险因素. 结论 慢性肾脏病3~5期患者冠状动脉钙化严重,收缩压和估计肾小球滤过率是冠状动脉钙化的独立危险因素.

  8. Transient cortical blindness after coronary artery angiography.

    Science.gov (United States)

    Terlecki, Michał; Wojciechowska, Wiktoria; Rajzer, Marek; Jurczyszyn, Artur; Bazan-Socha, Stanisława; Bryniarski, Leszek; Czarnecka, Danuta

    2013-01-01

    Coronary angiography is the current gold standard for the diagnosis of ischemic heart disease and therefore the prevalence of percutaneous coronary procedures such as angiography and angioplasty is high. The occurrence of cerebral complications after coronary angiography and coronary angioplasty is low and it mainly includes transient ischemic attack and stroke. The prevalence of transient cortical blindness after X-ray contrast media is low and it is usually seen after cerebral angiography. Until now only a few cases of transient cortical blindness have been described after coronary artery angiography. Regarding the spread of coronary angiography worldwide and in Poland this complication is uniquely rare. A 32-year-old man with multiple extrasystolic ventricular arrhythmia suggesting Brugada syndrome diagnosis according to morphology of the left bundle branch block and with decreased left ventricular ejection fraction was admitted to the First Department of Cardiology and Hypertension, Medical College of the Jagiellonian University in Krakow. Coronary angiography was performed in order to exclude ischemic etiology of the observed abnormalities. No arteriosclerotic lesions were found in coronary arteries. Transient cortical blindness was observed directly after angiography which may have been caused by the neurotoxic effect of the used X-ray contrast medium. In ophthalmologic and neurologic examination as well as in the cerebral computed tomography scan no pathologies were found. Visual impairment disappeared totally within several hours.

  9. [Acute coronary syndrome suspicion in patient with left coronary artery arising from right coronary sinus].

    Science.gov (United States)

    Kern, Adam; Górny, Jerzy; Rzeszowski, Bartłomiej; Witkowska, Ewa; Wasilewski, Grzegorz

    2013-01-01

    We present a case of 73 year-old patient who underwent coronary angiography due to suspicion of acute coronary syndrome without persistent ST segment elevation. The angiographic result showed no lesions that could cause recurrent chest pain,but it also revealed a seldom coronary artery abnormality - left coronary artery arising from right coronary sinus. Performed computed tomography of the chest confirmed the result of the coronarography. But apart from that it found the signs of neoplastic disease which was probably responsible for clinical presentation.

  10. Aortic arch calcification on chest X-ray combined with coronary calcium score show additional benefit for diagnosis and outcome in patients with angina

    OpenAIRE

    Woo, Jong Shin; Kim, Weon; Kwon, Se Hwan; Youn, Hyo Chul; KIM, HYUN SOO; Kim, Jin Bae; Kim, Soo Joong; Kim, Woo-Shik; Kim, Kwon Sam

    2016-01-01

    Background The coronary artery calcium (CAC) and aortic arch calcification (AoAC) are individually associated with cardiovascular disease and outcome. This study investigated the predictive value of AoAC combined with CAC for cardiovascular diagnosis and outcome in patients with angina. Methods A total of 2018 stable angina patients who underwent chest X-ray and cardiac multi-detector computed tomography were followed up for four years to assess adverse events, which were categorized as cardi...

  11. Coronary CT Angiography in Heavily Calcified Coronary Arteries: Improvement of Coronary Lumen Visualization and Coronary Stenosis Assessment With Image Postprocessing Methods

    Science.gov (United States)

    Sun, Zhonghua; Ng, Curtise K.C.; Xu, Lei; Fan, Zhanming; Lei, Jing

    2015-01-01

    Abstract To compare the diagnostic value of coronary CT angiography (CCTA) with use of 2 image postprocessing methods (CCTA_S) and (CCTA_OS) and original data (CCTA_O) for the assessment of heavily calcified plaques. Fifty patients (41 men, 9 women; mean age 61.9 years ± 9.1) with suspected coronary artery disease who underwent CCTA and invasive coronary angiography (ICA) examinations were included in the study. Image data were postprocessed with “sharpen” and smooth reconstruction algorithms in comparison with the original data without undergoing any image postprocessing to determine the effects on suppressing blooming artifacts due to heavy calcification in the coronary arteries. Minimal lumen diameter and degree of stenosis were measured and compared between CCTA_S, CCTA_OS, and CCTA_O with ICA as the reference method. The area under the curve (AUC) by receiver-operating characteristic curve analysis (ROC) was also compared among these 3 CCTA techniques. On a per-vessel assessment, the sensitivity, specificity, positive predictive value and negative predictive value, and 95% confidence interval (CI) were 100% (95% CI: 89%, 100%), 33% (95% CI: 22%, 45%), 41% (95% CI: 30%, 53%), 100% (95% CI: 85%, 100%) for CCTA_O, 94% (95% CI: 79%, 99%), 66% (95% CI: 54%, 77%), 57% (95% CI: 43%, 70%), and 95% (95% CI: 85%, 99%) for CCTA_S, 94% (95% CI: 79%, 99%), 44% (95% CI: 32%, 57%), 44% (95% CI: 32%, 57%), and 97% (95% CI: 79%, 99%) for CCTA_OS, respectively. The AUC by ROC curve analysis for CCTA_S showed significant improvement for detection of >50% coronary stenosis in left anterior descending coronary artery compared to that of CCTA_OS and CCTA_O methods (P coronary stenosis in the left circumflex and right coronary arteries (P > 0.05). CCTA with “sharpen” reconstruction reduces blooming artifacts from heavy calcification, thus, leading to significant improvement of specificity and positive predictive value of CCTA in patients with heavily calcified

  12. Microvascular Coronary Artery Spasm Presents Distinctive Clinical Features With Endothelial Dysfunction as Nonobstructive Coronary Artery Disease

    Science.gov (United States)

    Ohba, Keisuke; Sugiyama, Seigo; Sumida, Hitoshi; Nozaki, Toshimitsu; Matsubara, Junichi; Matsuzawa, Yasushi; Konishi, Masaaki; Akiyama, Eiichi; Kurokawa, Hirofumi; Maeda, Hirofumi; Sugamura, Koichi; Nagayoshi, Yasuhiro; Morihisa, Kenji; Sakamoto, Kenji; Tsujita, Kenichi; Yamamoto, Eiichiro; Yamamuro, Megumi; Kojima, Sunao; Kaikita, Koichi; Tayama, Shinji; Hokimoto, Seiji; Matsui, Kunihiko; Sakamoto, Tomohiro; Ogawa, Hisao

    2012-01-01

    Background Angina without significant stenosis, or nonobstructive coronary artery disease, attracts clinical attention. Microvascular coronary artery spasm (microvascular CAS) can cause nonobstructive coronary artery disease. We investigated the clinical features of microvascular CAS and the therapeutic efficacy of calcium channel blockers. Methods and Results Three hundred seventy consecutive, stable patients with suspected angina presenting nonobstructive coronary arteries (<50% diameter) in coronary angiography were investigated with the intracoronary acetylcholine provocation test, with simultaneous measurements of transcardiac lactate production and of changes in the quantitative coronary blood flow. We diagnosed microvascular CAS according to lactate production and a decrease in coronary blood flow without epicardial vasospasm during the acetylcholine provocation test. We prospectively followed up the patients with calcium channel blockers for microvascular coronary artery disease. We identified 50 patients with microvascular CAS who demonstrated significant impairment of the endothelium-dependent vascular response, which was assessed by coronary blood flow during the acetylcholine provocation test. Administration of isosorbide dinitrate normalized the abnormal coronary flow pattern in the patients with microvascular CAS. Multivariate logistic regression analysis indicated that female sex, a lower body mass index, minor–borderline ischemic electrocardiogram findings at rest, limited–baseline diastolic-to-systolic velocity ratio, and attenuated adenosine triphosphate–induced coronary flow reserve were independently correlated with the presence of microvascular CAS. Receiver-operating characteristics curve analysis revealed that the aforementioned 5-variable model showed good correlation with the presence of microvascular CAS (area under the curve: 0.820). No patients with microvascular CAS treated with calcium channel blockers developed cardiovascular

  13. Additive prognostic value of plasma N-terminal pro-brain natriuretic peptide and coronary artery calcification for cardiovascular events and mortality in asymptomatic patients with type 2 diabetes

    DEFF Research Database (Denmark)

    von Scholten, Bernt Johan; Reinhard, Henrik; Hansen, Tine Willum;

    2015-01-01

    BACKGROUND: In patients with type 2 diabetes, cardiovascular disease (CVD) is the major cause of morbidity and mortality. We evaluated the combination of NT-proBNP and coronary artery calcium score (CAC) for prediction of combined fatal and non-fatal CVD and mortality in patients with type 2...... treatment. Patients with baseline NT-proBNP > 45.2 ng/L and/or CAC ≥ 400 were stratified as high-risk patients (n = 133). Occurrence of fatal- and nonfatal CVD (n = 40) and mortality (n = 26), was traced after 6.1 years (median). RESULTS: High-risk patients had a higher risk of the composite CVD endpoint...... (adjusted hazard ratio [HR] 10.6 (95 % confidence interval [CI] 2.4-46.3); p = 0.002) and mortality (adjusted HR 5.3 (95 % CI 1.2-24.0); p = 0.032) compared to low-risk patients. In adjusted continuous analysis, both higher NT-proBNP and CAC were strong predictors of the composite CVD endpoint and mortality...

  14. Association of lower extremity arterial calcification with amputation and mortality in patients with symptomatic peripheral artery disease.

    Directory of Open Access Journals (Sweden)

    Chi-Lun Huang

    Full Text Available OBJECTIVE: The clinical implication of the coronary artery calcium score (CS is well demonstrated. However, little is known about the association between lower extremity arterial calcification and clinical outcomes. METHODS AND RESULTS: Eighty-two patients with symptomatic peripheral artery disease (age 61.0±12.4 years were followed for 21±11 months. CSs, ranging from the common iliac artery bifurcation to the ankle area, were analyzed through noncontrast multidetector computed tomography images retrospectively. The primary endpoints of this study were amputation and mortality. Old age, diabetes, hyperlipidemia, and end-stage renal disease were associated with higher CSs. Patients with more advanced Fontaine stages also tended to have significantly higher CSs (p = 0.03. During the follow-up period (21±11 months, 29 (35% patients underwent amputation, and 24 (29% patients died. Among the patients who underwent amputation, there were no significant differences in CSs between the amputated legs and the non-amputated legs. In the Cox proportional hazard model with CS divided into quartiles, patients with CS in the highest quartile had a 2.88-fold (95% confidence interval [CI] 1.18-12.72, p = 0.03 and a 5.16-fold (95% CI 1.13-21.61, p = 0.04 higher risk for amputation and all-cause mortality, respectively, than those with CS in the lowest quartile. These predictive effects remained after conventional risk factor adjustment. CONCLUSION: Lower extremity arterial CSs are associated with disease severity and outcomes, including amputation and all-cause mortality, in patients with symptomatic peripheral artery disease. However, the independent predictive value needs further investigation in large scale, prospective studies.

  15. [Bilateral coronary artery-pulmonary artery fistulas in a case with unstable angina pectoris].

    Science.gov (United States)

    Kepez, Alper; Kaya, Ergün Bariş; Aytemir, Kudret; Oto, Ali

    2008-03-01

    Bilateral coronary artery fistulas originating from both right and left coronary arteries are rare congenital abnormalities. A 58-year-old man presented with chest pain unrelated to exertion. Coronary angiography showed a fistula originating from the level of the first diagonal branch of the left anterior descending (LAD) coronary artery and a 95% stenosis just distal to the fistula. Right coronary angiography showed another fistula originating from the ostium of the right coronary artery. Both fistulas drained into the pulmonary artery. Coronary bypass surgery was performed for the LAD lesion using the left internal mammary artery graft, during which both fistulas were ligated. No complications were encountered postoperatively.

  16. Thoracic Sympathectomy for Severe Refractory Multivessel Coronary Artery Spasm.

    Science.gov (United States)

    Cardona-Guarache, Ricardo; Pozen, Jonah; Jahangiri, Arehzo; Koneru, Jayanthi; Shepard, Richard; Roberts, Charlotte; Abbate, Antonio; Cassano, Anthony

    2016-01-01

    Coronary artery spasm is a rare but potentially fatal disease. Herein, we report a case of recurrent ST-segment myocardial infarctions and ventricular fibrillation complicating severe multivessel coronary artery spasm successfully treated with bilateral thoracic surgical sympathectomy.

  17. Coronary Artery Dissection: Not Just a Heart Attack

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Coronary Artery Dissection: Not Just a Heart Attack Updated:Oct 4, ... cannot reach the heart muscle. Spontaneous coronary artery dissection (SCAD) is an uncommon occurrence, but because it ...

  18. Prevalence of thoracic aortic calcification and its relationship to cardiovascular risk factors and coronary calcification in an unselected population-based cohort: the Heinz Nixdorf Recall Study.

    Science.gov (United States)

    Kälsch, Hagen; Lehmann, Nils; Möhlenkamp, Stefan; Hammer, Cornelia; Mahabadi, Amir A; Moebus, Susanne; Schmermund, Axel; Stang, Andreas; Bauer, Marcus; Jöckel, Karl-Heinz; Erbel, Raimund

    2013-01-01

    Thoracic aortic calcification (TAC) and coronary artery calcium (CAC) have been proposed for risk assessment of coronary artery and cardiovascular disease events. The aim of this analysis is to assess the prevalence of TAC and to determine its relationship with cardiovascular risk factors and CAC in a general unselected population. TAC was measured from electron beam computed tomography scans and quantified by Agatston-Score in 4,025 participants aged 45-75 years (mean age 59.4 ± 7.8 years, 53% female) from the Heinz Nixdorf Recall Study. Multivariable generalized linear regression was used to evaluate relationships between TAC and cardiovascular risk factors and CAC. Overall 2,538/4,025 (63.1%) participants revealed TAC. Prevalence of TAC was greater in men than in women (65.2 vs. 61.7%, p = 0.009). TAC was most strongly associated with age, systolic blood pressure, smoking and high levels of LDL-cholesterol. Prevalence of CAC was significantly higher in participants with TAC than without (74.0 vs. 57.6%, p CAC in the presence of TAC (prevalence ratio (PR) 1.29 [95% CI: 1.22-1.35], p TAC has high prevalence and largely shares cardiovascular risk factors with CAD while being independently associated with present CAC.

  19. Percutaneous transradial artery approach for coronary stent implantation.

    Science.gov (United States)

    Kiemeneij, F; Laarman, G J

    1993-10-01

    A new approach for implantation of Palmaz Schatz coronary stents is reported. We describe the technique and rationale of coronary stenting with miniaturized angioplasty equipment via the radial artery. This technique is illustrated in three patients. One patient underwent Palmaz Schatz stent implantation for a saphenous vene coronary bypass graft stenosis, the second patient for a restenosis in the anterior descending coronary artery after atherectomy, and the third patient for a second restenosis after balloon angioplasty in the circumflex coronary artery.

  20. Suture-induced right coronary artery stenosis.

    Science.gov (United States)

    Seltmann, Martin; Achenbach, Stephan; Muschiol, Gerd; Feyrer, Richard

    2010-01-01

    An 82-year-old patient developed right heart failure in the days after surgical aortic valve replacement. Coronary CT angiography showed a high-grade stenosis of the mid-right coronary artery. Adjacent suture material seen on noncontrast CT suggested that the lesion was related to surgical closure of the right atrial cannulation site. Invasive angiography confirmed the stenosis, and percutaneous intervention was successfully performed.

  1. Successful percutaneous coronary intervention for chronic total occlusion of right coronary artery in patient with dextrocardia.

    Science.gov (United States)

    Munawar, Muhammad; Hartono, Beny; Iskandarsyah, Kurniawan; Nguyen, Thach N

    2013-07-01

    Situs inversus with dextrocardia is rare congenital anomaly. Coronary artery disease in such patients is quite rare. We reported a 52-year-old man with dextrocardia and chronic total occlusion at the proximal right coronary artery just after conus branch and severe stenosis at the proximal left anterior descending artery. He underwent successful percutaneous coronary intervention with stenting of total occluded right coronary artery and simultaneously stenting of the proximal left anterior descending artery.

  2. An Update on the Utility of Coronary Artery Calcium Scoring for Coronary Heart Disease and Cardiovascular Disease Risk Prediction.

    Science.gov (United States)

    Kianoush, Sina; Al Rifai, Mahmoud; Cainzos-Achirica, Miguel; Umapathi, Priya; Graham, Garth; Blumenthal, Roger S; Nasir, Khurram; Blaha, Michael J

    2016-03-01

    Estimating cardiovascular disease (CVD) risk is necessary for determining the potential net benefit of primary prevention pharmacotherapy. Risk estimation relying exclusively on traditional CVD risk factors may misclassify risk, resulting in both undertreatment and overtreatment. Coronary artery calcium (CAC) scoring personalizes risk prediction through direct visualization of calcified coronary atherosclerotic plaques and provides improved accuracy for coronary heart disease (CHD) or CVD risk estimation. In this review, we discuss the most recent studies on CAC, which unlike historical studies, focus sharply on clinical application. We describe the MESA CHD risk calculator, a recently developed CAC-based 10-year CHD risk estimator, which can help guide preventive therapy allocation by better identifying both high- and low-risk individuals. In closing, we discuss calcium density, regional distribution of CAC, and extra-coronary calcification, which represent the future of CAC and CVD risk assessment research and may lead to further improvements in risk prediction.

  3. Coronary Anomaly and Coronary Artery Fistula as Cause of Angina Pectoris with Literature Review

    Science.gov (United States)

    Koneru, Jayanth; Samuel, Anish; Joshi, Meherwan; Hamden, Aiman; Shamoon, Fayez E.; Bikkina, Mahesh

    2011-01-01

    Coronary artery fistulas are rare anomalies of the coronary arteries that may sometimes cause symptoms by shunting blood flow away from the myocardial capillary network. We report the case of a 46-year old lady which shows the right coronary cusp giving rise to left main coronary artery called anomalous origin of a coronary artery (AOCA), and also a fistula between the left coronary artery and pulmonary artery. We describe our diagnostic approach and review the literature on the epidemiology, pathophysiology, the diagnostic modalities, and treatment options. PMID:22937462

  4. Coronary Anomaly and Coronary Artery Fistula as Cause of Angina Pectoris with Literature Review

    Directory of Open Access Journals (Sweden)

    Jayanth Koneru

    2011-01-01

    Full Text Available Coronary artery fistulas are rare anomalies of the coronary arteries that may sometimes cause symptoms by shunting blood flow away from the myocardial capillary network. We report the case of a 46-year old lady which shows the right coronary cusp giving rise to left main coronary artery called anomalous origin of a coronary artery (AOCA, and also a fistula between the left coronary artery and pulmonary artery. We describe our diagnostic approach and review the literature on the epidemiology, pathophysiology, the diagnostic modalities, and treatment options.

  5. [Arterial calcification and risk of cardiovascular events in diabetes mellitus].

    Science.gov (United States)

    Iwai, Kunimitu; Morimoto, Shigeto

    2010-11-01

    The cohort studies reported the subclinical vascular calcification including atheroslerosis starts during prediabetic state characterized by impaired fasting glucose. In the cardiovascular systems of diabetes mellitus there is an original mechanism to induce the medial calcification other than intimal calcification observed in the classical atherosclerosis. This is characterized as the ectipic osteogenesis induced by paracrine signals from inflammatory lesions in the adventitia. On the other hand, many internal systems have been discovered to inhibit vascular calcification.

  6. [Emergency coronary artery bypass grafting for acute coronary syndrome].

    Science.gov (United States)

    Yamaguchi, Atsushi; Murayama, Takanori

    2012-09-01

    Since the drug eluting stents appeared in Japan, the indication for percutaneous coronary intervention has become wide-spread for the treatment of coronary artery disease. In the past decade, 216 patients underwent emergency/urgent coronary artery bypass grafting (CABG) in our institution, while the annual numbers of both emergency and elective CABG cases have declined. On the contrary to the decreasing number, emergency CABG patients were significantly getting older with multiple co-morbidities. Thus, off-pump CABG is likely to be beneficial for preventing postoperative complications, leading to the decreased postoperative mortality. When emergency CABG patients developed refractory myocardial ischemia and unstable hemodynamics, a percutaneous cardiopulmonary support system was quickly applicable and useful for on-pump beating CABG achieving complete surgical revascularization. For keeping satisfactory hemodynamics during CABG, communication between cardiovascular surgeons, anesthesiologists, and perfusionists is most important.

  7. Bone biomarkers help grading severity of coronary calcifications in non dialysis chronic kidney disease patients.

    Directory of Open Access Journals (Sweden)

    Marion Morena

    Full Text Available BACKGROUND: Osteoprotegerin (OPG and fibroblast growth factor-23 (FGF23 are recognized as strong risk factors of vascular calcifications in non dialysis chronic kidney disease (ND-CKD patients. The aim of this study was to investigate the relationships between FGF23, OPG, and coronary artery calcifications (CAC in this population and to attempt identification of the most powerful biomarker of CAC: FGF23? OPG? METHODOLOGY/PRINCIPAL FINDINGS: 195 ND-CKD patients (112 males/83 females, 70.8 [27.4-94.6] years were enrolled in this cross-sectional study. All underwent chest multidetector computed tomography for CAC scoring. Vascular risk markers including FGF23 and OPG were measured. Logistic regression analyses were used to study the potential relationships between CAC and these markers. The fully adjusted-univariate analysis clearly showed high OPG (≥10.71 pmol/L as the only variable significantly associated with moderate CAC ([100-400[ (OR = 2.73 [1.03;7.26]; p = 0.04. Such association failed to persist for CAC scoring higher than 400. Indeed, severe CAC was only associated with high phosphate fractional excretion (FEPO(4 (≥38.71% (OR = 5.47 [1.76;17.0]; p = 0.003 and high FGF23 (≥173.30 RU/mL (OR = 5.40 [1.91;15.3]; p = 0.002. In addition, the risk to present severe CAC when FGF23 level was high was not significantly different when OPG was normal or high. Conversely, the risk to present moderate CAC when OPG level was high was not significantly different when FGF23 was normal or high. CONCLUSIONS: Our results strongly suggest that OPG is associated to moderate CAC while FGF23 rather represents a biomarker of severe CAC in ND-CKD patients.

  8. Right coronary ostium agenesis with anomalous origin of the right coronary artery from an ectasic circumflex artery. A case report.

    Science.gov (United States)

    Ayala, F; Badui, E; Murillo, H; Madrid, R; Almazan, A; Rangel, A; Gutierrez-Vogel, S

    1995-07-01

    In this report the authors present a case with right coronary ostium agenesis with anomalous origin of the right coronary artery from an ectasic circumflex artery, which, according to the literature review, they consider to be a unique case.

  9. Magnetic resonance imaging of the coronary arteries : anatomy of the coronary arteries and veins in three-dimensional imaging

    NARCIS (Netherlands)

    van Geuns, R J; Wielopolski, P A; Rensing, B J; van Ooijen, P M; Oudkerk, M; de Feyter, P J

    Magnetic resonance imaging of coronary arteries will visualize, besides the arteries, the myocardium, blood in the cavities and cardiac veins. This will hamper the application of projectional visualization techniques such as those used in conventional coronary angiography. Volume rendering, a

  10. [Anatomy and physiology of the heart and coronary arteries].

    Science.gov (United States)

    Leclercq, Florence

    2015-03-01

    The myocardium assures the supply of oxygen to the body. The provision of oxygen to the myocardium by the coronary arteries is dependent on two key parameters: the coronary blood flow and the ability to extract oxygen from the arterial blood. Coronary artery disease is almost always the consequence of atherosclerosis and can lead to myocardial infarction.

  11. Effect of obesity on coronary artery plaque using 64 slice multidetector cardiac computed tomography angiography.

    Science.gov (United States)

    Isma'eel, Hussain; Tellalian, David; Hamirani, Yasmin S; Kadakia, Jigar; Nasir, Khurram; Budoff, Matthew J

    2010-04-30

    Patients with a coronary artery calcification score (CACS) of zero and an intermediate risk of coronary artery disease have been shown to have a low prevalence of non-calcified coronary artery plaque (NCP). 181 consecutive patients with CAC 'zero', undergoing cardiac computed tomography angiography (CCTA) angiography at our center were evaluated. Presence of detectable NCP on CCTA in these patients was 13.8%. Mild non-obstructive disease (50%). Traditional risk factors were not found to be associated with the presence of NCP. However higher body mass index (BMI) was strongly found to be associated with NCP (31.6 in patients with NCP vs. 27.6 kg/m(2) in patients without NCP, pNCP as compared to normal BMI (p<0.05).

  12. Reverse type IV dual left anterior descending coronary artery accompanying with anomalous origin of circumflex artery from right coronary sinus

    Directory of Open Access Journals (Sweden)

    Ahmet Seyfeddin Gurbuz

    2016-03-01

    Full Text Available Dual left anterior descending (LAD artery is an infrequent coronary anomaly classified into six types. Short LAD arising from left main coronary artery (LMCA and long LAD sourcing from proximal right coronary artery comprise Type IV dual LAD. We reported anomalous origin of circumflex artery (Cx with reverse Type IV LAD including short LAD arising from right coronary sinus and long LAD originated form LMCA.

  13. Classification of coronary artery tissues using optical coherence tomography imaging in Kawasaki disease

    Science.gov (United States)

    Abdolmanafi, Atefeh; Prasad, Arpan Suravi; Duong, Luc; Dahdah, Nagib

    2016-03-01

    Intravascular imaging modalities, such as Optical Coherence Tomography (OCT) allow nowadays improving diagnosis, treatment, follow-up, and even prevention of coronary artery disease in the adult. OCT has been recently used in children following Kawasaki disease (KD), the most prevalent acquired coronary artery disease during childhood with devastating complications. The assessment of coronary artery layers with OCT and early detection of coronary sequelae secondary to KD is a promising tool for preventing myocardial infarction in this population. More importantly, OCT is promising for tissue quantification of the inner vessel wall, including neo intima luminal myofibroblast proliferation, calcification, and fibrous scar deposits. The goal of this study is to classify the coronary artery layers of OCT imaging obtained from a series of KD patients. Our approach is focused on developing a robust Random Forest classifier built on the idea of randomly selecting a subset of features at each node and based on second- and higher-order statistical texture analysis which estimates the gray-level spatial distribution of images by specifying the local features of each pixel and extracting the statistics from their distribution. The average classification accuracy for intima and media are 76.36% and 73.72% respectively. Random forest classifier with texture analysis promises for classification of coronary artery tissue.

  14. Computed tomography for the measurement of coronary calcification in asymptomatic risk patients

    Directory of Open Access Journals (Sweden)

    Pichlbauer, Ernest

    2006-05-01

    Full Text Available Background: In 2003 nearly 20% of deaths in Germany were caused by coronary heart disease (CHD. Risk models are used to estimate the ten-year-risk of a coronary event. Coronary calcification may be seen as an additional risk factor. The amount of calcium is correlated with atherosclerotic lesions, but there is no direct correlation with the probability of a plaque rupture. Coronary calcification may be measured either by electron beam computed tomography (EBCT or multi-detector computed tomography (MDCT. Objectives: The aim of this HTA report is to investigate the diagnostic validity and cost effectiveness of computed tomography techniques in measuring coronary calcification of asymptomatic risk patients. Ethical aspects are discussed. Methods: A systematic literature research was performed in 35 international databases which yielded 1080 articles. Overall 43 publications were included for assessment, according to predefined selection criteria. Results: Measuring coronary calcification offers additional information compared with traditional risk factors. Yet at present it cannot be said - according to published literature - which population groups gain most. For determining adequate calcium score thresholds standardisation for age and sex is important. When comparing the reference standard EBCT with MDCT results are inconsistent and depend on the calcium-score value as well as on the scoring method. EBCT as a triage instrument in diagnosing CHD appears to be cost-effective. Yet it is rather not cost-effective as a refinement tool for risk stratification. Discussion: Most of the literature was published in the United States and discusses the use of EBCT as well as (traditional risk stratification by the Framingham Score. Regarding coronary calcification measured by MDCT (which is more widespread in Germany than EBCT and a risk model applicable for European populations clear recommendations based on published literature cannot be made at present

  15. Calcifications

    Energy Technology Data Exchange (ETDEWEB)

    Reichelt, S.; Erlemann, R.

    1989-02-01

    Juvenile dermatomyositis is a rare disease in early to mid-childhood. We describe the case of a young girl who was found to have prominent soft-tissue calcifications on the preoperative chest study. The clinical and radiological symptoms of dermatomyositis are demonstrated and the differential diagnosis of this kind of calcification is discussed.

  16. Adipocyte induced arterial calcification is prevented with sodium thiosulfate

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Neal X., E-mail: xuechen@iupui.edu [Divison of Nephrology, Indiana University School of Medicine, Indianapolis, IN (United States); O’Neill, Kalisha; Akl, Nader Kassis [Divison of Nephrology, Indiana University School of Medicine, Indianapolis, IN (United States); Moe, Sharon M. [Divison of Nephrology, Indiana University School of Medicine, Indianapolis, IN (United States); Roudebush VA Medical Center, Indianapolis, IN (United States)

    2014-06-20

    Highlights: • High phosphorus can induce calcification of adipocytes, even when fully differentiated. • Adipocytes can induce vascular calcification in an autocrine manner. • Sodium thiosulfate inhibits adipocyte calcification. - Abstract: Background: Calcification can occur in fat in multiple clinical conditions including in the dermis, breasts and in the abdomen in calciphylaxis. All of these are more common in patients with advanced kidney disease. Clinically, hyperphosphatemia and obesity are risk factors. Thus we tested the hypothesis that adipocytes can calcify in the presence of elevated phosphorus and/or that adipocytes exposed to phosphorus can induce vascular smooth muscle cell (VSMC) calcification. Methods: 3T3-L1 preadipocytes were induced into mature adipocytes and then treated with media containing high phosphorus. Calcification was assessed biochemically and PCR performed to determine the expression of genes for osteoblast and adipocyte differentiation. Adipocytes were also co-cultured with bovine VSMC to determine paracrine effects, and the efficacy of sodium thiosulfate was determined. Results: The results demonstrated that high phosphorus induced the calcification of differentiated adipocytes with increased expression of osteopontin, the osteoblast transcription factor Runx2 and decreased expression of adipocyte transcription factors peroxisome proliferator-activated receptor γ (PPARγ) and CCAAT-enhancer-binding protein α (CEBPα), indicating that high phosphorus led to a phenotypic switch of adipocytes to an osteoblast like phenotype. Sodium thiosulfate, dose dependently decreased adipocyte calcification and inhibited adipocyte induced increase of VSMC calcification. Co-culture studies demonstrated that adipocytes facilitated VSMC calcification partially mediated by changes of secretion of leptin and vascular endothelial growth factor (VEGF) from adipocytes. Conclusion: High phosphorus induced calcification of mature adipocytes, and

  17. 羧甲基赖氨酸和可溶性糖基化终产物受体水平与2型糖尿病冠状动脉钙化相关性研究%Correlation of Nε-(carboxymethyl) lysine and sRAGE with Coronary Artery Calcification in Type 2 Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    殷汉; 孙子林; 王尧

    2011-01-01

    目的 探讨羧甲基赖氨酸(CML)和可溶性糖基化终产物受体(sRAGE)水平与2型糖尿病冠状动脉钙化及其危险因素的关系.方法 101例2型糖尿病患者采用ELISA法检测sRAGE和CML水平;根据64排螺旋CT冠状动脉钙化积分(CACS)结果分为钙化组(CACS>0),无钙化组(CACS=0),并进一步分四个亚组;测定踝臂指数(ABI)、颈动脉内膜中层厚度(IMT)及糖脂指标等;所有资料均以SPSS 16.0软件进行统计分析.结果 二项分类Logistic回归分析发现年龄及ABI是冠状动脉钙化独立相关因素;CACS与年龄呈正相关,与ABI呈负相关;重度钙化组sRAGE水平较无钙化组明显降低,差异有统计学意义(P<0.05).结论 ABI可作为评估冠状动脉钙化的独立预测因子;年龄是冠状动脉钙化的独立危险因素;sRAGE是冠状动脉硬化、钙化进程中的预测指标和保护因子.%Objective To investigate the relationship between the levels of serum Ne - ( carboxymethyl ) lysine ( CML ) and soluble receptor for advanced glycation end products ( sRAGE ) and the coronary artery calcification ( CAC ), and analyze the risk factors of coronary artery calcification in type 2 diabetes mellitus. Methods The levels of CML and sRAGE were detected by ELISA for 101 patients with type 2 diabetes mellitus; according to CAC score ( CACS ) measured by 64 - detector computed tomography the patients were divided as CAC group ( CACS > 0 ) and non - CAC group ( CACS = 0 ), and further divided into 4 subgroups of different degrees of CAC. The clinical data of patients including intima - media thickness ( IMT ), ankle -brachial index ( ABI ), and the indexes of glucose and fat were collected. All data were analyzed by using SPSS 16.0 software. Results Binar Logistic regression analysis showed that the age and ABI were significantly and independently associated with CAC, and CACS was correlated positively with age and negatively with ABI. The serum sRAGE level was obviously decreased

  18. Diffuse coronary artery ectasia in a patient with left main coronary artery trifurcation.

    Science.gov (United States)

    Wasilewski, Jarosław; Desperak, Piotr; Bujak, Kamil; Głowacki, Jan; Gąsior, Mariusz

    2016-09-01

    The term coronary ectasia is reserved to describe a diffuse dilatation of coronary artery segments that have a diameter that exceeds the size of normal adjacent coronary segments by 1.5 times. The occurrence of coronary artery ectasia (CAE) ranges from 3% to 8% in the group of patients undergoing coronary computed tomography angiography. The CAE is associated with traditional risk factors and often co-exists with coronary atherosclerosis, which suggests that ectasia may represent an advanced form of atherosclerosis. Nevertheless, there is a lack of consensus on the clinical implications and management of patients in whom the occurrence of CAE is observed, especially in patients without concomitant obstructive atherosclerosis. Here, we present a rare case of a 62-year-old patient with multiple CAEs and left main trifurcation.

  19. Spontaneous coronary artery dissection in pregnancy requiring emergency caesarean delivery followed by coronary artery bypass grafting.

    Science.gov (United States)

    Weinberg, L; Ong, M; Tan, C O; McDonnell, N J; Lo, C; Chiam, E

    2013-03-01

    Spontaneous coronary artery dissection is a rare and often fatal condition of pregnancy. The long-term morbidity is unknown, but a small cohort of patients develop severe ventricular dysfunction as a consequence. We describe a 37-week gestation parturient who presented with cardiogenic shock secondary to spontaneous left main coronary artery dissection. Despite rapid diagnosis, stabilisation with an intra-aortic balloon pump and prompt transfer to a tertiary centre for emergency caesarean delivery and coronary artery bypass grafting, the patient developed a severe postoperative dilated ischaemic cardiomyopathy. There is little information about the long-term outcomes and the specific anaesthesia management of combined emergency caesarean delivery and cardiac surgery in pregnancy for spontaneous coronary artery dissection. Therefore, we outline our multidisciplinary management of this critically ill pregnant woman.

  20. An unreported type of coronary artery naomaly in congenitally corrected transposition of great arteries

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Min Kyu; Jeong, Yeon Joo; Lee, Gee Won; Lee, Nam Kyung; Choi, Jung Hyun; Lee, Ji Won [Medical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of)

    2016-07-15

    Coronary artery variations are associated anomalies in 45% of congenitally corrected transposition of the great arteries (ccTGA) cases, and it is important to detect any coronary artery anomalies before cardiac surgery. We report a case of a 51-year-old woman with ccTGA and an unreported type of coronary artery anomaly.

  1. Epicardial ultrasound in coronary artery bypass surgery

    NARCIS (Netherlands)

    Budde, R.P.J.

    2005-01-01

    Chapter 1 Coronary artery bypass surgery (CABG) is traditionally performed via a median sternotomy approach on cardiopulmonary bypass (arrested heart). Since the mid 1990ties, beating heart, minimally invasive and even totally endoscopic CABG are (re)explored. In all approaches to CABG, the

  2. Patient's Perception About Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Kelminda Maria Bulhões Mendonça

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: The diagnosis of coronary artery disease referred for heart surgery has an important psychological component. The purpose of this study was to access the difficulties experienced by individuals awaiting coronary artery bypass grafting and to determine strategies that facilitate adaptation to a new lifestyle, modified by the disease. METHODS: A qualitative, exploratory study involving patients admitted to a university teaching hospital in the city of Salvador, Bahia, Brazil, awaiting coronary artery bypass grafting. Semi-structured interviews were performed in accordance with a previously defined script based on the study objective. Each transcription was read in its entirety to verify the representativeness, homogeneity and pertinence of the data obtained (pre-analysis, followed by separation of categories of analysis. RESULTS: The descriptions of this study show that patients admitted to the completion of coronary artery bypass grafting experience a wide range of psychological difficulties, considering that surgery acquires interpretations that vary according to individuals' subjectivity. The patients recognized the benefit of being able to discuss their feelings as a means of diminishing their fear and anxiety. CONCLUSION: Helping patients find resources to confront more positively the daily hospitalization is an important aspect for the health care professionals who assist them. This goal can be achieved through modification of the biomedical model of care for a biopsychosocial view. The investment of time and attention is of fundamental importance and aims to overcome existing deficiencies that interfere with the outcome of patients after cardiac surgery.

  3. Emergency coronary artery stenting for coronary dissection complicating diagnostic cardiac catheterisation.

    OpenAIRE

    Knight, C; Stables, R; Sigwart, U

    1995-01-01

    Dissection of a coronary artery is a recognised and significant complication of diagnostic coronary angiography that often requires emergency coronary artery bypass grafting. A coronary stent was used to treat this complication. This technique has potential advantages in terms of speed of reperfusion and availability in centres performing diagnostic angiography without surgical cover on site.

  4. Dextrocardia with situs inversus totalis: coronary artery bypass grafting.

    Science.gov (United States)

    Hashmi, Salila; Anis, Mariam; Darr, Umer

    2012-01-01

    Dextrocardia with situs inversus is a rare congenital abnormality involving a left-handed mal rotation of the visceral organs. The incidence of coronary artery disease is the same as that in the general population. Performing coronary artery bypass surgery on patients with dextrocardia poses a more challenging task. It is recommended that the right internal mammary artery be the first choice of graft for the anterior descending artery for a "situs inversus" situation. We report 2 cases of patients with Dextrocardia who developed coronary artery disease and underwent coronary artery bypass grafting. Also mentioned is the slight difference in our technique.

  5. [Morphofunctional correlation in congenital anomalies of the coronary arteries. II. The ectopic origin of the coronary arteries].

    Science.gov (United States)

    Rangel-Abundis, A; Muñoz-Castellanos, L; Chávez-Pérez, E; Sánchez-Moreira, L M; Marín, G; Badui, E; Solorio, S

    1994-01-01

    The authors describe the morphogenesis and functional alterations of the coronary arterial net in the ectopic coronary arteries: a) with origin in the aorta or its branches and b) with origin in the pulmonary artery. The coronary arteries are developed from: 1) endothelial sprouts localized in the great arteries walls at the level of the sigmoidal values, 2) right and left subepicardial vascular network and 3) the intramyocardial sinusoids. Most of the ectopic coronary arteries result from alterations in the connection between these three embryonic elements. The deviation of one of the subepicardial vascular network in a wrong way (in direction of pulmonary artery or the opposite Valsalva sinus) will stimulate the development of endothelial sprouts which will connect such network originating abnormal connections and anomalous origin of the coronary arteries. The origin of both coronary arteries from the pulmonary artery is in compatible with life. Myocardial ischemia is absent in patients with type I (infant) or type II (adult) anomalous origin of one coronary artery from the pulmonary artery, only in the transitional phase between both types (I and II) there is myocardial ischemia previous to the formation of the collateral coronary circulation. The ectopic origin of the coronary artery from the aortic Valsalva sinus have very little hemodynamic repercussion in the patient. Although there are cases with postexercise sudden dead. These anomalies associated to atherosclerotic coronary stenosis have an impact on the evolution and prognosis of ischemic heart disease.

  6. Coronary artery disease: medical therapy

    African Journals Online (AJOL)

    hypertension, smoking, diabetes, abdominal obesity, diet poor in daily ... Evidence indicates that a life-time low LDL-cholesterol level lowers the risk of ... of the drugs used.14. In the chronic artery disease setting, non-adherence to.

  7. Robotically-Assisted Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Thierry A. Folliguet

    2010-01-01

    Full Text Available Objectives. Robotic surgery enables to perform coronary surgery totally endoscopically. This report describes our experience using the da Vinci system for coronary artery bypass surgery. Methods. Patients requiring single-or-double vessel revascularization were eligible. The procedure was performed without cardiopulmonary bypass on a beating heart. Results. From April 2004 to May 2008, fifty-six patients were enrolled in the study. Twenty-four patients underwent robotic harvesting of the mammary conduit followed by minimal invasive direct coronary artery bypass (MIDCAB, and twenty-three patients had a totally endoscopic coronary artery bypass (TECAB grafting. Nine patients (16% were converted to open techniques. The mean total operating time for TECAB was 372±104 minutes and for MIDCAB was 220±69 minutes. Followup was complete for all patients up to one year. There was one hospital death following MIDCAB and two deaths at follow up. Forty-eight patients had an angiogram or CT scan revealing occlusion or anastomotic stenoses (>50% in 6 patients. Overall permeability was 92%. Conclusions. Robotic surgery can be performed with promising results.

  8. Incidental internal carotid artery calcifications on temporal bone CT in children

    Energy Technology Data Exchange (ETDEWEB)

    Koch, Bernadette; Jones, Blaise [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Blackham, Aaron [University of Cincinnati College of Medicine, Cincinnati, OH (United States)

    2007-02-15

    Incidental internal carotid artery (ICA) calcifications are occasionally noted on CT images of the brain and temporal bone. In adults, incidental calcifications have been correlated with increased incidence of hypercholesterolemia, cardiac disease, diabetes and carotid stenosis. To determine the incidence of incidental calcifications of the carotid siphon on temporal bone CT in children. We retrospectively reviewed 24 months of consecutive temporal bone CT examinations in children aged 18 years and younger. CT examinations on 663 patients were reviewed and the presence or absence of ICA calcifications was ranked as absent, questionable or definitive. In patients in whom definitive calcifications were identified, hospital charts were reviewed for evidence of diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, hyperlipidemia and chronic renal disease as potential causes of early atherosclerosis. Of the 663 patients, 25% had definitive calcifications within the wall of the ICA: 6% of children younger than 2 years and 28% of children 12-19 years of age. Incidentally noted ICA calcifications are a common finding on temporal bone CT in children, most likely a physiologic response to turbulent flow at natural bends in the artery rather than secondary to underlying disease predisposing to early atherosclerotic calcification. (orig.)

  9. Fixed Coronary Artery Stenosis in Tunneled Coronary Artery Identified by Intravascular Ultrasound: A Case Report

    Directory of Open Access Journals (Sweden)

    Yuxiang Dai

    2014-10-01

    Full Text Available Myocardial bridging is characterized as the compression of a segment of the coronary artery during systole. Significant atherosclerosis within the bridge is almost never seen at pathologic examination because of the absence of synthetic type smooth muscle cells in the intima of the tunneled artery. To date, there have been no reports of significant atherosclerosis at the site of myocardial bridging documented by angiography or intravenous ultrasound. We report a rare case of fixed coronary artery stenosis at the site of myocardial bridging identified by intravascular ultrasound.

  10. Coronary artery bypass grafting for Kawasaki disease

    Institute of Scientific and Technical Information of China (English)

    GUO Hong-wei; CHANG Qian; XU Jian-ping; SONG Yun-hu; SUN Han-song; HU Sheng-shou

    2010-01-01

    Background Kawasaki disease (KD) is the leading cause of pediatric ischemic heart disease. The incidence of serious coronary sequelae is low and about 2%-3% of patients with KD, but once myocardial infarction occurs in children, the mortality is quite high and 22% at the first infarction.This study aimed to evaluate the efficacy of coronary artery bypass grafting (CABG) in patients with KD.Methods Eight patients with a history of KD underwent CABG between October 1997 and July 2005. The number of bypass grafts placed was 2 to 4 per patient (mean 2.5±0.8). Various bypass grafts were used in patients, i.e. the left internal mammary artery (LIMA) in 3 patients, bilateral internal mammary artery (IMA) in 2 patients, LIMA plus gastroepiploic artery (GEA) in 1 patient and total saphenous vein grafts (SVGs) in 2 patients. The combined procedures included ventricular aneurysmectomy in 1 patient, mitral valve plasty in 1 and right coronary aneurysmectomy in 1. One patient was not able to wean from cardiopulmonary bypass (CPB), after being supported with intra-aortic balloon pump (IABP), the patient was weaned from CPB successfully.Results One patient died of low cardiac output syndrome and acute renal failure 19 days after operation. Other patients recovered and were discharged uneventfully. During the follow-up that ranged from 3 to 57 months (mean 27 months),clincal angina disappeared or improved. Cardiac function was in Class Ⅰ-Ⅱ (NYHA).Conclusion CABG is a safe and effective procedure for Kawasaki coronary artery disease. However long-term results need to be followed up.

  11. Absence of left circumflex with superdominant right coronary artery

    Science.gov (United States)

    Quijada-Fumero, Alejandro; Pimienta-González, Raquel; Rodriguez-Esteban, Marcos

    2014-01-01

    Congenital anomalies of coronary arteries are a group of diseases that are infrequently found. Their prevalence has been reported from 0.6% to 1.3%. Most clinical manifestations are benign and asymptomatic. Congenital absence of the left circumflex artery is a very rare congenital anomaly of the coronary circulation, and only a few cases have been reported in the literature. We report a case of a 51-year-old man who underwent a cardiac catheterisation. Coronary angiography showed a left anterior descending coronary artery with no circumflex and a dominant right coronary artery. PMID:25535241

  12. Coronary angiography of pregnancy-associated coronary artery dissection: a high-risk procedure.

    Science.gov (United States)

    Martins, Raphaël Pedro; Leurent, Guillaume; Corbineau, Hervé; Fouquet, Olivier; Seconda, Sébastien; Baruteau, Alban E; Moreau, Olivier; Le Breton, Hervé; Bedossa, Marc

    2010-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome occurring predominantly in young women without any cardiovascular risk factors, especially during the peripartum and early postpartum period. Here, we report a case of a 28-year-old pregnant woman who was found to have an isolated distal SCAD of the left anterior descending artery (LAD). Coronary angiography was complicated by extensive LAD and circumflex arteries dissection, requiring an emergency coronary artery bypass grafting associated with ventricular assist device implantation and underlying the extreme fragility of coronary arteries in pregnant women.

  13. Arterial stiffness as a risk factor for coronary artery disease.

    Science.gov (United States)

    Liao, Josh; Farmer, John

    2014-02-01

    Hypertension is a major modifiable risk factor, and clinical trials have demonstrated that successful reduction of elevated blood pressure to target levels translates into decreased risk for the development of coronary artery disease, stroke, heart failure, and renal failure. The arterial system had previously been regarded as a passive conduit for the transportation of arterial blood to peripheral tissues. The physiologic role the arterial system was greatly expanded by the recognition of the central role of the endothelial function in a variety of physiologic processes. The role of arterial function and structure in cardiovascular physiology was expanded with the development of a variety of parameters that evaluate arterial stiffness. Markers of arterial stiffness have been correlated with cardiovascular outcomes, and have been classified as an emerging risk factor that provides prognostic information beyond standard stratification strategies involving hypertension, diabetes, obesity, dyslipidemia and smoking. Multiple epidemiologic studies have correlated markers of arterial stiffness such as pulse-wave velocity, augmentation index and pulse pressure with risk for the development of fatal and nonfatal cardiovascular events. Additionally, measurements of arterial stiffness had clarified the results of clinical trials that demonstrated differing impacts on clinical outcomes, despite similar reductions in blood pressure, as measured by brachial and sphygmomanometry.

  14. Submaximal exercise coronary artery flow increases in postmenopausal women without coronary artery disease after estrogen and atorvastatin.

    Science.gov (United States)

    Puntawangkoon, Chirapa; Morgan, Tim M; Herrington, David M; Hamilton, Craig A; Hundley, W Gregory

    2010-01-01

    The aim of this study was to determine the effect of statins and hormone therapy on submaximal exercise-induced coronary artery blood flow in postmenopausal women without a history of coronary artery disease. Hormone therapy or statin therapy in early postmenopausal women without coronary artery disease has been shown to enhance arterial endothelial function; we hypothesized that these agents would improve submaximal exercise-induced coronary artery blood flow. Sixty-four postmenopausal women, aged 50 to 65 years without documented coronary artery disease, were randomized in a double-blind, crossover fashion to receive 8 weeks of hormone therapy versus placebo, with or without 80 mg/day of atorvastatin. Before receipt of any therapy and after each treatment period, each woman underwent measures of coronary artery blood flow at rest and stress. The combination of hormone therapy and atorvastatin increased submaximal exercise-induced coronary artery blood flow (P = 0.04). In the subgroups of women compliant with treatment, resting coronary artery blood flow increased in those receiving hormone therapy (P = 0.03) or statin therapy (P = 0.02). In postmenopausal women aged 50 to 65 years without documented coronary artery disease, resting and submaximal exercise-induced coronary artery blood flow improves after receipt of high-dose atorvastatin and conjugated estrogens therapy.

  15. Mammographically detected breast arterial calcifications: Indicators for arteriosclerotic diseases?

    Energy Technology Data Exchange (ETDEWEB)

    Taskin, Fuesun [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey)]. E-mail: fusuntaskin@yahoo.com; Akdilli, Alev [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Karaman, Can [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Unsal, Alparslan [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Koeseoglu, Kutsi [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Ergin, Filiz [Adnan Menderes University, Faculty of Medicine, Department of Public Health, Aydin (Turkey)

    2006-11-15

    Purpose: To determine the prevalence of breast arterial calcifications (BAC) detected on mammography and search for conditions that may influence their existence. Materials and methods: The mammograms of 6156 consecutive patients were reevaluated for the presence of BAC. Four hundred eighty-five women having BAC were enrolled in the patient group. Additionally, randomly selected 500 women, without BAC constituted the control group. Hospital records of the participants were reviewed for parity, menopausal status, oral contraceptive agent (OCA) usage, hormone replacement therapy (HRT) usage, presence of diabetes, hypertension, hyperlipidemia, albuminuria and history of myocardial infarction (MI). Results: Prevalence of BAC was 7.9% on mammograms. Ninety-four women were aged between 40 and 49 years, 165 were aged between 50 and 59 years and 226 were over 60 years among BAC positive 485 women. A significant relationship was found for the frequency of BAC versus age and HRT usage in all age groups (p < 0.05). Similarly, significant relationships were also found for the frequency of BAC versus OCA usage, HRT usage, hyperlipidemia and diabetes in age group of 40-49 and in age group of 50-59, and for the frequency of BAC versus albuminuria in age group of 40-49, BAC versus history of myocardial infarction in age group of 59-59 and over 60 years (p < 0.05). The correlations were not significant for the relationships of BAC with OCA usage, hyperlipidemia, diabetes and albuminuria in women over 60 years (p > 0.05). Conclusion: Most benign findings like BAC are not routinely reported during mammographic evaluation. Our study showed that, presence of BAC on mammography was strongly related to advancing age. However, these findings may signify a systemic risk and can be used as precautious indicators for undocumented systemic diseases, especially in premenopausal women.

  16. [Myocardial infarction with normal coronary arteries].

    Science.gov (United States)

    Espinosa, R; Badui, E; Narvaez, M G; Hurtado, R

    1986-01-01

    We retrospectively studied 36 cases of myocardial Infarction (MI) with normal coronary arteries, which had been obtained from a total of 538 patients with MI admitted to our Hospital in the last 3 years. All patients had coronary angiogram and left ventriculogram. The following data was reviewed: age, sex, coronary risk factors, clinical picture, short and long term follow up. The angiography findings were correlated. The average age of the patients was 42 years, 75% were male and 25% female. The 36 cases represent 7% of the total MI. Cigarette smoking was the only important risk factor. MI was the first manifestation of ischemic heart disease in 94% of the cases. The ejection fraction was normal in 94%; 27.6% presented some complication during the acute event. In the long term follow; up to 88% of the patients are asymptomatic. The physiopathologic mechanisms are analyzed.

  17. Current status of coronary artery bypass surgery

    Institute of Scientific and Technical Information of China (English)

    CHEN Xin

    2009-01-01

    @@ Surgical revascularization for atherosclerotic heart disease, also called coronary artery bypass grafting (CABG), was first performed in 1962, and is one of the great achievements in medicine. Relief of angina, improvement of exercise tolerance, and the realization of survival benefit have been documented.1 CABG has been used in multi-vessel disease and left main stenosis for over 40 years.2 In the last two decades the mortality of CABG has decreased to less than 2% despite an aging population with increased risk factors. However, percutaneous coronary intervention (PCI), especially with drug-eluting stents, has been challenging CABG, While PCI has improved, CABG has also progressed with better peri-operative management, a higher use of arterial grafting, off-pump surgery, and improved techniques with minimally invasive surgical options.3,4

  18. Audiometric changes after coronary artery bypass graft

    Directory of Open Access Journals (Sweden)

    Khorsandi M T

    2007-09-01

    Full Text Available Background: Hearing is one of the most significant senses; There fore, any defect can be frightening. The incidence of sever hearing loss following coronary artery bypass surgery has been estimated as one per thousand. This Prospective study carried out to determine hearing effects of coronary artery bypass surgery."nMethods: age, audiometric changes before and after surgery (hearing levels at multiple frequencies, speech reception threshold and speech discrimination score, minimum blood pressure during the operation, and the time on bypass, measured on One hundred consecutive patients who candidate for coronary artery bypass surgery and the results analysed."nResults: One hundred patients completed the tests. Based on hearing changes found on pre- and post-operative tests, the patients were divided into 3 groups: Those with no change (47 patients according to their audiometric results; those with slight changes ≤10 db (43 patients; and those having average deficits of more than 10 db (10 patients. All the patients were male. None of the patients had complete or severe sensorineural hearing loss. The third group had more prolonged pumping duration when compared with the others groups (p=0.002. Furthermore, 90 percent of patients with a sensorineural hearing loss more than 10 db had diabetes mellitus and hyperlipidemia as risk factors."nConclusion: Sudden sensorineural hearing loss is a sequela in patients who undergoing coronary artery bypass surgery; however, it was usually mild and asymptomatic. Pumping time during the operation is a significant factor in occurring of this complication. With proper treatment of underlying diseases and eliminating the risk factors with improvement of our cardiopulmonary pumps we probably can get better hearing results.

  19. Psychosocial Complications of Coronary Artery Disease

    OpenAIRE

    Karimi-Moonaghi, Hossein; Mojalli, Mohammad; Khosravan, Shahla

    2014-01-01

    Background: Cardiovascular diseases are the leading causes of death around the world. The coronary artery disease (CAD) is one of the most common diseases in this category, which can be the trigger to various psychosocial complications. We believe that inadequate attention has been paid to this issue. Objectives: The purpose of the present study was to explore the psychosocial complications of CAD from the Iranian patients’ perspective. Patients and Methods: A qualitative design based on the ...

  20. Minimally invasive direct coronary artery bypass plus coronary stent for acute coronary syndrome: a case report

    Institute of Scientific and Technical Information of China (English)

    Caiyi Lu; Gang Wang; Qi Zhou; Jinwen Tian; Lei Gao; Shenhua Zhou; Jinyue Zhai; Rui Chen; Zhongren Zhao; Cangqing Gao; Shiwen Wang; Yuxiao Zhang; Ming Yang; Qiao Xue; Cangsong Xiao; Wei Gao; Yang Wu

    2008-01-01

    A 69-year old female patient was admitted because of 3 days of worsened chest pain.Coronary angiography showed60% stenosis of distal left main stem,chronic total occlusion of left anterior descending (LAD),70% stenosis at the ostium of a smallleft circumflex,70-90%stenosis at the paroxysmal and middle part of a dominant fight coronary artery (RCA),and a normal left internalmammary artery (LIMA) with normal origination and orientation.Percutaneous intervention was attempted but failed on the occludedlesion of LAD.The patient received minimally invasive direct coronary artery bypass (MIDCAB) with left LIMA isolation by Davincirobot.Eleven days later,the RCA lesion was treated by Sirolimus Rapamicin eluting stents implantation percutaneously.Then thepatient was discharged uneventfully after 3 days hospitalization.Our experience suggests that two stop shops of hybrid technique befeasible and safe in the treatment of elderly patient with multiple coronary diseases.

  1. Echocardiographic evaluation of coronary arteries in congenital heart disease.

    Science.gov (United States)

    Freire, Grace; Miller, Michelle S

    2015-12-01

    Among populations of patients with the congenital heart disease, there is considerable diversity in the anatomy of the coronary arteries. Understanding these anatomical differences is vitally important in directing interventions and surgical repair. In this report, the authors describe the echocardiographic evaluation of the variants of coronary artery anatomy in the following lesions: transposition of the great arteries, congenitally corrected transposition of the great arteries, double-inlet left ventricle, common arterial trunk, tetralogy of Fallot, and double-outlet right ventricle.

  2. Emergency coronary artery bypass surgery after failed percutaneous coronary intervention.

    Science.gov (United States)

    Darwazah, A K; Islim, I; Hanbali, B; Shama, R A; Aloul, J

    2009-12-01

    The incidence of patients subjected to emergency coronary artery bypass graft (CABG) after percutaneous coronary intervention (PCI) is decreasing due to improvement of PCI technique and device technology. The aim of our study is to evaluate cases subjected to emergency CABG after complicated PCI to determine incidence, indications and results of surgery and to compare them with other emergency cases which are not related to angioplasty or stenting. From April 1999 to December 2005, 1 200 patients who underwent PCI were analysed. Those patients who developed complications related to PCI and required surgical intervention were included (PCI group N.=31). These patients were compared with other emergency cases not related to PCI (non-PCI group N.=48). The selection of these patients was based on the criteria of the Society of Thoracic Surgeons. The incidence of PCI complications which necessitated emergency surgical intervention was 2.6%. The main indication was due to unsatisfactory angioplasty with ongoing myocardial ischemia (68%), stent thrombosis (13%), dissection (10%) retained angioplasty wire (6.5%), and perforation (3%). The incidence of cardiogenic shock, ongoing ischemia, acute infarction Emergency coronary artery bypass grafting among patients with PCI complications and those patients not related to PCI is associated with high mortality and morbidity. Although, the percentage of mortality and morbidity was more among PCI patients the difference between both groups was not significant. Surgical backup and collaboration between cardiologist and surgeons is needed to reduce delay in management and patients transfer to obtain the best surgical outcome.

  3. Coronary risk factors in patients underwent coronary artery bypass grafting.

    Science.gov (United States)

    Safaei, Nasser; Alikhah, Hossein; Abadan, Younes

    2011-01-01

    Coronary Artery Disease (CAD) risk increases with increasing number of risk factors. This study was aimed to assess different coronary risk factors among Coronary Artery Bypass Grafting (CABG) surgery patients. A total of 700 patients younger than 45 or older than 65 years and underwent CABG in Tabriz Shahid Madani Heart Center since 2003 to 2007 were enrolled. We examined the probable differences of CAD risk factors between male and female groups and age groups. We also assessed the change of risk factors presentation in last 5 years. There was not significant difference between risk factor numbers in 65 years groups, but smoking and dyslipidemia was more prevalent in patients 65 years old. Hypertension and diabetes mellitus was more prevalent in patients > 65 old than < 45 years old; also differences were found between males and females patients, so that dyslipidemia, diabetes and hypertension were more prevalent in women than men. Some risk factors were recognized as acting more on one gender than the other. Also, the majority of patients have one or more risk factors, but different age and gender groups may have different risk factors that suggest the need for exact programming for appropriate prophylactic and therapeutic interventions in all groups.

  4. Case Report: Calcific Aortic Valve Stenosis Due to Central Retinal Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Ender Sener

    2013-10-01

    Full Text Available In this case, it was reported that a 48 year old male patient with spontaneous central retinal artery occlusion (CRAO due to calcific aortic valve stenosis. He had no other systemic disease. CRAO usually occurs in elder patients with systemic risk factors. CRAO results in sudden, painless and severe vision loss. Altough, CRAO is seen rarely under 50 year old, it may appear in younger patient with aortic valve disease and calcific aortic valve stenosis caused cardiac disease.

  5. Diabetic retinopathy: A predictor of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Fawzia El Demerdash

    2012-06-01

    Conclusion: Diabetic retinopathy is a good predictor of coronary artery disease that exceeds the conventional risk factors. Diabetics with retinopathy would benefit from early coronary angiography and diabetic retinocoronary clinics are warranted.

  6. Coronary artery aneurysms: case report and treatment overview.

    Science.gov (United States)

    Chiusaroli, A; Segreto, A; De Salvatore, S; Congiu, S; Zicho, D; Bizzarri, F

    2015-01-01

    Coronary artery aneurysms (CAAs) are localized dilatations exceeding the diameter of adjacent normal coronary segments. These conditions, even rare, still represent an important risk factor for the patient life.

  7. Depression in Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Nasser Safaie

    2012-09-01

    Full Text Available Introduction: Depression is one of the Common psychological disorders. From the cognitive point of view, the unhealthy attitudes increase the severity of the depression. The aim of this study was to investigate depression and unhealthy attitudes in coronary patients hospitalized at Tabriz Shahid Madani Heart Center. Methods: One hundred twenty eight hospitalized patients having myocardial Infarctions were studied regarding unhealthy attitudes, severity of depression and demographic data. Results: The study showed a significant relation between unhealthy attitudes, BDI (Beck Depression Inventory and severe depression. Moreover, a significant relation existed between gender and depression (P=0.0001. In addition, the level of education increased the intensity of unhealthy attitudes (P=0.0001. Several researches in both outside and inside Iran support the idea. Conclusion: Based on present study and more other investigations, it can be suggested to provide the necessary elements and parameters such as antidepressant medication, psychologists, complementary treatment for coping with negative mood and its unwanted consequences.

  8. Calcium score of small coronary calcifications on multidetector computed tomography

    DEFF Research Database (Denmark)

    Groen, J M; Kofoed, K F; Zacho, M;

    2013-01-01

    Multi detector computed tomography (MDCT) underestimates the coronary calcium score as compared to electron beam tomography (EBT). Therefore clinical risk stratification based on MDCT calcium scoring may be inaccurate. The aim of this study was to assess the feasibility of a new phantom which ena...

  9. Bilateral Internal Thoracic Artery Configuration for Coronary Artery Bypass Surgery

    Science.gov (United States)

    Boodhwani, Munir; Hanet, Claude; de Kerchove, Laurent; Navarra, Emiliano; Astarci, Parla; Noirhomme, Philippe; El Khoury, Gebrine

    2016-01-01

    Background— Bilateral internal thoracic arteries (BITA) have demonstrated superior patency and improved survival in patients undergoing coronary artery bypass grafting. However, the optimal configuration for BITA utilization and its effect on long-term outcome remains uncertain. Methods and Results— We randomly assigned 304 patients undergoing coronary artery bypass grafting using BITA to either in situ or Y grafting configurations. The primary end point was 3-year angiographic patency. Secondary end points included major adverse cardiac and cerebrovascular events (ie, death from any cause, stroke, myocardial infarction, or repeat revascularization) at 7 years. More coronary targets were able to be revascularized using internal thoracic arteries in patients randomized to Y grafting versus in situ group (3.2±0.8 versus 2.4±0.5 arteries/patient; P<0.01). The primary end point did not show significant differences in graft patency between groups. Secondary end points occurred more frequently in the in situ group (P=0.03), with 7-year rates of 34±10% in the in situ and 25±12% in the Y grafting groups, driven largely by a higher incidence of repeat revascularization in the in situ group (14±4.5% versus 7.4±3.2% at 7 years; P=0.009). There were no significant differences in hospital mortality or morbidity or in late survival, myocardial infarction, or stroke between groups. Conclusions— Three-year systematic angiographic follow-up revealed no significant difference in graft patency between the 2 BITA configurations. However, compared with in situ configuration, the use of BITA in a Y grafting configuration results in lower rates of major adverse cardiovascular and cerebrovascular events at 7 years. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01666366. PMID:27406988

  10. Anomalous origin of the right coronary artery from the pulmonary artery: an autopsied sudden death case with severe atherosclerotic disease of the left coronary artery.

    Science.gov (United States)

    Nagai, T; Mukai, T; Takahashi, S; Takada, A; Saito, K; Harada, K; Mori, S; Abe, N

    2014-03-01

    Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare anomaly. It may contribute to myocardial ischemia or sudden death, although the lesion is usually asymptomatic. We report a sudden death case of a 58-year-old man with ARCAPA coexisting with severe atherosclerotic coronary artery disease. He had been healthy until he complained of chest pain, several days before death, despite the discovery of heart murmur in childhood and suspicion of valvular heart disease. The autopsy revealed not only typical findings of the right coronary anomaly with well-developed collateral circulations but also severe atherosclerotic lesions of the left coronary artery, and ischemic change of the myocardium in the left and right coronary arterial perfusion territory. In addition to the "coronary steal" phenomenon primarily caused by ARCAPA, the reduced flow of both coronary arteries and further increase of "coronary steal" due to atherosclerotic obstructive coronary disease might have contributed to the patient's death.

  11. A Case Report on Spontaneous Coronary Artery Dissection

    Directory of Open Access Journals (Sweden)

    Tunaggina Afrin Khan

    2015-01-01

    Full Text Available Spontaneous coronary artery dissection is an extremely rare cause of acute coronary syndrome. Although it predominantly affects young women in the peripartum period, it can also occur in men. The left coronary artery is most frequently involved. The usual presentation is ST segment elevation myocardial infarction. Although several treatment modalities have been proposed, the optimal treatment options still remain to be established. This current case report focuses on a 40- year-old male presented with acute coronary syndrome and subsequently was found to have coronary artery dissection.

  12. Relationship between arterial vascular calcifications seen on screening mammograms and biochemical markers of endothelial injury

    Energy Technology Data Exchange (ETDEWEB)

    Pidal, Diego [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain)], E-mail: dpidal@hotmail.com; Sanchez Vidal, M Teresa [Servicio de Medicina Interna, Hospital de Jove (Spain)], E-mail: medicinainterna@hospitaldejove.com; Rodriguez, Juan Carlos [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain); Servicio de Cirugia General, Hospital de Jove (Spain); Instituto Universitario de Oncologia del Principado de Asturias, Oviedo (Spain)], E-mail: investigacion@hospitaldejove.com; Corte, M Daniela [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain); Instituto Universitario de Oncologia del Principado de Asturias, Oviedo (Spain)], E-mail: mdanielac@hotmail.com; Pravia, Paz [Servicio de Radiodiagnostico, Hospital de Jove (Spain)], E-mail: radiologia@hospitaldejove.com; Guinea, Oscar [Servicio de Radiodiagnostico, Hospital de Jove (Spain)], E-mail: oscarfguinea@seram.org; Pidal, Ivan [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain)], E-mail: ivanpida@hotmail.com; Bongera, Miguel [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain)], E-mail: mbchoppy@hotmail.com; Escribano, Damaso [Servicio de Medicina Interna, Hospital de Jove (Spain)], E-mail: medicinainterna@hospitaldejove.com; Gonzalez, Luis O. [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain)], E-mail: lovidiog@telefonica.net; Diez, M Cruz [Servicio de Cirugia General, Hospital de Jove (Spain)], E-mail: cirugiageneral@hospitaldejove.com; Venta, Rafael [Servicio de Analisis Clinicos, Hospital de San Agustin, Aviles (Spain); Departamento de Bioquimica y Biologia Molecular, Universidad de Oviedo (Spain)], E-mail: rafael.venta@sespa.princast.es; Vizoso, Francisco J. [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain); Servicio de Cirugia General, Hospital de Jove (Spain); Instituto Universitario de Oncologia del Principado de Asturias, Oviedo (Spain)], E-mail: fjvizoso@telefonica.net

    2009-01-15

    To assess whether breast arterial calcifications (BAC) are associated with altered serum markers of cardiovascular risk, mammograms and records from 1759 women (age range: 45-65 years) screened for breast cancer were revised. One hundred and forty seven (8.36%) women showed BAC. A total of 136 women with BAC and controls (mean age: 57 and 55 years, respectively) accepted entering the study. There were no significant differences in serum levels of urea, glucose, uric acid, creatinine, total cholesterol, HDL-C, LDL-C, folic acid, vitamin B{sub 12}, TSH or cysteine, between both groups of patients. However, women with BAC showed higher serum levels of triglycerides (p = 0.006), homocysteine (p = 0.002) and hs-CRP (p = 0.003) than women without BAC. Likewise, we found a significantly higher percentage of cases with an elevated LDL-C/HDL-C ratio (coronary risk index >2) amongst women with BAC than in women without BAC (56.7 and 38.2%, respectively; p = 0.04). Our results indicate that the finding of BAC identify women showing altered serum markers of cardiovascular risk.

  13. Relationship between arterial vascular calcifications seen on screening mammograms and biochemical markers of endothelial injury.

    Science.gov (United States)

    Pidal, Diego; Sánchez Vidal, M Teresa; Rodríguez, Juan Carlos; Corte, M Daniela; Pravia, Paz; Guinea, Oscar; Pidal, Iván; Bongera, Miguel; Escribano, Dámaso; González, Luis O; Díez, M Cruz; Venta, Rafael; Vizoso, Francisco J

    2009-01-01

    To assess whether breast arterial calcifications (BAC) are associated with altered serum markers of cardiovascular risk, mammograms and records from 1759 women (age range: 45-65 years) screened for breast cancer were revised. One hundred and forty seven (8.36%) women showed BAC. A total of 136 women with BAC and controls (mean age: 57 and 55 years, respectively) accepted entering the study. There were no significant differences in serum levels of urea, glucose, uric acid, creatinine, total cholesterol, HDL-C, LDL-C, folic acid, vitamin B(12), TSH or cysteine, between both groups of patients. However, women with BAC showed higher serum levels of triglycerides (p=0.006), homocysteine (p=0.002) and hs-CRP (p=0.003) than women without BAC. Likewise, we found a significantly higher percentage of cases with an elevated LDL-C/HDL-C ratio (coronary risk index >2) amongst women with BAC than in women without BAC (56.7 and 38.2%, respectively; p=0.04). Our results indicate that the finding of BAC identify women showing altered serum markers of cardiovascular risk.

  14. Inhibition of angiotensin Ⅱ and blockade of endothelin receptors reduce arterial calcification in rats

    Institute of Scientific and Technical Information of China (English)

    Juxiang LI; Shengying WU; Chunshui PAN; Yongfen QI; Bin GENG; Xiuhua LIU; Chaoshu TANG

    2004-01-01

    Objective To examine whether the two vascular paracrine/autocrine factors, angiotensin Ⅱ (Ang Ⅱ) and endothelin, participate in the pathogenesis of arterial calcification. Methods Nicotine and vitamin D3 treated rats were studied. Vascular calcification was confirmed by using Von Kossa staining, measurement of calcium content,45Ca2+ uptake assay and alkaline phosphatase (ALP) activity. The plasma and vascular Ang Ⅱ and endothelin levels were measured by using radioimmunoassay. Angiotensinogen and endothelin mRNA levels were determined by RTPCR. Results The arterial calcium content, 45Ca2+ uptake and ALP activity were increased in calcification groups compared with control ( P < 0.01 ). Administration of the angiotensin receptor antagonist losartan, the endothelin receptor antagonist bosentan, and the angiotensin-converting enzyme inhibitor captopril reduced significantly the arterial calcium content, 45Ca2+ uptake and ALP activity. In addition, the plasma and aortic Ang Ⅱ and endothelin contents, and vascular angiotensinogen and endothelin mRNA expression were significantly up-regulated ( P <0.05).Conclusions These findings suggest that functional renin-angiotensin system and endothelin pathway are involved in vascular calcification, and that activation of these systems could potentiate pathogenesis of arterial calcification. ( J Geriatr Cardiol 2004;1(2) :108-113. )

  15. Surgical procedure for coronary artery ectasia associated with saccular fistula.

    Science.gov (United States)

    Murakami, Masanori; Gohra, Hidenori; Yagi, Takeshi; Jinbou, Mitsutaka; Kobayashi, Toshiro; Saito, Satoshi; Takahashi, Tsuyoshi; Shiomi, Kotaro; Ono, Siro; Hamano, Kimikazu

    2014-09-01

    Echocardiography of a 60 year-old woman with a three-year history of heart murmur revealed a coronary artery fistula. Coronary angiography indicated right coronary artery ectasia and fistula. The pulmonary-to-systemic blood flow ratio was 1.4, and left-to-right shunt, 29%. On follow-up, infective endocarditis of the tricuspid valve had developed and was treated using antibiotics. The right coronary artery was dilated along its length and was saccular at the distal aspect. At this point, a fistula also connected by the left anterior descending and left circumflex arteries drained into the right ventricle. Fistula closure and reduction aneurysmectomy were performed.

  16. Symptomatic Type IV Dual Left Anterior Descending Coronary Artery

    Directory of Open Access Journals (Sweden)

    Kyriacos Papadopoulos MD

    2016-12-01

    Full Text Available Dual left anterior descending coronary artery is a rare congenital anomaly with 4 subtypes. Double left anterior descending coronary artery originating from the left main stem and the right coronary artery (type IV dual left anterior descending artery has been reported to occur in 0.01% to 0.7% of patients undergoing cardiac catheterization. We report a case of a 49-year-old woman who was found to have this anomaly during coronary angiography. The patient had been complaining of chest pain that mimics angina pectoris and exercise tolerance test was positive for myocardial ischemia.

  17. A Case of Double Right Coronary Artery with Separate Ostium

    Directory of Open Access Journals (Sweden)

    Jalal Kheirkhah

    2015-10-01

    Full Text Available Coronary artery anomalies are rare, with their incidence varying from 1 to 5%. Angiography is a commonly used modality for the assessment of coronary artery anomalies. Based on previous reports, a majority of coronary artery anomalies are of origin or distribution, with separate ostia of the left anterior descending artery and left circumflex artery. Coronary artery anomalies may cause myocardial ischemia secondary to atherosclerosis in the same artery. We present a rare case of duplicated right coronary artery with a separate ostium, which caused myocardial ischemia. Our patient was a 51-year-old diabetic woman with typical chest pain and dyspnea on exertion. Electrocardiography showed left axis deviation, poor R progression, and biphasic T wave in the precordial leads. Echocardiography revealed left ventricular ejection fraction of 30-35% and global hypokinesia. Coronary angiography demonstrated three-vessel disease and a double ostial right coronary artery. We recommended coronary artery bypass graft surgery, but the patient refused it and we continued her treatment with anti-ischemic drugs.

  18. Generalized arterial calcification of infancy and pseudoxanthoma elasticum can be caused by mutations in either ENPP1 or ABCC6

    NARCIS (Netherlands)

    Nitschke, Y.; Baujat, G.; Botschen, U.; Wittkampf, T.; du Moulin, M.; Stella, J.; Merrer, M. le; Guest, G.; Lambot, K.; Tazarourte-Pinturier, M.F.; Chassaing, N.; Roche, O.; Feenstra, I.; Loechner, K.; Deshpande, C.; Garber, S.J.; Chikarmane, R.; Steinmann, B.; Shahinyan, T.; Martorell, L.; Davies, J.; Smith, W.E.; Kahler, S.G.; McCulloch, M.; Wraige, E.; Loidi, L.; Hohne, W.; Martin, L.; Hadj-Rabia, S.; Terkeltaub, R.; Rutsch, F.

    2012-01-01

    Spontaneous pathologic arterial calcifications in childhood can occur in generalized arterial calcification of infancy (GACI) or in pseudoxanthoma elasticum (PXE). GACI is associated with biallelic mutations in ENPP1 in the majority of cases, whereas mutations in ABCC6 are known to cause PXE.

  19. Generalized arterial calcification of infancy and pseudoxanthoma elasticum can be caused by mutations in either ENPP1 or ABCC6

    NARCIS (Netherlands)

    Nitschke, Y.; Baujat, G.; Botschen, U.; Wittkampf, T.; du Moulin, M.; Stella, J.; Merrer, M. le; Guest, G.; Lambot, K.; Tazarourte-Pinturier, M.F.; Chassaing, N.; Roche, O.; Feenstra, I.; Loechner, K.; Deshpande, C.; Garber, S.J.; Chikarmane, R.; Steinmann, B.; Shahinyan, T.; Martorell, L.; Davies, J.; Smith, W.E.; Kahler, S.G.; McCulloch, M.; Wraige, E.; Loidi, L.; Hohne, W.; Martin, L.; Hadj-Rabia, S.; Terkeltaub, R.; Rutsch, F.

    2012-01-01

    Spontaneous pathologic arterial calcifications in childhood can occur in generalized arterial calcification of infancy (GACI) or in pseudoxanthoma elasticum (PXE). GACI is associated with biallelic mutations in ENPP1 in the majority of cases, whereas mutations in ABCC6 are known to cause PXE. Howeve

  20. Rapid functional upregulation of vasocontractile endothelin ETB receptors in rat coronary arteries

    DEFF Research Database (Denmark)

    Skovsted, Gry Freja; Pedersen, Anne Fog; Larsen, Rikke;

    2012-01-01

    Endothelin ET(B) receptors mediate under normal physiological conditions vasorelaxation in coronary arteries. However, vasocontractile ET(B) receptors appear in coronary arteries of ischemic heart disease patients. Interestingly, organ culture of isolated coronary arteries also induces upregulati...

  1. Coronary artery thrombus resulting in sudden cardiac death in an infant with Kawasaki disease and giant coronary artery aneurysms

    Directory of Open Access Journals (Sweden)

    Umakumaran Ponniah

    2013-01-01

    Full Text Available We report a case of a six-month-old Hispanic male infant who had Kawasaki disease and coronary artery aneurysms on echocardiography. He died suddenly five months later in spite of aggressive medical therapy. Autopsy showed extensive coronary artery thrombosis. Giant coronary artery aneurysms need diligent follow up as they pose significant risks including risk of thrombus, myocardial infarction and sudden death.

  2. Presence of anomalous coronary seen on angiogram is not associated with increased risk of significant coronary artery disease.

    Science.gov (United States)

    Suryanarayana, Prakash; Kollampare, Shubha; Riaz, Irbaz Bin; Lee, Justin; Husnain, Muhammad; Luni, Faraz Khan; Movahed, Mohammad Reza

    2014-12-01

    It is unclear if anomalous coronary arteries are at higher risk for atherosclerosis. The link between anomalous coronary artery and early coronary artery disease has been suggested. The aim of this study is to determine whether the coronary artery anomaly predisposes to development of significant coronary disease. Using retrospective chart review, patients with documented anomalous coronary arteries recognized during coronary angiography between years 2000 to 2007 were analyzed. Prevalence of significant atherosclerotic coronary artery disease (defined as more than 50% luminal narrowing) was compared between normal and anomalous coronaries. A total of 147 patients with anomalous coronary arteries were found. Right coronary artery was the most common anomalous artery 128 of 148 (86.5%) in our dataset. There was no difference in the occurrence of atherosclerosis between anomalous and nonanomalous coronaries. Significant atherosclerosis was present in 59 of the 148 anomalous coronary arteries (37.8%), and 112 of the 293 nonanomalous coronary arteries (38.2%, p = 0.9). On the basis of our study, there is no evidence that anomalous coronary arteries predispose to significant coronary artery disease in comparison to normal coronary arteries.

  3. Vitamin K Status and Vascular Calcification: Evidence from Observational and Clinical Studies12

    OpenAIRE

    Shea, M. Kyla; Holden, Rachel M.

    2012-01-01

    Vascular calcification occurs when calcium accumulates in the intima (associated with atherosclerosis) and/or media layers of the vessel wall. Coronary artery calcification (CAC) reflects the calcium burden within the intima and media of the coronary arteries. In population-based studies, CAC independently predicts cardiovascular disease (CVD) and mortality. A preventive role for vitamin K in vascular calcification has been proposed based on its role in activating matrix Gla protein (MGP), a ...

  4. Syncope with spontaneous coronary artery dissection in an elderly woman

    Institute of Scientific and Technical Information of China (English)

    CHEN Yu-feng; CHANG Mu-hsin; CHANG Ting-chuan; LAI Chao-hung; JONG Gwo-ping

    2011-01-01

    Diagnosis of spontaneous coronary artery dissection (SCAD) is challenging because of its rarity and uncertain etiology.It frequently occurs in young women during pregnancy and in the postpartum period,and rarely found in elder women with no history of cardiovascular disease or coronary risk factors.In this article we report a case of SCAD in a 75-year-old woman without traditional cardiovascular risk factors who presented with syncope and mild chest discomfort.There were no abnormal electrocardiographic changes and no elevated cardiac enzymes were detected.Computed tomography of brain revealed nothing abnormal.Coronary artery disease was suspected.Coronary angiogram revealed dissection in the middle left circumflex artery.The patient underwent percutaneous transluminal coronary angioplasty and was free of symptoms at 6-month follow-up.Our report suggests that emergency coronary angiography is indicated if syncope caused by coronary artery disease is suspected.

  5. The association between angiotensin-converting enzyme gene polymorphism and coronary calcification - The Rotterdam Coronary Calcification Study

    NARCIS (Netherlands)

    Oei, HHS; Sayed-Tabatabaei, FA; Hofman, A; Oudkerk, M; van Duijn, CM; Witteman, JCM

    Background: An insertion/deletion (I/D) polymorphism in the gene encoding angiotensin-converting enzyme (ACE) has been associated with serum ACE levels. The association between the ACE I/D polymorphism and coronary heart disease is unclear. Electron-beam-computed tomography (EBT) is a technique to

  6. [Is coronary artery disease different in women?].

    Science.gov (United States)

    Schiele, François; Chopard, Romain

    2014-01-01

    Coronary artery disease (CAD) is the primary cause of death in women. Although acute coronary syndrome (ACS) is relatively infrequent in young women, failure to recognize ACS in this population can incur a major risk and registry data show that there is still plenty of room for improvement in this area. Women may suffer from "classical" CAD with development of atherosclerosis with a delay of about 10 years as compared to men, reflecting hormonal protection in women. Besides this classical presentation, angina in women often corresponds to impaired microcirculation, a syndrome known to associate typical angina, demonstrable myocardial ischemia, but no lesions on the coronary angiography. Finally, spasm, spontaneous dissection or coronary thrombosis through endothelial rupture are more frequent in women. The influence of risk factors on the development of CAD is comparable in both women and men. Recent registry studies show that in France, in particular, diabetes, obesity, and smoking are all risk factors that are on the rise in women. In addition, certain other risk factors are more specific to women, namely psycho-social stress. The methods to evaluate risk and detect CAD were mainly developed in male study populations, and these tools thus perform less well in female patients. In case of ACS, women benefit just as much from invasive management, but are at greater risk of iatrogenic complications, particularly with anti-thrombotic therapy or during revascularization procedures.

  7. Can Coronary Artery Involvement in Kawasaki Disease be Predicted?

    Science.gov (United States)

    Ghelani, Sunil J; Kwatra, Neha S; Spurney, Christopher F

    2013-03-26

    Coronary artery involvement is seen in approximately 15-20% of children with Kawasaki disease. There is conflicting literature regarding the clinical and laboratory findings associated with coronary artery involvement. In this retrospective study, we attempt identification of predictive factors for coronary artery involvement at our institute and review the existing literature. A review of 203 patients (65% males) with Kawasaki disease was performed, of whom 33 (16.3%) had coronary artery involvement. High erythrocyte sedimentation rate, high platelet count, low hematocrit, low albumin levels, and refractory Kawasaki disease showed significant association with coronary artery involvement. High erythrocyte sedimentation rate and refractory Kawasaki disease were found to be independent predictors of coronary artery involvement. Review of literature suggested a wide range of coronary involvement (60%), and highly conflicting clinical and laboratory associations. It remains difficult to accurately determine risk of coronary artery involvement, although some laboratory markers may provide information that is helpful for parental counseling and clinical follow up. Future identification of novel biomarkers and host predispositions may further our understanding of coronary artery risks and help personalize therapy for Kawasaki disease.

  8. The Severity of Fatty Liver Disease Relating to Metabolic Abnormalities Independently Predicts Coronary Calcification

    Directory of Open Access Journals (Sweden)

    Ying-Hsiang Lee

    2011-01-01

    Full Text Available Background. Nonalcoholic fatty liver disease (NAFLD is one of the metabolic disorders presented in liver. The relationship between severity of NAFLD and coronary atherosclerotic burden remains largely unknown. Methods and Materials. We analyzed subjects undergoing coronary calcium score evaluation by computed tomography (MDCT and fatty liver assessment using abdominal ultrasonography. Framingham risk score (FRS and metabolic risk score (MRS were obtained in all subjects. A graded, semiquantitative score was established to quantify the severity of NAFLD. Multivariate logistic regression analysis was used to depict the association between NAFLD and calcium score. Results. Of all, 342 participants (female: 22.5%, mean age: 48.7±7.0 years met the sufficient information rendering detailed analysis. The severity of NAFLD was positively associated with MRS (X2=6.12, trend P<0.001 and FRS (X2=5.88, trend P<0.001. After multivariable adjustment for clinical variables and life styles, the existence of moderate to severe NAFLD was independently associated with abnormal calcium score (P<0.05. Conclusion. The severity of NAFLD correlated well with metabolic abnormality and was independently predict coronary calcification beyond clinical factors. Our data suggests that NAFLD based on ultrasonogram could positively reflect the burden of coronary calcification.

  9. Pulmonary artery agenesis associated with coronary collaterals among adults.

    Science.gov (United States)

    Darwazah, Ahmad K; Alhaddad, Imad A

    2016-07-16

    Unilateral agenesis of the pulmonary artery is a rare congenital anomaly, which commonly involves the right side. Cases are associated with systemic collaterals, that may also rarely arise from the coronary arteries.Two adult patients are presented with a right pulmonary artery agenesis associated with collaterals from the right coronary artery. The implications of such an anomaly on pulmonary artery pressure and lung pathology differs among both cases. The association of coronary collaterals is rare and its implication is variable among various patients.

  10. Single coronary artery; extremely rare coronary anomaly successfully treated surgically in young adult male.

    LENUS (Irish Health Repository)

    Shah, A R

    2010-05-01

    Single coronary artery arising from aortic root, is a rare congenital anomaly. A 30-year-old male presented with acute myocardial infarction (MI) complaining of chest pain and raised troponin levels. Emergency angiography showed no coronary lesions but both left and right coronary arteries arising from single ostium. Patient was operated electively and perioperative findings confirmed the diagnosis of single coronary artery, as left coronary artery after taking origin from right sinus of valsalva runs through the septum, before dividing into left anterior descending and circumflex branches. The single coronary ostium opened with a slit like incision over the course of left main coronary, making the size of ostium three to four times bigger than the native one. In addition left internal mammary artery was harvested and grafted to the left anterior descending branch distally. Patient made successful recovery. Four months follow up dobutamine stress echo showed no inducible ischemia.

  11. Coronary artery disease: Which degree of coronary artery stenosis is indicative of ischemia?

    Energy Technology Data Exchange (ETDEWEB)

    Donati, Olivio F. [Institute of Diagnostic Radiology, University Hospital Zurich (Switzerland); Stolzmann, Paul [Institute of Diagnostic Radiology, University Hospital Zurich (Switzerland); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston (United States); Desbiolles, Lotus; Leschka, Sebastian [Institute of Diagnostic Radiology, University Hospital Zurich (Switzerland); Kozerke, Sebastian [Institute for Biomedical Engineering, University and ETH Zurich (Switzerland); Plass, Andre [Clinic for Cardiovascular Surgery, University Hospital Zurich (Switzerland); Wyss, Christophe [Cardiovascular Center, Cardiology, University Hospital Zurich (Switzerland); Falk, Volkmar [Clinic for Cardiovascular Surgery, University Hospital Zurich (Switzerland); Marincek, Borut [Institute of Diagnostic Radiology, University Hospital Zurich (Switzerland); Alkadhi, Hatem [Institute of Diagnostic Radiology, University Hospital Zurich (Switzerland); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston (United States); Scheffel, Hans, E-mail: hans.scheffel@usz.ch [Institute of Diagnostic Radiology, University Hospital Zurich (Switzerland); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston (United States)

    2011-10-15

    Purpose: To prospectively determine the best cut-off value of stenosis degree for low-dose computed tomography coronary angiography (CTCA) to predict the hemodynamic significance of coronary artery stenoses compared to catheter angiography (CA) using a cardiac magnetic resonance based approach as standard of reference. Materials and methods: Fifty-two patients (mean age, 64 {+-} 10 years) scheduled for CA underwent cardiac magnetic resonance (CMR) at 1.5-T and dual-source CTCA using prospective ECG-triggering the same day. Diagnostic performance of CTCA and CA to detect myocardial ischemia was evaluated with CMR as the standard of reference. The diagnostic performance and best cut-off values to predict the hemodynamic significance of coronary were determined from receiver operating characteristics analysis (ROC). Results: CA revealed >50% stenoses in 131/832 segments (15.7%) in 78/156 (50.0%) coronary arteries in 32/52 (62%) patients. CTCA revealed >50% stenoses in 148/807 (18.3%) segments, corresponding to 83/156 (53.2%) coronary arteries in 34/52 (65.4%) patients. CMR revealed ischemia in 118/832 (14.2%) myocardial segments corresponding to the territories of 60/156 (38.5%) coronary arteries in 29/52 (56%) patients. ROC analysis showed equal diagnostic performance for low-dose CTCA and CA with areas under the curve (AUC) of 0.82 and 0.83 (P = 0.64). The optimal cut-off value was determined at stenosis of >60% for the prediction of hemodynamically significant coronary stenosis by CTCA. Using this cut-off value, sensitivity, specificity, NPV and PPV to predict hemodynamic significance by CTCA were 100%, 83%, 100%, and 88% on a per-patient basis and 88%, 73%, 83% and 81% on a per-artery analysis, respectively. Conclusion: By considering coronary stenosis >60%, diagnostic performance for predicting the hemodynamic significance of coronary stenosis by CTCA is optimal and equals that of CA.

  12. Echocardiographic diagnosis of anomalous origin of the left coronary artery from the pulmonary artery.

    Science.gov (United States)

    Drinkovic, Niksa; Margetic, Eduard; Smalcelj, Anton; Brida, Vojtjeh

    2008-03-01

    We found increased systolic coronary flow in transthoracic pulsed wave (PW) Doppler in a 42-year-old patient with anomalous origin of left main coronary artery from the pulmonary artery. This is a characteristic echocardiographic finding in this anomaly in the presence of collateral circulation and coronary L-R shunt. In comparison with so far used echocardiographic criteria this parameter when present allows quick recognition of anomalous origin of left coronary artery from the pulmonary artery, and its differentiation from other potentially lethal coronary anomalies.

  13. Value of coronary artery calcium score to predict severity or complexity of coronary artery disease

    Science.gov (United States)

    Gökdeniz, Tayyar; Kalaycıoğlu, Ezgi; Aykan, Ahmet Çağrı; Boyacı, Faruk; Turan, Turhan; Gül, İlker; Çavuşoğlu, Gökhan; Dursun, İhsan

    2014-01-01

    Background Prediction of severity or complexity of coronary artery disease (CAD) is valuable owing to increased risk for cardiovascular events. Although the association between total coronary artery calcium (CAC) score and severity of CAD, Gensini score was not used, it has been previously demonstrated. There is no information about the association between total CAC score and complexity of CAD. Objectives To investigate the association between severity or complexity of coronary artery disease (CAD) assessed by Gensini score and SYNTAX score (SS), respectively, and coronary artery calcium (CAC) score, which is a noninvasive method for CAD evaluation in symptomatic patients with accompanying significant CAD. Methods Two-hundred-fourteen patients were enrolled. Total CAC score was obtained before angiography. Severity and complexity of CAD was assessed by Gensini score and SS, respectively. Associations between clinical and angiographic parameters and total CAC score were analyzed. Results Median total CAC score was 192 (23.0-729.8), and this was positively correlated with both Gensini score (r: 0.299, p 809 for SS >32 (high SS tertile). Conclusion In symptomatic patients with accompanying significant CAD, total CAC score was independently associated with SS and patients with SS >32 may be detected through high Agatston score. PMID:24676367

  14. DECT evaluation of noncalcified coronary artery plaque

    Energy Technology Data Exchange (ETDEWEB)

    Ravanfar Haghighi, Rezvan [Medical Imaging Research Center and Colorectal Research Center, Shiraz University of Medical Science, Shiraz 719 363 5899 (Iran, Islamic Republic of); Chatterjee, S. [BGVS Chemical Engineering Building (Old), Indian Institute of Science, Bangalore 560012 (India); Tabin, Milo; Singh, Rishi P.; Sharma, Munish; Krishna, Karthik [Department of Forensic Medicine, All India Institute of Medical Sciences, New Delhi 110029 (India); Sharma, Sanjiv; Jagia, Priya [Department of Cardiac-Radiology, All India Institute of Medical Sciences, New Delhi 110029 (India); Ray, Ruma; Arava, Sudhir [Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029 (India); Yadav, Rakesh [Department of Cardiology, All India Institute of Medical Sciences, New Delhi 110029 (India); Vani, V. C. [Department of Instrumentation and Applied Physics, Indian Institute of Science, Bangalore 560012 (India); Lakshmi, R.; Kumar, Pratik, E-mail: drpratikkumar@gmail.com [Department of Cardiac-Biochemistry, All India Institute of Medical Sciences, New Delhi 110029 (India); Mandal, Susama R. [Department of Medical Physics Unit IRCH, All India Institute of Medical Sciences, New Delhi 110029 (India)

    2015-10-15

    Purpose: Composition of the coronary artery plaque is known to have critical role in heart attack. While calcified plaque can easily be diagnosed by conventional CT, it fails to distinguish between fibrous and lipid rich plaques. In the present paper, the authors discuss the experimental techniques and obtain a numerical algorithm by which the electron density (ρ{sub e}) and the effective atomic number (Z{sub eff}) can be obtained from the dual energy computed tomography (DECT) data. The idea is to use this inversion method to characterize and distinguish between the lipid and fibrous coronary artery plaques. Methods: For the purpose of calibration of the CT machine, the authors prepare aqueous samples whose calculated values of (ρ{sub e}, Z{sub eff}) lie in the range of (2.65 × 10{sup 23} ≤ ρ{sub e} ≤ 3.64 × 10{sup 23}/cm{sup 3}) and (6.80 ≤ Z{sub eff} ≤ 8.90). The authors fill the phantom with these known samples and experimentally determine HU(V{sub 1}) and HU(V{sub 2}), with V{sub 1},V{sub 2} = 100 and 140 kVp, for the same pixels and thus determine the coefficients of inversion that allow us to determine (ρ{sub e}, Z{sub eff}) from the DECT data. The HU(100) and HU(140) for the coronary artery plaque are obtained by filling the channel of the coronary artery with a viscous solution of methyl cellulose in water, containing 2% contrast. These (ρ{sub e}, Z{sub eff}) values of the coronary artery plaque are used for their characterization on the basis of theoretical models of atomic compositions of the plaque materials. These results are compared with histopathological report. Results: The authors find that the calibration gives ρ{sub e} with an accuracy of ±3.5% while Z{sub eff} is found within ±1% of the actual value, the confidence being 95%. The HU(100) and HU(140) are found to be considerably different for the same plaque at the same position and there is a linear trend between these two HU values. It is noted that pure lipid type plaques

  15. Deep feature learning for automatic tissue classification of coronary artery using optical coherence tomography

    Science.gov (United States)

    Abdolmanafi, Atefeh; Duong, Luc; Dahdah, Nagib; Cheriet, Farida

    2017-01-01

    Kawasaki disease (KD) is an acute childhood disease complicated by coronary artery aneurysms, intima thickening, thrombi, stenosis, lamellar calcifications, and disappearance of the media border. Automatic classification of the coronary artery layers (intima, media, and scar features) is important for analyzing optical coherence tomography (OCT) images recorded in pediatric patients. OCT has been known as an intracoronary imaging modality using near-infrared light which has recently been used to image the inner coronary artery tissues of pediatric patients, providing high spatial resolution (ranging from 10 to 20 μm). This study aims to develop a robust and fully automated tissue classification method by using the convolutional neural networks (CNNs) as feature extractor and comparing the predictions of three state-of-the-art classifiers, CNN, random forest (RF), and support vector machine (SVM). The results show the robustness of CNN as the feature extractor and random forest as the classifier with classification rate up to 96%, especially to characterize the second layer of coronary arteries (media), which is a very thin layer and it is challenging to be recognized and specified from other tissues. PMID:28271012

  16. Microparticle-Induced Coagulation Relates to Coronary Artery Atherosclerosis in Severe Aortic Valve Stenosis.

    Directory of Open Access Journals (Sweden)

    Patrick Horn

    Full Text Available Circulating microparticles (MPs derived from endothelial cells and blood cells bear procoagulant activity and promote thrombin generation. Thrombin exerts proinflammatory effects mediating the progression of atherosclerosis. Aortic valve stenosis may represent an atherosclerosis-like process involving both the aortic valve and the vascular system. The aim of this study was to investigate whether MP-induced thrombin generation is related to coronary atherosclerosis and aortic valve calcification.In a cross-sectional study of 55 patients with severe aortic valve stenosis, we assessed the coronary calcification score (CAC as indicator of total coronary atherosclerosis burden, and aortic valve calcification (AVC by computed tomography. Thrombin-antithrombin complex (TATc levels were measured as a marker for thrombin formation. Circulating MPs were characterized by flow cytometry according to the expression of established surface antigens and by measuring MP-induced thrombin generation.Patients with CAC score below the median were classified as patients with low CAC, patients with CAC Score above the median as high CAC. In patients with high CAC compared to patients with low CAC we detected higher levels of TATc, platelet-derived MPs (PMPs, endothelial-derived MPs (EMPs and MP-induced thrombin generation. Increased level of PMPs and MP-induced thrombin generation were independent predictors for the severity of CAC. In contrast, AVC Score did not differ between patients with high and low CAC and did neither correlate with MPs levels nor with MP-induced thrombin generation.In patients with severe aortic valve stenosis MP-induced thrombin generation was independently associated with the severity of CAC but not AVC indicating different pathomechanisms involved in coronary artery and aortic valve calcification.

  17. Anomalous origin of the left coronary artery from the pulmonary artery in children: diagnostic use of multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Quanli; Yao, Qiong; Hu, Xihong [Children' s Hospital of Fudan University, Department of Radiology, Shanghai (China)

    2016-09-15

    Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly. It is important to demonstrate the anomalous origin of the left coronary artery and its course before surgery. To explore the clinical diagnostic use of multidetector CT coronary angiography in detecting anomalous origin of the left coronary artery from the pulmonary artery in children. Nine children (2 boys, 7 girls) ages 2 months to 9 years with surgically confirmed anomalous origin of the left coronary artery from the pulmonary artery were studied. Clinical data, transthoracic echocardiography and CT coronary angiography images were retrospectively analyzed. Transthoracic echocardiography correctly diagnosed anomalous origin of the left coronary artery from the pulmonary artery in 7 of 9 patients (95% CI: 40-97%). CT coronary angiography revealed the anomalous origin of the left coronary artery in all children (95% CI: 66-100%). In a 4-year-old girl and a 9-year-old girl, CT coronary angiography showed dilation of the right coronary artery and collateral circulation between the right and the left coronary arteries. CT coronary angiography is a useful method to show the anomalous origin of the coronary artery in children with anomalous origin of the left coronary artery from the pulmonary artery, especially for patients in whom origin of the left coronary artery cannot be detected by transthoracic echocardiography. (orig.)

  18. Haemostatic function in coronary artery disease (CAD).

    Science.gov (United States)

    Gupta, A; Sikka, M; Madan, N; Dwidedi, S; Rusia, U; Sharma, S

    1997-04-01

    Tests to evaluate haemostatic function bleeding time (BT), prothrombin time (PT) partial thromboplastin time with kaolin (PTTK), thrombin time (TT), platelet count, platelet function tests (platelet adhesiveness and microthrombus index) and plasma fibrinogen levels were performed in 30 patients of coronary artery disease (14 myocardial infarction, 16 angina pectoris) and 20 age and sex matched controls. There was no statistically significant difference in platelet adhesiveness and mean microthrombus index in patients and controls. The BT, PT, PTTK and TT were normal in all patients and controls. Stepwise logistic regression analysis showed that plasma fibrinogen was an independent risk factor in the production of CAD.

  19. Coronary collateral circulation in patients of coronary ectasia with significant coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Po-Chao Hsu

    Full Text Available OBJECTIVES: Patients with coronary ectasia (CE usually have coexisting coronary stenosis resulting in myoischemia. Coronary collateral plays an important role in protecting myocardium from ischemia and reducing cardiovascular events. However, limited studies investigate the role of CE in coronary collaterals development. METHODS: We evaluated 1020 consecutive patients undergoing coronary angiography and 552 patients with significant coronary artery disease (SCAD, defined as diameter stenosis more than 70%, were finally analyzed. CE is defined as the ectatic diameter 1.5 times larger than adjacent reference segment. Rentrop collateral score was used to classify patients into poor (grades 0 and 1 or good (grades 2 and 3 collateral group. RESULTS: 73 patients (13.2% had CE lesions which were most located in the right coronary artery (53.4%. Patients with CE had a lower incidence of diabetes (43.8% vs 30.1%, p = 0.03, higher body mass index (25.4±3.5 vs 26.7±4.6, p = 0.027 and poorer coronary collateral (58.2% vs 71.2%, p = 0.040. Patients with poor collateral (n = 331 had a higher incidence of CE (15.7% vs 9.5%, p = 0.040 and fewer diseased vessels numbers (1.96±0.84 vs 2.48±0.69, p<0.001. Multivariate analysis showed diabetes (odd ratio (OR 0.630, p = 0.026, CE (OR = 0.544, p = 0.048, and number of diseased vessels (OR = 2.488, p<0.001 were significant predictors of coronary collaterals development. CONCLUSION: The presence of CE was associated with poorer coronary collateral development in patients with SCAD.

  20. Early Results of Coronary Endarterectomy Combined with Coronary Artery Bypass Grafting in Patients with Diffused Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    Li-Qun Chi; Jian-Qun Zhang; Qing-Yu Kong; Wei Xiao; Lin Liang; Xin-Liang Chen

    2015-01-01

    Background:It is still a challenge for the cardiac surgeons to achieve adequate revascularization for diffused coronary artery disease (CAD).Coronary endarterectomy (CE) offers an alternative choice of coronary artery reconstruction and revascularization.In this study,short-term result of CE combined with coronary artery bypass graft (CABG) was discussed in the treatment for the diffused CAD.Methods:From January 2012 to April 2014,221 cases of CABG were performed by the same surgeon in our unit.Among these cases,38 cases of CE + CABG were performed,which was about 17.2% (38/221) of the cohort.All these patients were divided into two groups:CE + CABG group (Group A) and CABG alone group (Group B).All clinical data were compared between the two groups,and postoperative complications and in-hospital mortality were analyzed.The categorical and continuous variables were analyzed by Chi-square test and Student's t-test respectively.Results:Diabetes mellitus,hypertension,hyperlipidemia,and peripheral vascular disease were more common in group A.In this cohort,a total of 50 vessels were endarterectomized.Among them,CE was performed on left anterior descending artery in 11 cases,on right coronary artery in 29 cases,on diagonal artery in 3 cases,on intermediate artery in 2 cases,on obtuse marginal artery in 5 cases.There was no hospital mortality in both groups.The intro-aortic balloon pump was required in 3 cases in Group A (3/38),which was more often than that in Group B (3/183).At the time of follow-up,coronary computed tomography angiogram showed all the grafts with CE were patent (50/50).There is no cardio-related mortality in both groups.All these patients were free from coronary re-intervention.Conclusions:Coronary endarterectomy + CABG can offer satisfactory result for patients with diffused CAD in a short-term after the operation.

  1. Coronary artery anomalies: prevalence and clinical profile in elderly patients

    Institute of Scientific and Technical Information of China (English)

    Gianluca Rigatelli; Giorgio Rigatelli; Mario Trivellato

    2004-01-01

    Objective Although congenital heart diseases are uncommon in the elderly, coronary artery anomalies may be incidentally discovered in old age. We sought to determine the incidence and clinical features of coronary artery anomalies (CAAs) in patients over 65 years of age. Patients and methods Medical records of patients undergoing coronary artery angiography in the years 1997-2002 at the Legnago General Hospital were retrospectively reviewed, The clinical profiles of all patients with CAAs and CAA subtypes were noted. Comparison between patients under and over 65 was performed. Data are given as mean standard deviation and as percentages. Results Sixtysix patients (1.21%, Female/Male 22/44, mean age 65.3 ± 10.6 years) out of the 5450 who underwent coronary angiography in the years 1997-2002 had CAAs. In mast cases (63%, 41/66 patients), the patients were over 65.CAAs were discovered incidentally in these elderly patients while undergoing coronary artery angiography for dilated cardiomyopathy, ischemic heart disease, and valvular heart disease in 75% of the cases (30/41 patients). Patients over 65 had more cardiac comorbidities and .a higher incidence of coronary atherosclerosis. Conclusions The angiographic incidence of CAAs in elderly patients is increasing as the population ages and this occurrence calls for a wider knowledge of the anatomy and pathophysiology of CAAs among geriatric cardiologists. Elderly patients seem to present with lower risk coronary anomalies (separated origin of left anterior descending coronary artery and circanfflex artery, origin of circumflex artery from the right sinus or the right coronary artery, double coronary artery)but have a higher risk profile compared to younger patients due to the frequency of cardiac comorbidities and superimposed coronary artery atherosclerosis.

  2. Bioresorbable scaffolds in the treatment of coronary artery disease

    NARCIS (Netherlands)

    Y. Zhang (Yaojun); C.V. Bourantas (Christos); V. Farooq (Vasim); T. Muramatsu (Takashi); R. Diletti (Roberto); Y. Onuma (Yoshinobu); H.M. Garcia-Garcia (Hector); P.W.J.C. Serruys (Patrick)

    2013-01-01

    textabstractDrug-eluting stents have reduced the risk of in-stent restenosis and have broadened the application in percutaneous coronary intervention in coronary artery disease. However, the concept of using a permanent metallic endovascular device to restore the patency of a stenotic artery has inh

  3. Gender and age effects on risk factor-based prediction of coronary artery calcium in symptomatic patients

    DEFF Research Database (Denmark)

    Nicoll, R; Wiklund, U; Zhao, Y;

    2016-01-01

    BACKGROUND AND AIMS: The influence of gender and age on risk factor prediction of coronary artery calcification (CAC) in symptomatic patients is unclear. METHODS: From the European Calcific Coronary Artery Disease (EURO-CCAD) cohort, we retrospectively investigated 6309 symptomatic patients, 62......% male, from Denmark, France, Germany, Italy, Spain and USA. All of them underwent risk factor assessment and CT scanning for CAC scoring. RESULTS: The prevalence of CAC among females was lower than among males in all age groups. Using multivariate logistic regression, age, dyslipidaemia, hypertension......, diabetes and smoking were independently predictive of CAC presence in both genders. In addition to a progressive increase in CAC with age, the most important predictors of CAC presence were dyslipidaemia and diabetes (β = 0.64 and 0.63, respectively) in males and diabetes (β = 1.08) followed by smoking (β...

  4. Study on the screening program and risk factors of carotid artery stenosis with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    李庆祥

    2013-01-01

    Objective The purpose of this research project was to evaluate the relationship and risk factors between coronary artery disease and carotid artery stenosis (CAS) ,screened by duplex ultra-sonography.Methods 1339 patients with coronary artery disease were enrolled into this

  5. Unusually Looped and Muzzled Branches of Right Coronary Artery

    Directory of Open Access Journals (Sweden)

    Anitha Guru

    2017-01-01

    Full Text Available Coronary artery disease (CAD is the major cause of death in developed countries as it accounts on an average for 1 of every 5 deaths. Morphological variations of coronary arterial system is one of the causative factor for CAD. Anatomical knowledge of all possible variant patterns of coronary arterial system is imperative in the diagnostic and therapeutic approach of CAD. We report here a rare branching pattern of right coronary artery (RCA. The origin of RCA was normal but the course and branching pattern of it were atypical. RCA was not occupying its usual position in atrioventricular (coronary sulcus and its course was incomplete. It gave a ventricular branch to right ventricle, which presented an unusual looping pattern. It terminated as right marginal artery following its muzzled appearance within the musculature of the ventricle.

  6. Technical Considerations of Giant Right Coronary Artery Aneurysm Exclusion

    Directory of Open Access Journals (Sweden)

    James Barr

    2016-01-01

    Full Text Available Giant coronary artery aneurysms are rare clinical entities. We report the case of a 49-year-old man who presented with dyspnoea and exertional chest pain. Investigations confirmed an aneurysmal right coronary artery measuring 4 cm with a fistulous communication to the right atrium. Following right atriotomy, the fistula was oversewn and the aneurysmal right coronary artery ligated at its origin and at several points along its course. A saphenous vein graft was anastomosed to the posterior descending artery. Persistent ventricular fibrillation occurred upon chest closure, attributed to ischaemia following ligation of the aneurysmal coronary artery. Emergent resternotomy and internal defibrillation were successfully performed. The sternum was stented open to reduce right ventricular strain and closed the following day. The patient made an unremarkable recovery. We here address the technical challenges associated with surgical repair of right coronary aneurysms and the physiology and management of potential complications.

  7. Technical Considerations of Giant Right Coronary Artery Aneurysm Exclusion

    Science.gov (United States)

    Barr, James; Kourliouros, Antonios

    2016-01-01

    Giant coronary artery aneurysms are rare clinical entities. We report the case of a 49-year-old man who presented with dyspnoea and exertional chest pain. Investigations confirmed an aneurysmal right coronary artery measuring 4 cm with a fistulous communication to the right atrium. Following right atriotomy, the fistula was oversewn and the aneurysmal right coronary artery ligated at its origin and at several points along its course. A saphenous vein graft was anastomosed to the posterior descending artery. Persistent ventricular fibrillation occurred upon chest closure, attributed to ischaemia following ligation of the aneurysmal coronary artery. Emergent resternotomy and internal defibrillation were successfully performed. The sternum was stented open to reduce right ventricular strain and closed the following day. The patient made an unremarkable recovery. We here address the technical challenges associated with surgical repair of right coronary aneurysms and the physiology and management of potential complications. PMID:28018699

  8. Assessment of a Sudden Death Case due to Coronary Artery Disease Based on the PMCT and Forensic Autopsy

    Institute of Scientific and Technical Information of China (English)

    WAN Lei; ZHANG Jian-hua; HUANG Ping; YING Chong-liang; LIU Ning-guo; ZHU Guang-you

    2012-01-01

    It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography (PMCT).This article reported a case of sudden natural death after the complaint of anterior chest pain in which coronary artery calcification (CAC) was clearly displayed using PMCT scan.The entire coronary artery system was almost reconstructed via multiplanar reformation (MPR) and volume-rendering reconstruction (VR),and the total calcium score of the coronary arteries was obtained with CaScoring automatic analysis software.The results showed that CAC was conspicuous; the total calcium score was 640.3,considerably higher than 400.The pulmonary ground-glass opacity (GGO) and small amount of fluid both in the subglottic trachea and main bronchi were also found.The imaging results confirmed those of autopsy.In addition,the results concluded that PMCT might serve as an invaluable adjunct to the classic autopsy procedure.

  9. Prediction of Coronary Artery Disease by B-Mode Sonography

    Directory of Open Access Journals (Sweden)

    J Kheirkhah

    2010-09-01

    Full Text Available Background: Although coronary angiography is gold standard for diagnosis of coronary artery disease, it is nevertheless an invasive and potentially hazardous procedure. The aim of this study was to investigate the predictive value of carotid and femoral artery Intima-Media Thickness (IMT for detection of coronary artery disease.Methods: The present study comprised 100 consecutive patients referred for coronary angiography due to symptoms of ischemic heart disease. Ultrasound assessment of common carotid and common femoral artery were performed with an ultrasound device equipped with a high-resolution transducer. IMT was measured in the common carotid and common femoral artery (10 mm proximal to the deep femoral artery origin. Results: There were 25 cases in each of single (S, double (D and triple (T vessel disease and 25 in significant left main diseases groups of patients. In regard to common carotid artery IMT was 0.78 mm in S, 0.84 mm in D, 0.97 mm in T and 1.05 mm in left main disease groups. There was a significant correlation between IMT measured in the carotid artery and severity of coronary artery disease (P = 0.0001. With respect to common femoral artery IMT was 0.66 mm in S group, 0.73 mm in D group, 0.84 mm in T groups and 0.85 mm in patients with left main disease.. There is a significant correlation between IMT (measured in the common femoral artery and severity of coronary artery disease (P = 0.0001.Conclusion: Our results indicated that early atherosclerosis in both carotid and femoral arteries were highly predictive of coronary involvement and IMT being associated with the number of coronary vessels disorder.

  10. 血管内超声评价冠脉钙化长度比对介入治疗的影响%Effect of coronary calcification length on percutaneous coronary intervention:An intravascular ultrasound study

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

      目的探讨不同程度冠脉钙化病变对经皮冠脉介入治疗(percutaneous coronary intervention,PCI)疗效的影响。方法连续收集我中心2012年7月-2013年1月71例冠心病患者(71处靶病变),利用血管内超声分析冠脉斑块特征、评估支架植入情况。观察钙化组与非钙化组介入操作特征、即刻疗效和院内主要不良心脏事件(major adverse cardiac events,MACE)。在钙化弧度≤180°和>180°的病变中,对比钙化长度比>0.5与钙化长度比<0.5介入治疗即刻疗效。结果71处靶病变中43处钙化病变,28处非钙化病变。钙化组术后最小支架直径、最小支架横截面积明显小于非钙化组,预扩比例明显增高(P<0.05),支架膨胀指数亦小于非钙化组,但无统计学差异。在钙化弧度≤180°病变中,长钙化组支架膨胀指数明显低于短钙化组(P<0.05)。在钙化弧度>180°的病变中,长钙化组钙化弧度明显大于短钙化组,且支架膨胀指数倾向于小于短钙化组。所有患者均无院内MACE发生。结论冠脉钙化病变影响了支架的充分扩张;钙化弧度≤180°时,如钙化长度比>0.5,则支架的扩张明显受限;钙化弧度>180°时,长钙化病变往往伴随着大弧度钙化,其支架膨胀效果欠佳。%Objective To study the effect of different coronary calcification lengths on percutaneous coronary intervention (PCI). Methods Seventy-one patients (71 target lesions) with coronary heart disease (CHD) admitted to our center from July 2012 to January 2013 were divided into calcification group and non- calcification group. Their coronary artery plaques and stenting were assessed and analyzed by intravascular ultrasonography. The characteristics, immediate outcome and major adverse cardiac events (MACE) of PCI between the two groups were observed. The immediate outcomes of PCI were compared when the ratio of calcification length>0.5 or180

  11. Mean platelet volume in patients with coronary artery ectasia.

    Science.gov (United States)

    Sen, Nihat; Tavil, Yusuf; Yazici, Hüseyin Ugur; Hizal, Fatma; Açikgöz, Sadik Kadri; Abaci, Adnan; Cengel, Atiye

    2007-08-01

    Mean platelet volume (MPV) is an indicator of platelet activation, a central process in the pathophysiology of coronary heart disease. The importance of coronary artery ectasia (CAE) lies in the fact that in 85% of cases it is accompanied by atherosclerotic coronary disease. The present study was designed to investigate MPV values in CAE patients in comparison with individuals with normal coronary angiograms. MPV was measured in 67 consecutive patients (mean age: 55.3+/-9.7 years) with isolated CAE and 55 control subjects (mean age: 53.6+/-10.1 years). Coronary artery ectasia was defined as without any stenotic lesion, on visual assessment, of the coronary arteries with a luminal dilatation 1.5-fold or more of the adjacent normal coronary segments. Four subgroups were composed according to the extension of CAE in coronary arteries. MPV was significantly higher in patients with CAE than in the control group (9.27+/-1.32 vs. 8.40+/-0.95, p<0.001). There were no statistically significant differences in MPV among the subgroups with different CAE severity. It was shown for the first time that patients with CAE have higher MPVs than control subjects with normal coronary angiograms. Hence MPV might be used as a follow-up marker in patients with CAE with or without coronary artery disease.

  12. Developmental origin of age-related coronary artery disease

    Science.gov (United States)

    Wei, Ke; Díaz-Trelles, Ramon; Liu, Qiaozhen; Diez-Cuñado, Marta; Scimia, Maria-Cecilia; Cai, Wenqing; Sawada, Junko; Komatsu, Masanobu; Boyle, Joseph J.; Zhou, Bin; Ruiz-Lozano, Pilar; Mercola, Mark

    2015-01-01

    Aim Age and injury cause structural and functional changes in coronary artery smooth muscle cells (caSMCs) that influence the pathogenesis of coronary artery disease. Although paracrine signalling is widely believed to drive phenotypic changes in caSMCs, here we show that developmental origin within the fetal epicardium can have a profound effect as well. Methods and results Fluorescent dye and transgene pulse-labelling techniques in mice revealed that the majority of caSMCs are derived from Wt1+, Gata5-Cre+ cells that migrate before E12.5, whereas a minority of cells are derived from a later-emigrating, Wt1+, Gata5-Cre− population. We functionally evaluated the influence of early emigrating cells on coronary artery development and disease by Gata5-Cre excision of Rbpj, which prevents their contribution to coronary artery smooth muscle cells. Ablation of the Gata5-Cre+ population resulted in coronary arteries consisting solely of Gata5-Cre− caSMCs. These coronary arteries appeared normal into early adulthood; however, by 5–8 months of age, they became progressively fibrotic, lost the adventitial outer elastin layer, were dysfunctional and leaky, and animals showed early mortality. Conclusion Taken together, these data reveal heterogeneity in the fetal epicardium that is linked to coronary artery integrity, and that distortion of the coronaries epicardial origin predisposes to adult onset disease. PMID:26054850

  13. 血液透析患者长期生存与冠状动脉钙化积分的关系%Impact of coronary artery calcification score measured with electron beam computed tomography on cardiovascular disease and its mortality in hemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    李文歌; 卞维静; 张凌; 傅芳婷; 吕滨

    2010-01-01

    目的 长期随访冠状动脉钙化积分(coronary artery calcification score,CACS)与维持性血液透析(maintain hemodialysis,MHD)患者心血管疾病(cardiavascular disease,CVD)的发生与死亡的关系.方法 通过追踪随访电子柬CT(electron beam computed tomography,EBCT)测定CACS的MHD患者22例,在2002年至2009年期间CVD的发生及其死亡情况,分析CACS与CVD的关系,通过Kaplan-Meier生存曲线比较CACS≥100分组和CACS0分),CACS平均为1935.54分(0~9833分).随访至2009年12月31日,17例发生过CVD(81.096);14例死亡(66.7%),全部死于CVD相关疾病.在CACS≥100分组,15例患者中有14例发生CVD(93.396),12例死亡(80.096);其显著高于CACS<100分组的CVD发生率(50.096,3/6)和死亡率(33.3%,2/6),差异均有统计学意义(P<0.05).CACS≥100分组与<100分组比较,hs-CRP分别为(0.006±0.005)g/L和(0.002±0.002)g/L,Alb分别为(38.00±1.56)g/L和(42.00±3.79)g/L,差异均有统计学意义(P<0.05).Kaplan-Meier生存曲线显示CACS≥100分组的平均生存时间111.3个月,GAGS<100分组的平均生存时间222.7个月,两者之间差异有统计学意义(P=0.042).结论 CACS与MHD患者CVD的发生和死亡相关,微炎症和营养不良可能是重要的风险因素,CACS<100分组生存时间明显长于CACS≥100分组.

  14. Transposition of Great Arteries with Intramural Coronary Artery: Experience with a Modified Surgical Technique

    Directory of Open Access Journals (Sweden)

    Amit Mishra

    2016-02-01

    Full Text Available Abstract Objective: Transposition of the great arteries is a common congenital heart disease. Arterial switch is the gold standard operation for this complex heart disease. Arterial switch operation in the presence of intramural coronary artery is surgically the most demanding even for the most experienced hands. We are presenting our experience with a modified technique for intramural coronary arteries in arterial switch operation. Methods: This prospective study involves 450 patients undergoing arterial switch operation at our institute from April 2006 to December 2013 (7.6 years. Eighteen patients underwent arterial switch operation with intramural coronary artery. The coronary patterns and technique used are detailed in the text. Results: The overall mortality found in the subgroup of 18 patients having intramural coronary artery was 16% (n=3. Our first patient had an accidental injury to the left coronary artery and died in the operating room. A seven-day old newborn died from intractable ventricular arrhythmia fifteen hours after surgery. Another patient who had multiple ventricular septal defects with type B arch interruption died from residual apical ventricular septal defect and sepsis on the eleventh postoperative day. The remainder of the patients are doing well, showing a median follow-up duration of 1235.34±815.26 days (range 369 - 2730. Conclusion: Transposition of the great arteries with intramural coronary artery is demanding in a subset of patients undergoing arterial switch operation. We believe our technique of coronary button dissection in the presence of intramural coronary arteries using coronary shunt is simple and can be a good addition to the surgeons' armamentarium.

  15. Transposition of Great Arteries with Intramural Coronary Artery: Experience with a Modified Surgical Technique

    Science.gov (United States)

    Mishra, Amit; Jain, Anil; Hinduja, Manish; Wadhawa, Vivek; Patel, Ramesh; Vaidhya, Nikunj; Rodricks, Dayesh; Patel, Hardik

    2016-01-01

    Objective: Transposition of the great arteries is a common congenital heart disease. Arterial switch is the gold standard operation for this complex heart disease. Arterial switch operation in the presence of intramural coronary artery is surgically the most demanding even for the most experienced hands. We are presenting our experience with a modified technique for intramural coronary arteries in arterial switch operation. Methods: This prospective study involves 450 patients undergoing arterial switch operation at our institute from April 2006 to December 2013 (7.6 years). Eighteen patients underwent arterial switch operation with intramural coronary artery. The coronary patterns and technique used are detailed in the text. Results: The overall mortality found in the subgroup of 18 patients having intramural coronary artery was 16% (n=3). Our first patient had an accidental injury to the left coronary artery and died in the operating room. A seven-day old newborn died from intractable ventricular arrhythmia fifteen hours after surgery. Another patient who had multiple ventricular septal defects with type B arch interruption died from residual apical ventricular septal defect and sepsis on the eleventh postoperative day. The remainder of the patients are doing well, showing a median follow-up duration of 1235.34±815.26 days (range 369 - 2730). Conclusion: Transposition of the great arteries with intramural coronary artery is demanding in a subset of patients undergoing arterial switch operation. We believe our technique of coronary button dissection in the presence of intramural coronary arteries using coronary shunt is simple and can be a good addition to the surgeons' armamentarium. PMID:27074270

  16. Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

    Directory of Open Access Journals (Sweden)

    Venkat Gangadharan MD

    2017-01-01

    Full Text Available A 36-year-old woman was seen with complaints of exertional chest pain and shortness of breath. Her medical history included atrial fibrillation and diabetes. Physical examination was unremarkable except for an irregular cardiac rhythm. Myocardial perfusion imaging revealed the presence of a large area of infarction involving the entire anterior and apical walls and part of the anteroseptal wall with minimal periinfarct ischemia. Computed tomography coronary angiogram revealed an anomalous left main coronary artery arising from the main pulmonary artery. Right and left heart catheterizations demonstrated moderate pulmonary hypertension with a slight step-up in oxygen saturation between the right ventricle and main pulmonary artery. Coronary angiography showed a large tortuous right coronary artery with collaterals to the left anterior descending artery that drained into the main pulmonary artery. She was referred for surgery. This case demonstrates a rare coronary artery anomaly in an adult where survival is dependent on collateral circulation.

  17. The clinical value of myocardial perfusion imaging and coronary artery calcification with fusion imaging by acquisition by SPECT/CT in detection of coronary artery disease in elderly patients%单光子发射断层与透射断层图像融合探查心肌灌注和冠状动脉钙化在老年患者中的临床价值

    Institute of Scientific and Technical Information of China (English)

    薛倩倩; 姚稚明; 于治国; 刘秀芹; 陈聪霞; 郭悦; 李文婵; 李旭; 许斌

    2015-01-01

    Objective To investigate the clinical value of myocardial perfusion imaging (MPI) and coronary artery calcification (CAC) with one-stop-shop acquisition by SPECT/CT in detection of coronary artery disease (CAD) in elderly patients.Methods The 133 patients with suspected or diagnosed CAD who underwent gated MPI and CAC scan by SPECT/CT during October 2012 to December 2012 were prospectively studied.All patients were divided into elderly group (aged ≥60 years) and non-elderly group (aged<60 years),normal MPI group and abnormal MPI group,and 0,1-9,10-99,100-399,≥400 subgroups according to CAC scores (CACS).Mann-Whitney U test,Kruskal-Wallis one-way AVOVA test,x2 test,Fisher's exact test were performed for statistical analysis.Results CAC positive rate and CACS were higher in normal MPI group than in abnormal MPI group [72.6% (69/95) vs.52.6% (20/38),(386.8±815.0)scores vs.(56.5±109.0)scores,P<0.05 or 0.01].The abnormal MPI rate was higher in CACS ≥400 group than in the other four CACS groups (P<0.05 或 P<0.01),there was no significant difference between the other four CACS groups (P>0.05).The sensitivity,specificity and accuracy of CAC in detection of myocardial ischemia or infarction were 72.6% (69/95),47.4% (18/38),65.4% (87/133),respectively.The CACS was higher in elderly group than in non-elderly group[(356.7 ± 790.0)scores vs.(89.7± 233.0)scores,P<0.01].The sensitivity of CAC in detection of myocardial ischemia was higher in elderly group than in non-elderly group [79.7% (59/74) vs.47.6% (10/21),P<0.01],while the specificity in elderly group had a decreased tendency as compared with non-elderly group [72.7% (10/27) vs.37.0% (8/11),P>0.05].Conclusions One-stop-shop acquisition of MPI and CAC by SPECT/CT is convenient.MPI-CAC SPECT/CT may offer comprehensive information on both myocardial perfusion and CAC and provide a better information platform for the accurate exploration of myocardial ischemia and infarction in

  18. Arterial calcification: Finger-pointing at resident and circulating stem cells

    Institute of Scientific and Technical Information of China (English)

    Francesco; Vasuri; Silvia; Fittipaldi; Gianandrea; Pasquinelli

    2014-01-01

    The term "Stammzelle"(stem cells) originally appeared in 1868 in the works of Ernst Haeckel who used it to describe the ancestor unicellular organism from which he presumed all multicellular organisms evolved. Since then stem cells have been studied in a wide spectrum of normal and pathological conditions; it is remarkable to note that ectopic arterial calcification was considered a passive deposit of calcium since its original discovering in 1877; in the last decades, resident and circulating stem cells were imaged to drive arterial calcification through chondro-osteogenic differentiation thus opening the idea that an active mechanism could be at the basis of the process that clinically shows a Janus effect: calcifications either lead to the stabilization or rupture of the atherosclerotic plaques. A review of the literature underlines that 130 years after stem cell discovery, antigenic markers of stem cells are still debated and the identification of the osteoprogenitor phenotype is even more elusive due to tissue degradation occurring at processing and manipulation. It is necessary to find a consensus to perform comparable studies that implies phenotypic recognition of stem cells antigens. A hypothesis is based on the singular morphology and amitotic mechanism of division of osteoclasts: it constitutes the opening to a new approach on osteoprogenitors markers and recognition. Our aim was to highlight all the present evidences of the active calcification process, summarize the different cellular types involved, and discuss a novel approach to discover osteoprogenitor phenotypes in arterial wall.

  19. Arterial calcification: Finger-pointing at resident and circulating stem cells.

    Science.gov (United States)

    Vasuri, Francesco; Fittipaldi, Silvia; Pasquinelli, Gianandrea

    2014-11-26

    The term ''Stammzelle'' (stem cells) originally appeared in 1868 in the works of Ernst Haeckel who used it to describe the ancestor unicellular organism from which he presumed all multicellular organisms evolved. Since then stem cells have been studied in a wide spectrum of normal and pathological conditions; it is remarkable to note that ectopic arterial calcification was considered a passive deposit of calcium since its original discovering in 1877; in the last decades, resident and circulating stem cells were imaged to drive arterial calcification through chondro-osteogenic differentiation thus opening the idea that an active mechanism could be at the basis of the process that clinically shows a Janus effect: calcifications either lead to the stabilization or rupture of the atherosclerotic plaques. A review of the literature underlines that 130 years after stem cell discovery, antigenic markers of stem cells are still debated and the identification of the osteoprogenitor phenotype is even more elusive due to tissue degradation occurring at processing and manipulation. It is necessary to find a consensus to perform comparable studies that implies phenotypic recognition of stem cells antigens. A hypothesis is based on the singular morphology and amitotic mechanism of division of osteoclasts: it constitutes the opening to a new approach on osteoprogenitors markers and recognition. Our aim was to highlight all the present evidences of the active calcification process, summarize the different cellular types involved, and discuss a novel approach to discover osteoprogenitor phenotypes in arterial wall.

  20. Large common left and right coronary artery to coronary sinus fistula

    NARCIS (Netherlands)

    Hoendermis, E.S.; Waterbolk, Tjalling W.; Willems, Els; Zijlstra, F.

    2006-01-01

    Coronary fistulas are vascular anomalies which in rare cases can cause hemodynamic problems with indication for intervention. We report about a 47-year-old man with a large coronary fistula arising from both, the left and right coronary artery. To our knowledge this is the first case described with

  1. Emergency stenting for refractory acute coronary artery occlusion during coronary angioplasty

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); I. DeScheerder (Ivan); M.J.B.M. van den Brand (Marcel); G-J. Laarman (GertJan); H. Suryapranata (Harry); P.W.J.C. Serruys (Patrick)

    1990-01-01

    markdownabstractAbstract Acute coronary artery occlusion occurs in 2 to 11% of the patients who undergo coronary angioplasty and is the major cause of in-hospital mortality and morbidity associated with coronary angioplasty. This procedural complication is usually caused by an occlusive

  2. Giant aneurysm in a left coronary artery fistula

    DEFF Research Database (Denmark)

    Frestad, Daria; Helqvist, Steffen; Helvind, Morten

    2013-01-01

    Congenital coronary artery fistula complicated with giant coronary artery aneurysm is a very rare condition. In this case report, we present a 65-year-old woman, referred to us with a continuous heart murmur, occasional atypical chest pain and few episodes of fainting. A giant aneurysm and a coro......Congenital coronary artery fistula complicated with giant coronary artery aneurysm is a very rare condition. In this case report, we present a 65-year-old woman, referred to us with a continuous heart murmur, occasional atypical chest pain and few episodes of fainting. A giant aneurysm...... and a coronary-pulmonary fistula were diagnosed using multiple cardiovascular imaging modalities to provide a sufficient anatomical picture. The patient was considered at high risk of sudden death from aneurysm rupture and received surgical treatment. Subsequent histopathological examination revealed a true...

  3. Repair of an Atherosclerotic Coronary Artery Aneurysm by Implantation of a Coronary Covered Stent

    Directory of Open Access Journals (Sweden)

    Antenor Portela

    2002-05-01

    Full Text Available An atherosclerotic aneurysm of the right coronary artery complicated by a recent myocardial infarction was successfully treated with coronary artery stenting, using a device consisting of 2 stents with a layer of expandable polytetrafluorethylene (PTFE placed between them. A follow-up angiograph 5 months after the procedure showed sustained initial results.

  4. Woven Coronary Artery Disease Successfully Managed with Percutaneous Coronary Intervention: A New Case Report

    OpenAIRE

    Yakup Alsancak; Burak Sezenoz; Sedat Turkoglu; Adnan Abacı

    2015-01-01

    Woven coronary artery is relatively rare and can be complicated in both acute and chronic phases. A few case reports have been published until now. Herein we report a case with right woven coronary artery managed with drug-eluted stent implantation without complication.

  5. Woven Coronary Artery Disease Successfully Managed with Percutaneous Coronary Intervention: A New Case Report.

    Science.gov (United States)

    Alsancak, Yakup; Sezenoz, Burak; Turkoglu, Sedat; Abacı, Adnan

    2015-01-01

    Woven coronary artery is relatively rare and can be complicated in both acute and chronic phases. A few case reports have been published until now. Herein we report a case with right woven coronary artery managed with drug-eluted stent implantation without complication.

  6. Woven Coronary Artery Disease Successfully Managed with Percutaneous Coronary Intervention: A New Case Report

    Directory of Open Access Journals (Sweden)

    Yakup Alsancak

    2015-01-01

    Full Text Available Woven coronary artery is relatively rare and can be complicated in both acute and chronic phases. A few case reports have been published until now. Herein we report a case with right woven coronary artery managed with drug-eluted stent implantation without complication.

  7. Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE)

    DEFF Research Database (Denmark)

    Mäkikallio, Timo; Holm, Niels R; Lindsay, Mitchell

    2016-01-01

    Background Coronary artery bypass grafting (CABG) is the standard treatment for revascularisation in patients with left main coronary artery disease, but use of percutaneous coronary intervention (PCI) for this indication is increasing. We aimed to compare PCI and CABG for treatment of left main...... coronary artery disease. Methods In this prospective, randomised, open-label, non-inferiority trial, patients with left main coronary artery disease were enrolled in 36 centres in northern Europe and randomised 1: 1 to treatment with PCI or CABG. Eligible patients had stable angina pectoris, unstable......), a composite of all-cause mortality, non-procedural myocardial infarction, any repeat coronary revascularisation, and stroke. Non-inferiority of PCI to CABG required the lower end of the 95% CI not to exceed a hazard ratio (HR) of 1 . 35 after up to 5 years of follow-up. The intention-to-treat principle...

  8. [Aftermaths of lesions of coronary arteries in Kawasaki disease].

    Science.gov (United States)

    Vostokova, A A; Grunina, E A; Klemenov, A V

    2016-01-01

    Kawasaki disease, also known as cutaneous-mucous-glandular mucocutaneous glandular syndrome, is acute systemic vasculitis of small-to-medium calibre arteries, frequently involving coronary arteries, affect almost exceptionally children, with reports concerning cases of Kawasaki syndrome in 20-to-30-year-old adults being extremely rare. The most serious manifestation of Kawasaki disease is coronaritis and formation of coronary artery aneurysms. The dynamics of the formed coronary aneurysms and, consequently, the fate of patients may be different. Thrombosis of an aneurysm in the early period of the disease and stenosing of the affected coronary artery later on present possible complications of Kawasaki disease and potential causes of myocardial infection in young adults. Increased risk of coronary artery thromboses in Kawasaki disease is conditioned by a decrease in velocity of blood flow and its turbulent pattern in the aneurysms, endothelial dysfunction due to currently existing or endured coronaritis and thrombocytosis typical of this pathology. Predisposing factors of coronary artery stenosing are unfavourable haemodynamic conditions appearing at the sites of the "entry" and "exit" of the aneurysm. Described herein are two case reports of myocardial infarction, one of which being a complication of an acute case of Kawasaki disease in a 29-year-old patient, with the second one being a consequence of coronary artery stenosing in a 25-year-old patient who had endured Kawasaki disease in his childhood.

  9. Coronary Artery Bypass Grafting (CABG) Dengan Menggunakan Vena Saphenous, Arteri Mammaria Interna

    OpenAIRE

    Lita Feriyawati

    2006-01-01

    Coronary Artery Bypass Grafting (CABG) merupakan salahsatu penanganan intervensi dari Penyakit Jantung Koroner (PJK), dengan cara membuat saluran baru melewati bagian Arteri Coronaria yang mengalami penyempitan atau penyumbatan, oleh Lita Feriyawati 06001193

  10. Carotid artery stenting in patients with coexistent carotid and coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    LUO Jian-fang; HUANG Wen-hui; WANG Shuo; DAI Cheng-bo; LI Guang; CHEN Ji-yan; ZHOU Ying-ling; WANG Li-juan

    2007-01-01

    @@ Atherosclerotic disease, as a systemic process, affects all arteries to varying degrees. In particular,coexistent carotid and coronary artery diseases are common; Management of such patients has been a point of continuing controversy.

  11. Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy

    Directory of Open Access Journals (Sweden)

    Alexander L. Pan

    2012-01-01

    Full Text Available Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year-old female who developed two spontaneous coronary dissections while on topical hormonal replacement therapy. The patient had no other risk factors for coronary dissection. After withdrawal from topical hormonal therapy, our patient has done well and has not had recurrent coronary artery dissections over a one-year follow-up period. The potential contributory role of topical hormonal therapy as a cause of spontaneous coronary dissection should be recognized.

  12. Doppler findings in a rare Coronary Artery Fistula

    Directory of Open Access Journals (Sweden)

    Jorns Carl

    2007-03-01

    Full Text Available Abstract One of the primary forms of congenital anomalies of the coronary arteries is coronary artery fistula (CAF. It is defined as a direct communication between the coronary artery and any surrounding cardiac chamber or vascular structure, which bypasses the myocardial capillary bed. We present a newborn baby with a large coronary artery fistula connecting the left anterior descending (LAD artery to the left ventricular (LV apex. Associated cardiac abnormalities were found: a ventricular septal defect (diameter 4 mm, a patent foramen ovale as well as trivial tricuspid and mitral regurgitation. Here we demonstrate the echocardiograms of an extremely rare form of CAF diagnosed within the first days of postnatal life.

  13. Diffuse coronary artery spasm treated by extracorporeal membrane oxygenation.

    Science.gov (United States)

    Smith, Chez; Akowuah, Enoch; Theodore, Sanjay; Brown, Robin

    2009-07-01

    Diffuse coronary vasospasm is an unpredictable and serious complication following coronary artery bypass surgery. The treatment of this emergency is dependent on patient suitability for angiography and direct injection of vasodilators into the affected vessels. In patients unable to proceed to angiography the diagnosis can only be suspected but treatment is nevertheless still towards reinstitution of coronary blood flow. We present one such case in which re-grafting and extracorporeal membranous oxygenation proved successful in restoring cardiac function in a patient with diffuse coronary artery spasm.

  14. Measurement of coronary artery calcification with multi-slice spiral computed tomography and the associated factors in maintenance hemodialysis patients%维持性血液透析患者冠状动脉钙化的评价及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    郑淑蓓; 金领微; 李占园; 周志宏

    2015-01-01

    Objective To investigate the factors correlated to coronary artery calcification (CAC) in maintenance hemodialysis (MHD) patients.Methods This study included 132 patients(54 females,78 males),aged 26-94 years,who were on hemodialysis for 10-204 months(median dialysis duration 51.00 months).The parameters including calcium,phosphorus,parathyroid hormone,total cholesterol,low density lipoprotein,triglycerides,C-reactive protein (CRP),klotho,and so on were assessed.Quantification of CAC was determined by multi-slice spiral computed tomography (MSCT),known as the coronary artery calcification score (CACs).Results Ninety-two patients (69.70%) had CAC,with CACs ranging from 0 to 13 450.20.More than 30% patients experienced one even a variety of cardiovascular and cerebrovascular diseases.A positive correlation was observed between the degree of CAC and the incidence of cardiovascular and cerebrovascular diseases.Whereas a positive correlation existed between CACs and age (r=0.347,P=0.000),duration of hemodialysis (r=0.245,P=0.005),systolic blood pressure (r=0.184,P=0.034),diabetes history (r=0.211,P=0.015),phosphorus (r=0.262,P=0.002),calcium-phosphorus product (r=0.247,P=0.004);and a negative correlation between CACs and klotho level (r=-0.294,P=0.001).Multivariate logistic regression analysis showed that the main factor influencing the degree of CAC in MHD patients was age.Conclusions CAC is common and widespread in hemodialysis patients,who are often accompanied by cardiovascular and cerebrovascular diseases.The prevalence rate of cardiovascular and cerebrovascular diseases increases with the aggravation of CAC degree.Age,duration of hemodialysis,systolic blood pressure,diabetes history,disturbance of calcium and phosphorus metabolism and klotho are correlated with the severity of CAC.Age is an independent risk factor of CAC degree.%目的 探讨影响维持性血液透析(MHD)患者冠状动脉钙化(CAC)的相关因素.方法 收集2012年12月至2014年8月在

  15. Coronary fluorine-18-sodium fluoride uptake is increased in healthy adults with an unfavorable cardiovascular risk profile

    DEFF Research Database (Denmark)

    Blomberg, Björn A; Thomassen, Anders; de Jong, Pim A

    2017-01-01

    OBJECTIVE: Coronary artery fluorine-18-sodium fluoride (F-NaF) uptake reflects coronary artery calcification metabolism and is considered to be an early prognostic marker of coronary heart disease. This study evaluated the relationship between coronary artery F-NaF uptake and cardiovascular risk...

  16. Association of coronary heart disease with age-adjusted aortocoronary calcification in patients with familial hypercholesterolaemia

    DEFF Research Database (Denmark)

    Jensen, J M; Gerdes, Lars Ulrik; Jensen, H K

    2000-01-01

    OBJECTIVES: Existing algorithms of risk of coronary heart disease (CHD) do not pertain to patients with familial hypercholesterolaemia (FH), whose arteries have been exposed to hypercholesterolaemia since birth. We studied a cohort of FH patients to compare four diagnostic models of CHD: traditio...

  17. "Obesity paradox" in coronary artery disease.

    Science.gov (United States)

    Akin, Ibrahim; Nienaber, Christoph A

    2015-10-26

    Obesity used to be among the more neglected public health problems, but has unfolded as a growing medical and socioeconomic burden of epidemic proportions. Morbid obesity is linked to traditional cardiovascular risk factors like, hypertension, hyperlipidemia and diabetes, and suspected to incur increased morbidity and mortality in the Western and even third world populations. This patient cohort is also at greater risk to develop coronary artery disease. Recent population-based registries revealed that 43% and 24% of all cases of coronary revascularization were carried out in overweight and obese patients, respectively. However, despite evidence of a positive correlation between obesity and increased cardiovascular morbidity, some authors have described a better clinical outcome in overweight and obese patients, a phenomenon they coined "obesity paradoxon". Thus, there is an ongoing debate in light of conflicting data and the possibility of confounding bias causing misconception and challenging the "obesity paradox". In this review article we present the current evidence and throughly discuss the validity of the "obesity paradoxon" in a variety of clinical settings.

  18. Debate over patient-centered care: percutaneous coronary intervention or coronary artery bypass grafting?

    Science.gov (United States)

    Kawasuji, Michio

    2011-04-01

    Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) have developed as effective therapies to treat coronary artery disease. Initial CABG is associated with lower mortality than initial medical management, especially among high- and intermediate-risk patients with coronary artery disease. However, PCI is currently the most frequent initial treatment delivered by interventional cardiologists to treat multivessel coronary artery disease, despite substantial evidence from meta-analyses of randomized trials and registry data favoring CABG. Recent advancements in PCI did not result in detectable improvements in death or myocardial infarction compared with medical therapy, although significant reductions in target lesions or vessel revascularization were identified after implantation of a drug-eluting stent (DES) rather than a bare-metal stent. The SYNTAX trial compared patients with left main and/or three-vessel coronary artery disease treated with DES or CABG. The results of the trial demonstrated the 1-year inferiority of PCI compared with CABG with respect to major adverse cardiac and cerebrovascular events. Nevertheless, patients with coronary artery disease continue to receive more recommendations for PCI and fewer for CABG than are indicated in the guidelines. A multidisciplinary team approach should be the standard of care when recommending interventions for treating complex coronary artery disease among patients for whom CABG is superior in terms of survival and freedom from reintervention.

  19. Correlation of invasive central arterial pressure with peripheral arterial pressure and coronary sclerosis

    Institute of Scientific and Technical Information of China (English)

    吴琪

    2013-01-01

    Objective To study the consistency among non-invasive and invasive brachial artery pressure,radial artery pressure and invasive central arterial pressure,and to explore the correlation between the severe degree of coronary artery disease and invasive central aortic pressure.

  20. Factors influencing delay time and coronary arterial density during coronary angiography with DSCT

    Energy Technology Data Exchange (ETDEWEB)

    Lijun Tang; Xiaomei Zhu; Yi Xu; Tongfu Yu; Hai Xu; Jinhua Tang; Dehang Wang (Dept. of Radiology, the First Affiliated Hospital of Nanjing Medical Univ., Nanjing, Jiangsu (China)), e-mail: wangdehang@hotmail.com; Dogra, Vikram (Dept. of Radiology, Univ. of Rochester, NY (United States))

    2011-02-15

    Background: CT angiography (CTA) plays an important role in diagnosing coronary arterial disease. Delay time and density of the coronary arteries related with patient-specific factors are essential for getting an optimal CTA image. Purpose: To investigate various factors influencing delay time and coronary arterial density during coronary CTA with dual source CT. Material and Methods: One hundred and sixteen consecutive subjects who underwent cardiac DSCT with retrospective ECG-gating were included. Factors including gender, age, height, weight, transversal cardiac diameter (TCD), transversal thoracic diameter (TTD), heart rate (HR), body surface area (BSA = [weight x height/3600]1/2) and cardiothoracic ratio (CTR = TCD/TTD) were recorded, measured and calculated before administration of contrast media during coronary CT angiography. Delay time was determined as duration from the beginning of the injection to the density in the descending aorta at the level of right main pulmonary artery reaching a threshold of 100 HU. Coronary arterial density was measured at the mid portion of the right coronary artery. Regression analysis and stepwise regression analysis were used to investigate the influence of these factors on delay time and coronary arterial density. Results: Delay time decreased with an increasing HR and it was shorter in women than men. Delay time increased with an increasing TCD. Delay time could be predicted by the formula: DT = 16.651-0.110 x HR + 1.902 x gender + 0.394 x TCD (where DT is abbreviation for delay time, gender is 0 for women and 1 for men). Coronary arterial density decreased with an increasing HR and weight. Coronary arterial density could be predicted by the formula: CAD = 923.42-4.099 x HR-3.293 x weight (CAD = coronary arterial density). There was no relationship between the other factors mentioned above and delay time or coronary arterial density. Conclusion: Delay time is influenced by HR, gender and TCD. Coronary arterial density

  1. Direct communication between the left circumflex and the right coronary arteries: a very rare coronary anomaly circulation.

    Science.gov (United States)

    Oliveira, Marcos Danillo Peixoto; Cavalcanti, Rafael R César; Kajita, Alexandre H; Miranda, Thais; Kajita, Luiz J; Horta, Pedro E; Ribeiro, Expedito E; Lemos, Pedro Alves

    2016-02-01

    Coronary artery anomalies (CAA) are congenital changes in their origin, course, and/or structure. Intercoronary communication (ICC) is a very rare subset with uni- or bidirectional blood flow between two or more coronary arteries. We present the case of a 58-year-old man with an acute coronary syndrome whose coronary angiography incidentally showed a surprising and very rare communication between the right coronary and left circumflex arteries.

  2. Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Report of an Adult Case

    Directory of Open Access Journals (Sweden)

    Celso K. Takimura

    2002-03-01

    Full Text Available We report the clinical findings, pathophysiology, diagnostic characteristics, and surgical repair of anomalous origin of the left coronary artery from the pulmonary artery in a 26-year-old female patient with a clinical diagnosis of coronary heart disease.

  3. Coronary artery bypass grafting in Takayasu's disease--importance of the proximal anastomosis: a case report

    NARCIS (Netherlands)

    Kuijer, A.; Oosterhout, M.F. van; Kloppenburg, G.T.; Morshuis, W.J.

    2015-01-01

    INTRODUCTION: Treatment of coronary artery involvement in Takayasu's arteritis is challenging. Coronary artery bypass grafting may be required. The use of saphenous vein grafts is recommended because of possible inflammatory involvement of the internal thoracic arteries. However, inserting the proxi

  4. Syphilitic Coronary Artery Ostial Stenosis Resulting in Acute Myocardial Infarction Treated by Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Marcelo A. Nakazone

    2010-01-01

    Full Text Available Cardiovascular abnormalities are well-known manifestations of tertiary syphilis infections which although not frequent, are still causes of morbidity and mortality. A less common manifestation of syphilitic aortitis is coronary artery ostial narrowing related to aortic wall thickening. We report a case of a 46-year-old male admitted due to acute anterior ST elevation myocardial infarction submitted to primary percutaneous coronary intervention successfully. Coronary angiography showed a suboccluded ostial lesion of left main coronary artery. VDRL was titrated to 1/512. The patient was discharged with treatment including benzathine penicillin. Previous case reports of acute myocardial infarction in association with syphilitic coronary artery ostial stenosis have been reported, but the fact that the patient was treated by percutaneous coronary intervention is unique in this case.

  5. A head-to-head comparison of the coronary calcium score by computed tomography with myocardial perfusion imaging in predicting coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    Mansour Almoudi; Zhong-Hua Sun

    2012-01-01

    Objectives The coronary artery calcium (CAC) score has been shown to predict future cardiac events. However the extent to which the added value of a CAC score to the diagnostic performance of myocardial perfusion imaging (MPI) by single photon emission computed tomography (SPECT) is unclear. The purpose of this study is to investigate the correlation between CAC score and SPECT in patients with suspected coronary artery disease. Methods A retrospective review of the CAC scores by use of the Agatston calcium scoring method and cardiac SPECT diagnostic reports was conducted in 48 patients, who underwent both coronary computed tomography (CT) and SPECT examinations due to suspected coronary artery disease. A Pearson correlation test was used to determine the relation between CAC scores and MPI-SPECT assessments with regard to the evaluation of the extent of disease. Results Forty-seven percent of the patients had CAC scores more than 100, while 42% of these patients demonstrated abnormal, or probably abnormal, MPI-SPECT. Of the 23% of patients with a zero CAC score, only 7% had normal MPI-SPECT findings. No significant correlation was found between the CAC scores and MPISPECT assessments (r value ranged from 0.012 to 0.080), regardless of the degree of coronary calcification. Conclusions There is a lack of correlation between the CAC scores and the MPI-SPECT findings in the assessment of the extent of coronary artery disease. CAC scores and MPI-SPECT should be considered complementary approaches in the evaluation of patients with suspected coronary artery disease.

  6. Multiple giant coronary aneurysms arising from coronary istula to the pulmonary artery revealed in aorta CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Ju; Lee, Ki Nam [Dept. of Radiology, Dong A University Hospital, Dong-A University College of Medicine, Busan (Korea, Republic of); Lee, Jong Min [Dept. of Radiology, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu (Korea, Republic of)

    2015-12-15

    Coronary fistula is a rare coronary abnormality through which blood drains into the cardiac chamber, great vessel or other vessels. In addition, giant aneurysm arising from coronary fistula is rare pathologic manifestation. Herein, we presented a rare case of multiple giant coronary artery aneurysms arising from coronary to pulmonary artery fistula in a 79-year-old woman presenting with sudden loss of consciousness. The aneurysms were detected using thoracic computed tomography angiography and consequently confirmed by invasive coronary angiography.

  7. Coronary arterial complications after percutaneous coronary intervention in Behçet’s disease

    Directory of Open Access Journals (Sweden)

    Kinoshita T

    2013-02-01

    Full Text Available Toshio Kinoshita,1 Shinichiro Fujimoto,1 Yukio Ishikawa,2 Hitomi Yuzawa,1 Shunji Fukunaga,1 Mikihito Toda,3 Kenji Wagatsuma,3 Yoshikiyo Akasaka,2 Toshiharu Ishii,2 Takanori Ikeda11Department of Cardiovascular Medicine, 2Department of Pathology, 3Division of Interventional Cardiology, Toho University Faculty of Medicine, Ohta City, Tokyo, JapanAbstract: Behçet’s disease is a multisystemic vascular inflammatory disease, but concurrent cardiac diseases, such as acute myocardial infarction, are rare. Several complications may arise after coronary intervention for coronary lesions that interfere with treatment, and the incidence of coronary arterial complications due to invasive therapy remains unclear. Further, the long-term outcomes in patients with Behçet’s disease after stenting for acute myocardial infarction have not been described. The present report describes a 35-year-old Japanese man with Behçet’s disease who developed acute myocardial infarction. A coronary aneurysm developed at the stenting site of the left anterior descending coronary artery, along with stenosis in the left anterior descending segment proximal to the site. Although invasive therapy was considered, medication including immunosuppressants was selected because of the high risk of vascular complications after invasive therapy. The coronary artery disease has remained asymptomatic for the 4 years since the patient started medication. This case underscores the importance of considering the incidence of coronary arterial complications and of conservative treatment when possible.Keywords: Behçet’s disease, myocardial infarction, coronary arterial complications, percutaneous coronary intervention, immunosuppressants

  8. Hepatitis C virus infection and risk of coronary artery disease

    DEFF Research Database (Denmark)

    Roed, Torsten; Lebech, Anne-Mette; Kjaer, Andreas

    2012-01-01

    Several chronic infections have been associated with cardiovascular diseases, including Chlamydia pneumoniae, human immunodeficiency virus and viral hepatitis. This review evaluates the literature on the association between chronic hepatitis C virus (HCV) infection and the risk of coronary artery...

  9. [Psychoprophylaxis in patients after coronary artery bypass graft operations].

    Science.gov (United States)

    Rymaszewska, Joanna; Chładzińska-Kiejna, Sylwia; Górna, Renata; Kustrzycki, Wojciech

    2004-05-01

    The paper presented problems of quality of life and psychosocial functioning of patients following coronary artery bypass grafting operations. Possibilities of psychoprophylactic effects towards these patients and its efficacy were described.

  10. Multiple coronary arterial loops as a cause of myocardial ischemia

    Science.gov (United States)

    Bashour, Tali T.; Mansour, Nagi N.; Lee, Damon

    1993-01-01

    A case of long-standing angina with ischemia documented by exercise testing and thallium scintigraphy in a patient who had multiple proximal loops in all three major coronary arteries in the absence of luminal stenosis, is reported.

  11. Antiplatelet therapy at the time of coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Kremke, Michael; Tang, Mariann; Bak, Mikkel;

    2013-01-01

    OBJECTIVES: The purpose of this multicentre cohort study was to examine the relationship between antiplatelet therapy (APT) at the time of coronary artery bypass grafting (CABG) and postoperative bleeding complications, transfusion requirements and adverse cardiovascular events. METHODS: A matched...

  12. Association of arterial stiffness with coronary flow reserve in revascularized coronary artery disease patients

    Institute of Scientific and Technical Information of China (English)

    Vlassis Tritakis; Stavros Tzortzis; Ignatios Ikonomidis; Kleanthi Dima; Georgios Pavlidis; Paraskevi Trivilou; Ioannis Paraskevaidis; Giorgos Katsimaglis; John Parissis; John Lekakis

    2016-01-01

    AIM: To investigate the association of arterial wave reflection with coronary flow reserve(CFR) in coronary artery disease(CAD) patients after successful revascularization.METHODS: We assessed 70 patients with angiographically documented CAD who had undergone recent successful revascularization. We measured(1) reactive hyperemia index(RHI) using fingertip peripheral arterial tonometry(RH-PAT Endo-PAT);(2) carotid to femoral pulse wave velocity(PWVc-Complior);(3) augmentation index(AIx), the diastolic area(DAI%) and diastolic reflection area(DRA) of the central aortic pulse wave(Arteriograph);(4) CFR using Doppler echocardiography; and(5) blood levels of lipoprotein-phospholipase A2(LpPLA2).RESULTS: After adjustment for age, sex, blood pressure parameter, lipidemic, diabetic and smoking status, we found that coronary flow reserve was independently related to AIx(b =-0.38, r = 0.009), DAI(b = 0.36, P = 0.014), DRA(b = 0.39, P = 0.005) and RT(b =-0.29,P = 0.026). Additionally, patients with CFR < 2.5 had higher PWVc(11.6 ± 2.3 vs 10.2 ± 1.4 m/s, P = 0.019), SBPc(139.1 ± 17.8 vs 125.2 ± 19.1 mm Hg, P = 0.026), AIx(38.2% ± 14.8% vs 29.4% ± 15.1%, P = 0.011) and lower RHI(1.26 ± 0.28 vs 1.50 ± 0.46, P = 0.012), DAI(44.3% ± 7.9% vs 53.9% ± 6.7%, P = 0.008), DRA(42.2 ± 9.6 vs 51.6 ± 11.4, P = 0.012) and Lp PLA2(268.1 ± 91.9 vs 199.5 ± 78.4 ng/m L, P = 0.002) compared with those with CFR ≥ 2.5. Elevated Lp PLA2 was related with reduced CFR(r =-0.33, P = 0.001), RHI(r =-0.37, P < 0.001) and DRA(r =-0.35, P = 0.001) as well as increased PWVc(r = 0.34, P = 0.012) and AIx(r = 0.34, P = 0.001). CONCLUSION: Abnormal arterial wave reflections are related with impaired coronary flow reserve despite successful revascularization in CAD patients. There is a common inflammatory link between impaired aortic wall properties, endothelial dysfunction and coronary flow impairment in CAD.

  13. Transcatheter Aortic Valve Implantation Assisted with Microcatheter: A New Method to Avoid Coronary Artery Obstruction

    Institute of Scientific and Technical Information of China (English)

    Xiang Chen; Guo-Jun Chu; Fei-Yu Wang; Yu-Feng Zhu; Ben Zhang; Xian-Xian Zhao; Yong-Wen Qin

    2015-01-01

    Background:Lack of fluoroscopic landmarks can make valve deployment more difficult in patients with absent aortic valve (AV)calcification.The goal of this article was to evaluate the feasibility and effectiveness oftranscatheter implantation of a valved stent into the AV position of a goat,assisted with a microcatheter which provides accurate positioning of coronary artery ostia to help valved stent deployment.Methods:The subjects were 10 healthy goats in this study.A microcatheter was introduced into the distal site of right coronary artery (RCA)through femoral artery sheath.A minimal thoracic surgery approach was used to access the apex of the heart.The apex of the left ventricle was punctured; a delivery catheter equipped with the valved stent was introduced over a stiffguidewire into the aorta arch.We could accurately locate the RCA ostia through the microcatheter placed in the RCA under fluoroscopy.After correct valve position was confirmed,the valved stent was implanted after rapid inflation of the balloon.The immediate outcome of the function of the valved stents was evaluated after implantation.Results:All ten devices were successfully implanted into the AV position of the goats.Immediate observation after the procedure showed that the valved stents were in the desired position after implantation by angiography,echocardiogram.No obstruction of coronary artery ostia occurred,and no moderate to severe aortic regurgitation was observed.Conclusions:When the procedure of transcatheter implantation of a balloon-expandable valved stent into the AV position of goats is assisted with microcatheter positioning coronary artery ostia,the success rate of operation can be increased in those with noncalcified AV.

  14. Spontaneous coronary artery dissection as a cause of myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Aytekin; Aksakal; U?ur; Arslan; Mehmet; Yaman; Mehmet; Urumda?; Ahmet; Hakan; Ate?

    2014-01-01

    Spontaneous coronary artery dissection(SCAD) is a rare disease that is usually seen in young women in left descending coronary artery and result in events like sudden cardiac death and acute myocardial infarction. A 70-year-old man was admitted to the emergency department with chest pain which started 1 h ago during a relative’s funeral. The initial electrocardiography demonstrated 2 mm ST-segment depression in leads V1-V3 and the patient underwent emergent coronary angiography. SCAD simultaneously in two different coronary arteries [left anterior descending(LAD) artery and left circumflex(LCx)] artery was detected and SCAD in LCx artery was causing total occlusion which resulted in acute myocardial infarction. Successful stenting was performed thereafter for both lesions. In addition to the existence of SCAD simultaneously in two different coronary arteries, the presence of muscular bridge and SCAD together at the same site of the LAD artery was another interesting point which made us report this case.

  15. Association of Aortic Valve Sclerosis with Previous Coronary Artery Disease and Risk Factors

    Directory of Open Access Journals (Sweden)

    Filipe Carvalho Marmelo

    2014-11-01

    Full Text Available Background: Aortic valve sclerosis (AVS is characterized by increased thickness, calcification and stiffness of the aortic leaflets without fusion of the commissures. Several studies show an association between AVS and presence of coronary artery disease. Objective: The aim of this study is to investigate the association between presence of AVS with occurrence of previous coronary artery disease and classical risk factors. Methods: The sample was composed of 2,493 individuals who underwent transthoracic echocardiography between August 2011 and December 2012. The mean age of the cohort was 67.5 ± 15.9 years, and 50.7% were female. Results: The most frequent clinical indication for Doppler echocardiography was the presence of stroke (28.8%, and the most common risk factor was hypertension (60.8%. The most prevalent pathological findings on Doppler echocardiography were mitral valve sclerosis (37.1% and AVS (36.7%. There was a statistically significant association between AVS with hypertension (p < 0.001, myocardial infarction (p = 0.007, diabetes (p = 0.006 and compromised left ventricular systolic function (p < 0.001. Conclusion: Patients with AVS have higher prevalences of hypertension, stroke, hypercholesterolemia, myocardial infarction, diabetes and compromised left ventricular systolic function when compared with patients without AVS. We conclude that there is an association between presence of AVS with previous coronary artery disease and classical risk factors.

  16. Intake of fish and marine n-3 fatty acids in relation to coronary calcification: the Rotterdam Study

    NARCIS (Netherlands)

    Heine-Bröring, R.C.; Brouwer, I.A.; Vliegenthart, P.R.; Rooij, van F.J.A.; Hofman, A.; Oudkerk, M.; Witteman, J.C.M.; Geleijnse, J.M.

    2010-01-01

    Background: Epidemiologic and experimental data suggest a cardioprotective effect of n–3 (omega-3) fatty acids from fish [eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA)]. Objective: The objective was to examine the association of fish and EPA plus DHA intakes with coronary calcification

  17. Off-pump coronary artery bypass grafting or percutaneous transluminal coronary angioplasty with stenting for proximal left anterior descending coronary artery disease?

    NARCIS (Netherlands)

    Drenth, Derk Jan

    2005-01-01

    This thesis describes and discusses the results of a prospective randomized controlled clinical trial comparing percutaneous coronary angioplasty with stenting (stenting) and off-pump coronary artery bypass grafting with a left internal mammary artery (surgery) in patients with a high-grade stenosis

  18. Off-pump coronary artery bypass grafting or percutaneous transluminal coronary angioplasty with stenting for proximal left anterior descending coronary artery disease?

    NARCIS (Netherlands)

    Drenth, Derk Jan

    2005-01-01

    This thesis describes and discusses the results of a prospective randomized controlled clinical trial comparing percutaneous coronary angioplasty with stenting (stenting) and off-pump coronary artery bypass grafting with a left internal mammary artery (surgery) in patients with a high-grade stenosis

  19. Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy

    OpenAIRE

    2012-01-01

    Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year...

  20. The clinical application of clopidogrel in current coronary artery surgery

    Institute of Scientific and Technical Information of China (English)

    Yangyang Zhang; Kejiang Cao

    2008-01-01

    The article presents an overview of the current clinical application of clopidogrel in coronary artery surgery. The viewpoint is that clopidogrel can reduce preoperative and postoperative ischemic events of coronary artery bypass grafting(CABG). With the development of standardized medication and the corresponding preventive technique, it will be of great value to reduce hemorrhage complications and obtain the maximum benefit from clopidogrel' s anti-platelet properties.

  1. Acoustic Coupler for the Acquisition of Coronary Artery Murmurs

    DEFF Research Database (Denmark)

    Zimmermann, Niels Henrik; Schmidt, Samuel; Hansen, John

    The weak murmurs originating from stenosis in the coronary arteries can only be acquired with a dedicated coupler and system design. The aim of the study was to design and evaluate such a coupler. The suggested design is based on the use of a high quality microphone, coupled to the chest through...... that the sensor is suitable for recording of coronary murmurs....

  2. Aspects on the treatment of experimentally induced coronary artery disease

    NARCIS (Netherlands)

    L.M. Sassen

    1990-01-01

    textabstractIn this thesis some therapeutic aspects of experimentally induced coronary artery disease are being highlighted. In chapter 2 the effects of the Ca2 • antagonist diltiazem on the progression of coronary and aortic atherosclerosis in pigs is being studied. So far, studies on the

  3. Risk stratification of patients suspected of coronary artery disease

    DEFF Research Database (Denmark)

    Jensen, Jesper Møller; Voss, Mette; Hansen, Vibeke B;

    2012-01-01

    To compare the performance of five risk models (Diamond-Forrester, the updated Diamond-Forrester, Morise, Duke, and a new model designated COronary Risk SCORE (CORSCORE) in predicting significant coronary artery disease (CAD) in patients with chest pain suggestive of stable angina pectoris....

  4. Coronary artery fly-through using electron beam computed tomography

    NARCIS (Netherlands)

    van Ooijen, P M; Oudkerk, M; van Geuns, R J; Rensing, B J; de Feyter, P J

    2000-01-01

    BACKGROUND: Virtual reality techniques have recently been introduced into clinical medicine. This study examines the possibility of coronary artery fly-through using a dataset obtained by noninvasive coronary angiography with contrast-enhanced electron-beam computed tomography. METHODS AND RESULTS:

  5. Coronary Artery Fly-Through Using Electron Beam Computed Tomography

    NARCIS (Netherlands)

    P.M.A. van Ooijen (Peter); M. Oudkerk (Matthijs); R.J.M. van Geuns (Robert Jan); B.J.W.M. Rensing (Benno); P.J. de Feyter (Pim)

    2000-01-01

    textabstractBACKGROUND: Virtual reality techniques have recently been introduced into clinical medicine. This study examines the possibility of coronary artery fly-through using a dataset obtained by noninvasive coronary angiography with contrast-enhanced electron-beam computed tom

  6. Spontaneous coronary artery dissection: complete angiographic resolution without stenting

    Directory of Open Access Journals (Sweden)

    Alexandre Abizaid

    2007-09-01

    Full Text Available A case of spontaneous coronary artery dissection in a 49-year-oldwoman is presented. She did not present the classical cardiovascular riskfactors. Etiology and treatment are discussed. She underwent primarypercutaneous coronary intervention of the left anterior descendingartery with no stenting and had complete angiographic resolution.

  7. Recurrent Syncope Attributed to Left Main Coronary Artery Severe Stenosis

    Directory of Open Access Journals (Sweden)

    Min Li

    2015-01-01

    Full Text Available Patients with acute coronary syndrome (ACS rarely manifest as recurrent syncope due to malignant ventricular arrhythmia. We report a case of a 56-year-old Chinese male with complaints of paroxysmal chest burning sensation and distress for 2 weeks as well as loss of consciousness for 3 days. The electrocardiogram (ECG revealed paroxysmal multimorphologic ventricular tachycardia during attack and normal heart rhythm during intervals. Coronary angiograph showed 90% stenosis in left main coronary artery and 80% stenosis in anterior descending artery. Two stents sized 4.0*18 mm and 2.75*18 mm were placed at left main coronary artery and anterior descending artery, respectively, during percutaneous coronary intervention (PCI. The patient was discharged and never had ventricular arrhythmia again during a 3-month follow-up since the PCI. This indicated that ventricular tachycardia was correlated with persistent severe myocardial ischemia. Coronary vasospasm was highly suspected to be the reason of the sudden attack and acute exacerbation. PCI is recommended in patients with both severe coronary artery stenosis and ventricular arrhythmia. Removing myocardial ischemia may stop or relieve ventricular arrhythmia and prevent cardiac arrest.

  8. Low prevalence of significant carotid artery disease in Iranian patients undergoing elective coronary artery bypass

    Directory of Open Access Journals (Sweden)

    Karimi Fatemeh

    2007-01-01

    Full Text Available Abstract Background Coronary artery bypass grafting ranks as one of the most frequent operations worldwide. The presence of carotid artery stenosis may increase the stroke rate in the perioperative period. Routine preoperative noninvasive assessment of the carotid arteries are recommended in many institutions to reduce the stroke rate. Methods 271 consecutive patients undergoing coronary artery bypass grafting at Shaheed Madani hospital of Tabriz, Iran (age, 58.5 Y; 73.1% male underwent preoperative ultrasonography for assessment of carotid artery wall thickness. Results Plaque in right common, left common, right internal and left internal carotid arteries was detected in 4.8%, 7.4%, 43.2% and 42.1% of patients respectively. 5 patients (1.8% had significant ( Conclusion Consecutive Iranian patients undergoing elective coronary artery bypass surgery show a very low prevalence of significant carotid artery disease.

  9. A case of anomalous coronary artery origin: The role of computerised tomography

    Directory of Open Access Journals (Sweden)

    Jeeva John

    2016-01-01

    Full Text Available Objective: To illustrate the utility of CT coronary angiography in the assessment of patients with anomalous coronary arteries. Methods: A 65-year-old woman who presented with a clinical history of unstable angina was investigated with both computerised tomography and invasive coronary angiography. Results: Coronary angiography demonstrated aberrant coronary arteries all arising from separate ostia from the right coronary cusp. Computerised tomography coronary angiography was required to confirm the course of the aberrant coronary arteries in relation to other cardiovascular structures. Conclusions: This case illustrates the important role of computerised tomography coronary angiography and that early use might avoid the need for invasive coronary angiography.

  10. Risk of coronary artery involvement in Kawasaki disease.

    Science.gov (United States)

    Soriano-Ramos, María; Martínez-Del Val, Elena; Negreira Cepeda, Sagrario; González-Tomé, María I; Cedena Romero, Pilar; Fernández-Cooke, Elisa; Albert de la Torre, Leticia; Blázquez-Gamero, Daniel

    2016-04-01

    Kawasaki disease refers to systemic vasculitis with risk of coronary artery disease. Our objective is to identify risk factors associated with coronary artery disease in patients with complete and incomplete Kawasaki disease. Descriptive, retrospective study conducted in patients diagnosed with Kawasaki disease in a tertiary-care hospital between 2008 and 2014. The American Heart Association diagnostic criteria were used to define complete and incomplete Kawasaki disease. Thirty-one children were diagnosed with Kawasaki disease; 24 met the criteria for the complete form, and 7, for the incomplete form of this condition. Five had coronary artery disease. One of them had incomplete Kawasaki disease (1/7= 14.3%), and the remaining four had the complete form (4/24= 16.7%). No significant differences were found between both groups (p= 1.0). Patients with coronary artery involvement had a higher C-reactive protein level (median: 16.2 mg/dL versus 8.4 mg/dL, p= 0.047) and lower albuminemia (median: 3.2 mg/dL versus 3.99 mg/dL, p= 0.002). The risk of coronary artery involvement in incomplete Kawasaki disease is similar to that in complete Kawasaki disease; therefore, in patients with the incomplete form, immunoglobulin therapy should not be delayed. In our population, C-reactive protein and albumin levels were related to a higher risk of coronary artery involvement. Sociedad Argentina de Pediatría.

  11. Detection of coronary artery disease with MCG.

    Science.gov (United States)

    Hailer, B; Van Leeuwen, P

    2004-11-30

    The diagnosis of cardiac ischemia related to coronary artery disease (CAD) is a clinical challenge. Despite many methods clinically available, the predictive value of each is still limited. Magnetocardiography (MCG) offers new insights in the electrogenesis of the disease. In the last decade a number of studies using biomagnetometers have dealt with the identification of CAD patients using coronary angiography as a gold standard. As the availability of these systems is limited, studies have focused either on exercise-induced ischemia or on chronic ischemia and the infarct scar at rest. Different parameters have been developed based on signal morphology, time intervals, source parameters or magnetic field map analysis. Concerning signal morphology, main work concentrates on ST-depression, ST-T signal amplitude as well as QRS and ST-T integrals. Dealing with time intervals, most studies focus on the QT interval. The evaluation of of QT dispersion spatially in the MCG, reflecting regional heterogeneity of repolarization, improved the identification of CAD patients. Besides the calculation of the equivalent current dipole during de- and repolarization, parameters of the magnetic field orientation were used to identify CAD patients and localize exercise-induced ischemic regions. Heart rate adjusted alteration in the magnetic field orientation allowed the quantification of ischemia-induced changes in MCG. The estimation of current density (CDV) further enabled to separate healthy subjects from CAD patients at rest. In the course of interventional therapy CDV maps returned toward that of healthy subjects.Thus, there is justification for routine clinical use of the MCG in the diagnosis of CAD.

  12. CORONARY ARTERY DISEASE IN INDIAN WOMEN

    Directory of Open Access Journals (Sweden)

    Mohammed Umar Farooque

    2017-05-01

    Full Text Available BACKGROUND Cardiovascular disease is the leading cause of death among women regardless of race or ethnicity accounting for deaths of 1 in 3 women. The aim of the study is to identify the important risk factors contributing to the coronary artery disease in Indian women. MATERIALS AND METHODS Study conducted on 120 women patients of age >40 yrs. visiting a female outpatient department of Jawahar Lal Nehru Medical College, Bhagalpur, who presented with complaints related to CAD cases diagnosed from the electrocardiogram findings, clinical features and biochemical marker as per World Health Organization guidelines. RESULTS 50-59 years age group is most effected group in study with 44.2%. Most of the women are of postmenopausal age group. The maximum number of cases was seen in upper lower socioeconomic status (37.5% followed by lower (19.2%. CAD incidence was minimum in upper class. Chest pain was the main complaint in patients, next in frequency was sweating and followed by breathlessness. The major risk factors in the study group were hypertension (74.1, diabetes (63.3, sedentary habits (49.1, stress (34.2, family history (29.2 and tobacco consumption (21.8. 25 patients had obesity and 54 peoples were overweight. In our study, 48 patients had 3 children, 19 had more than 3 children. 61.7% of the patients are with hypercholesterolaemia, which most of the patients found with 2 vessel block is most common blocks observed. CONCLUSION Despite this delay in onset, mortality from coronary heart disease is increasing more rapidly among women than men.

  13. RELATIONS OF ENDOTHELIAL FUNCTION AND BLOOD FLOW IN BRACHIAL ARTERY AND CORONARY ARTERY

    Institute of Scientific and Technical Information of China (English)

    孙寅光; 沈卫峰; 施仲伟; 张大东

    2003-01-01

    Objective To determine the relations between endothelium dependent vasodilator function and blood flow in the brachial and coronary arteries in patients with suspected coronary artery disease.MethodsTwenty eight patients with suspected coronary artery disease underwent brachial artery endothelial function test by using high resolution B mode ultrasound before coronary angiography (CAG) and coronary flow reserve (CFR) test by using intracoronary Doppler technique. The correlation of coronary artery dilatation induced by an increase in blood flow after intracoronary adenosine infusion and brachial artery flow mediated dilatation (FMD) following reactive hyperemia was evaluated. The relation between the change of brachial artery blood flow and CFR was also studied.ResultsThere was a positive correlation between brachial FMD and percent change of coronary diameter after adenosine infusion (12.50%±9.35% vs 11.38%±7.55%, r=0.425,P=0.02). There was also a weak negative relation between brachial flow change following reactive hyperemia and CFR (r=0.397, P=0.04).ConclusionThere is a correlation between the coronary endothelial function and the CFR by ultrasonic determination of brachial flow changes following reactive hyperemia.

  14. Right pulmonary artery agenesis and coronary-to-bronchial artery aneurysm.

    Science.gov (United States)

    De Dominicis, Florence; Leborgne, Laurent; Raymond, Alexandre; Berna, Pascal

    2011-03-01

    Isolated unilateral pulmonary artery agenesis is a rare congenital anomaly that may be complicated with hemoptysis, recurrent pulmonary infections or pulmonary hypertension. To our knowledge the occurrence of a coronary syndrome associated with a coronary-to-bronchial artery saccular aneurysmal collateralization has never been described before. A 44-year-old female presented a congenital right pulmonary artery agenesis associated with a hypotrophic and multicystic right lung complicated with recurrent bronchitis. This patient had a coronary syndrome for which the coronary artery imaging showed a coronary-to-bronchial artery collateralization with an aneurysm at this level. It gives rise to a coronary syndrome by coronary steal. Two bronchial collaterals arising from a diaphragmatic artery and the subclavian artery were also found on the computed tomography (CT)-scan. This last collateral also showed another saccular aneurysm. We first performed an embolization of those two aneurysms in order to decrease the risk of hemorrhage and coronary steal, before performing a right pneumonectomy. In this case, the surgery was indicated because of the pathological lung and the risk of postembolization ischaemia. The postoperative course was uneventful and the patient was doing well six months later.

  15. Global metabolic optimality in the structure of the coronary arteries

    CERN Document Server

    Keelan, Jonathan; Hague, James P

    2014-01-01

    The structure of the large coronary arteries is both heritable and reasonably consistent between individuals, but the extent to which this results from evolutionary pressure towards an energy-efficient, globally-optimal, structure is unknown. We present an algorithm for the determination of an energetically globally optimal arterial tree in arbitrary tissue geometries. We demonstrate through application of the algorithm that it is possible to generate in-silico vasculatures that closely match porcine anatomical data on all length scales. We therefore conclude that evolutionary pressure has resulted in a near globally optimal structure of the larger coronary arteries. We also examine the effect of changing length scales, predicting that the structures of the coronary arteries can change from a meandering form for small animals to very straight vessels for large animals. The method presented here is not limited to hearts, and represents a major advance in modeling the arterial vasculature, that could have impor...

  16. Coronary Artery Development: Progenitor Cells and Differentiation Pathways

    Science.gov (United States)

    Sharma, Bikram; Chang, Andrew; Red-Horse, Kristy

    2017-01-01

    Coronary artery disease (CAD) is the number one cause of death worldwide and involves the accumulation of plaques within the artery wall that can occlude blood flow to the heart and cause myocardial infarction. The high mortality associated with CAD makes the development of medical interventions that repair and replace diseased arteries a high priority for the cardiovascular research community. Advancements in arterial regenerative medicine could benefit from a detailed understanding of coronary artery development during embryogenesis and of how these pathways might be reignited during disease. Recent research has advanced our knowledge on how the coronary vasculature is built and revealed unexpected features of progenitor cell deployment that may have implications for organogenesis in general. Here, we highlight these recent findings and discuss how they set the stage to interrogate developmental pathways during injury and disease. PMID:27959616

  17. [Exrercise tolerance in patients with coronary artery disease after coronary artery stenting].

    Science.gov (United States)

    Tseluyko, V; Kreyndel, K; Vashakidze, Z

    2014-01-01

    The aim of the research is to investigate the impact of coronary stenting on exercise tolerance after 4-8 week and after 12-15 months. The study involved total 90 patients with coronary artery disease, who underwent coronary stenting. All patients underwent clinical examination, including an assessment of their condition, the frequency of angina attacks, echocardioscopy, resting ECG was recorded in all the patients in the standard 12 -lead veloergometry. Statistical processing was performed using Statistica 6.0 for Windows, the method of Wald - Wolfowitz . Data are presented as arithmetic means and error average M ± m. We used a statistical method of calculation - the median ranks (with the median calculated by the usual rules of statistics - the arithmetic mean of the central members of the ordered series). Significant differences were assessed by t-test . The level of significance was considered significant when p <0,05. According to the monitoring data of patients have a significant increase in exercise tolerance: threshold power increased by 63% and in 12-15 months by 58 % compared with the original. The duration of the test conducted after stenting increased by almost 2 -fold. In addition, significantly reduced the proportion of patients whose test results were evaluated as positive. Stenting of the coronary arteries after 4-8 weeks promotes the significant increase in exercise tolerance that persists after 12-15 months. The factors of associated with insufficient increase in exercise tolerance after stenting according veloergometry are: female gender, diabetes, smoking cessation further contributes to the increase in the threshold of physical activity.

  18. Computerized analysis of coronary artery disease: Performance evaluation of segmentation and tracking of coronary arteries in CT angiograms

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Chuan, E-mail: chuan@umich.edu; Chan, Heang-Ping; Chughtai, Aamer; Kuriakose, Jean; Agarwal, Prachi; Kazerooni, Ella A.; Hadjiiski, Lubomir M.; Patel, Smita; Wei, Jun [Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109 (United States)

    2014-08-15

    Purpose: The authors are developing a computer-aided detection system to assist radiologists in analysis of coronary artery disease in coronary CT angiograms (cCTA). This study evaluated the accuracy of the authors’ coronary artery segmentation and tracking method which are the essential steps to define the search space for the detection of atherosclerotic plaques. Methods: The heart region in cCTA is segmented and the vascular structures are enhanced using the authors’ multiscale coronary artery response (MSCAR) method that performed 3D multiscale filtering and analysis of the eigenvalues of Hessian matrices. Starting from seed points at the origins of the left and right coronary arteries, a 3D rolling balloon region growing (RBG) method that adapts to the local vessel size segmented and tracked each of the coronary arteries and identifies the branches along the tracked vessels. The branches are queued and subsequently tracked until the queue is exhausted. With Institutional Review Board approval, 62 cCTA were collected retrospectively from the authors’ patient files. Three experienced cardiothoracic radiologists manually tracked and marked center points of the coronary arteries as reference standard following the 17-segment model that includes clinically significant coronary arteries. Two radiologists visually examined the computer-segmented vessels and marked the mistakenly tracked veins and noisy structures as false positives (FPs). For the 62 cases, the radiologists marked a total of 10191 center points on 865 visible coronary artery segments. Results: The computer-segmented vessels overlapped with 83.6% (8520/10191) of the center points. Relative to the 865 radiologist-marked segments, the sensitivity reached 91.9% (795/865) if a true positive is defined as a computer-segmented vessel that overlapped with at least 10% of the reference center points marked on the segment. When the overlap threshold is increased to 50% and 100%, the sensitivities were 86

  19. Calciphylaxis: Temporal Artery Calcification Preceding Widespread Skin Lesions and Penile Necrosis

    Directory of Open Access Journals (Sweden)

    Manzoor A. Shah

    2012-01-01

    Full Text Available Temporal artery calciphylaxis has rarely been described in chronic kidney disease patients on dialysis. We report a case of 72-year-old Caucasian man with multiple comorbidities and end-stage renal disease on dialysis who presented with temporal artery calcification leading to bilateral loss of vision followed by extensive skin lesions including one on glans penis. While on peritoneal dialysis, he developed anterior ischemic optic neuropathy, had no improvement on high dose steroids, and temporal artery biopsy showed marked calcification without any evidence of vasculitis. Few weeks later on hemodialysis, he developed widespread cutaneous lesions on extremities and penile necrosis with skin biopsy revealing calciphylaxis. On literature review of calciphylaxis in chronic kidney disease, we found only four cases of temporal artery calciphylaxis leading to anterior ischemic optic neuropathy and blindness. We believe this is the first case in which the rare temporal artery calciphylaxis and the uncommon penile necrosis are being described together. The objective is to emphasize the need to recognize this condition early in the CKD patients on dialysis presenting with visual symptoms as the different treatment strategies may help prevent complete loss of vision and also modify or prevent a full blown calciphylaxis.

  20. Testosterone Treatment and Coronary Artery Plaque Volume in Older Men With Low Testosterone

    Science.gov (United States)

    Budoff, Matthew J.; Ellenberg, Susan S.; Lewis, Cora E.; Mohler, Emile R.; Wenger, Nanette K.; Bhasin, Shalender; Barrett-Connor, Elizabeth; Swerdloff, Ronald S.; Stephens-Shields, Alisa; Cauley, Jane A.; Crandall, Jill P.; Cunningham, Glenn R.; Ensrud, Kristine E.; Gill, Thomas M.; Matsumoto, Alvin M.; Molitch, Mark E.; Nakanishi, Rine; Nezarat, Negin; Matsumoto, Suguru; Hou, Xiaoling; Basaria, Shehzad; Diem, Susan J.; Wang, Christina; Cifelli, Denise; Snyder, Peter J.

    2017-01-01

    IMPORTANCE Recent studies have yielded conflicting results as to whether testosterone treatment increases cardiovascular risk. OBJECTIVE To test the hypothesis that testosterone treatment of older men with low testosterone slows progression of noncalcified coronary artery plaque volume. DESIGN, SETTING, AND PARTICIPANTS Double-blinded, placebo-controlled trial at 9 academic medical centers in the United States. The participants were 170 of 788 men aged 65 years or older with an average of 2 serum testosterone levels lower than 275 ng/dL (82 men assigned to placebo, 88 to testosterone) and symptoms suggestive of hypogonadism who were enrolled in the Testosterone Trials between June 24, 2010, and June 9, 2014. INTERVENTION Testosterone gel, with the dose adjusted to maintain the testosterone level in the normal range for young men, or placebo gel for 12 months. MAIN OUTCOMES AND MEASURES The primary outcome was non calcified coronary artery plaque volume, as determined by coronary computed tomographic angiography. Secondary outcomes included total coronary artery plaque volume and coronary artery calcium score (range of 0 to >400 Agatston units, with higher values indicating more severe atherosclerosis). RESULTS Of 170 men who were enrolled, 138 (73 receiving testosterone treatment and 65 receiving placebo) completed the study and were available for the primary analysis. Among the 138 men, the mean (SD) age was 71.2 (5.7) years, and 81%were white. At baseline, 70 men (50.7%) had a coronary artery calcification score higher than 300 Agatston units, reflecting severe atherosclerosis. For the primary outcome, testosterone treatment compared with placebo was associated with a significantly greater increase in noncalcified plaque volume from baseline to 12 months (from median values of 204 mm3 to 232 mm3 vs 317 mm3 to 325 mm3, respectively; estimated difference, 41 mm3; 95%CI, 14 to 67 mm3; P = .003). For the secondary outcomes, the median total plaque volume increased

  1. Plasminogen and fibrinogen plasma levels in coronary artery disease

    Science.gov (United States)

    Lima, Luciana Moreira; Carvalho, Maria das Graças; Sousa, Marinez de Oliveira

    2012-01-01

    Objective The formation of thrombi at the site of atherosclerotic lesions plays a central role in atherothrombosis. Impaired fibrinolysis may exacerbate pre-existing coronary artery disease and potentiate its evolution. While the fibrinogen plasma level has been strongly associated with the severity of coronary artery disease, its relevance in the evaluation of plasminogen in coronary artery disease patients remains unclear. This study evaluated fibrinogen and plasminogen levels in subjects with coronary artery disease as diagnosed by angiography. Methods This is a cross-sectional study. Blood samples obtained from 17 subjects with angiographically normal coronary arteries (controls), 12 with mild/moderate atheromatosis and 28 with severe atheromatosis were evaluated. Plasma plasminogen and fibrinogen levels were measured by chromogenic and coagulometric methods, respectively. Results Fibrinogen levels were significantly higher in the severe atheromatosis group compared to the other groups(p-value < 0.0001). A significant positive correlation was observed between the severity of coronary artery diseaseand increasing fibrinogen levels (r = 0.50; p-value < 0.0001) and between fibrinogen and plasminogen levels (r =0.46; p-value < 0.0001). There were no significant differences in the plasminogen levels between groups. Conclusion Plasma fibrinogen, but not plasminogen levels were higher in patients with coronary artery disease compared to angiographically normal subjects. The plasma fibrinogen levels also appear to be associated with the severity of the disease. The results of this study provide no evidence of a significant correlation between plasma plasminogen levels and the progress of coronary stenosis in the study population. PMID:23049444

  2. Two-vessel coronary artery dissection in the peripartum period. Case report and literature review.

    Science.gov (United States)

    Madu, E C; Kosinski, D J; Wilson, W R; Burket, M W; Fraker, T D; Ansel, G M

    1994-09-01

    The authors report a case of early peripartum myocardial infarction resulting from spontaneous dissection of the left anterior descending coronary artery and right coronary artery in a twenty-four-year-old woman. This is the first report of double-vessel coronary dissection involving both the left and right coronary arteries diagnosed antemortem and successfully treated.

  3. Systematic comparison of the effectiveness of radial artery and saphenous vein or right internal thoracic artery coronary bypass grafts in non-left anterior descending coronary arteries

    Institute of Scientific and Technical Information of China (English)

    Xiang HU; Qiang ZHAO

    2011-01-01

    Coronary artery bypass grafting surgery is increasingly being carried out on patients with multi-vessel coronary artery disease, but the best grafting candidate for non-left antetior descending coronary arteries is unclear.This research sought to systematically compare the efficacies and safeties of coronary bypass with radial artery and other available grafts. A systematic literature retrieval was performed for all clinical trials comparing the outcomes of coronary artery bypass surgery with radial artery and other grafts in PubMed, EMBASE, and the Cochrane Library.Seven eligible clinical studies, comparing radial artery and great saphenous vein grafts, were found between 1966 and 2010: one prospective non-randomized and six prospective randomized trials. The pooling analysis obtained a relative risk of 0.507 (P<0.05) of graft occlusion in radial arteries compared with great saphenous veins. There was a significantly lower infection rate in arms (i.e., harvest sites for radial arteries) relative to legs (harvest sites for veins), with a pooled relative risk of 0.140 (P<0.05). From the reports on mortality after follow-up ranging from one year to six years,there was no significant difference in mortality between the two graft types (P=0.927). In addition, four cohort controlled trials for radial and right internal thoracic artery grafts were included. The radial graft was associated with less cardiac related events relative to the right intemal thoracic artery graft (P=0.014), but with comparable mortality and comparable rates of repeat percutaneous transluminal coronary angioplasty. Subjects with radial arteries seemed to have a lower occlusion rate and a lower graft harvest site infection rate than those with great saphenous veins. Moreover there were fewer cardiac related events with radial arteries relative to the right internal thoracic artery grafts. More studies are needed to confirm these findings concerning the favorable outcomes of coronary artery

  4. Aortic arch calcification on chest X-ray combined with coronary calcium score show additional benefit for diagnosis and outcome in patients with angina

    Science.gov (United States)

    Woo, Jong Shin; Kim, Weon; Kwon, Se Hwan; Youn, Hyo Chul; Kim, Hyun Soo; Kim, Jin Bae; Kim, Soo Joong; Kim, Woo-Shik; Kim, Kwon Sam

    2016-01-01

    Background The coronary artery calcium (CAC) and aortic arch calcification (AoAC) are individually associated with cardiovascular disease and outcome. This study investigated the predictive value of AoAC combined with CAC for cardiovascular diagnosis and outcome in patients with angina. Methods A total of 2018 stable angina patients who underwent chest X-ray and cardiac multi-detector computed tomography were followed up for four years to assess adverse events, which were categorized as cardiac death, stroke, myocardial infarction, or repeated revascularization. The extent of AoAC on chest X-ray was graded on a scale from 0 to 3. Results During the four years of follow-up, 620 patients were treated by coronary stenting and 153 (7%) adverse events occurred. A higher grade of AoAC was associated with a higher CAC score. Cox regression showed that the CAC score, but not AoAC, were associated with adverse events. In patients with CAC score AoAC showed an additive predictive value in detecting significant coronary artery disease (CAD). A gradual increases in the risk of adverse events were noted if AoAC was present in patients with similar CAC score. Conclusions As AoAC is strongly correlated with the CAC score regardless of age or gender, careful evaluation of CAD would be required in patients with AoAC on conventional chest X-rays. PMID:27103916

  5. Advances in nanotechnology for the management of coronary artery disease.

    Science.gov (United States)

    Rhee, June-Wha; Wu, Joseph C

    2013-02-01

    Nanotechnology holds tremendous potential to advance the current treatment of coronary artery disease. Nanotechnology may assist medical therapies by providing a safe and efficacious delivery platform for a variety of drugs aimed at modulating lipid disorders, decreasing inflammation and angiogenesis within atherosclerotic plaques, and preventing plaque thrombosis. Nanotechnology may improve coronary stent applications by promoting endothelial recovery on a stent surface utilizing bio-mimetic nanofibrous scaffolds, and also by preventing in-stent restenosis using nanoparticle-based delivery of drugs that are decoupled from stents. Additionally, nanotechnology may enhance tissue-engineered graft materials for application in coronary artery bypass grafting by facilitating cellular infiltration and remodeling of a graft matrix.

  6. Total occlusion of left main coronary artery without angina pectoris.

    Science.gov (United States)

    DePace, N L; Kimbiris, D; Iskandrian, A S; Bemis, C E; Segal, B L

    1983-05-01

    A patient had total occlusion of the left main coronary artery that was proved by coronary arteriography. The patient was initially seen with clinical signs of congestive heart failure but without symptoms of angina pectoris or ECG evidence of myocardial infarction. The patient's extensive right-to-left coronary artery collaterals may have contributed to the absence of chest pain. Because of the severe left ventricular dysfunction and the absence of chest pain, the patient was treated with medical therapy. Six months after the cardiac catheterization, he was alive and well under New York Heart Association functional classification II.

  7. Revascularization using satellite vein after radial artery harvested for coronary artery bypass grafting.

    Science.gov (United States)

    Gon, Shigeyoshi; Yoshida, Shigehiko; Sanae, Tsutomu; Takahashi, Tamami; Inada, Eiichi

    2006-06-01

    The radial artery has been increasingly used for coronary artery bypass grafting and has excellent long-term patency rates. Hand claudication is one of the adverse effects after radial artery harvest. We reconstructed a radial artery using the satellite vein to prevent hand claudication. Pulsating blood flow at 35 cm/sec was evaluated using color Doppler echocardiography three months after surgery. This method makes it possible to use a radial artery in patients with a positive Allen test.

  8. Coronary CT Angiography in Coronary Artery Disease: Correlation between Virtual Intravascular Endoscopic Appearances and Left Bifurcation Angulation and Coronary Plaques

    Directory of Open Access Journals (Sweden)

    Zhonghua Sun

    2013-01-01

    Full Text Available The aim of this study is to investigate the relationship between intraluminal appearances of coronary plaques and left coronary bifurcation angle and plaque components using coronary CT virtual intravascular endoscopy (VIE. Fifty patients suspected of coronary artery disease undergoing coronary CT angiography were included in the study. The left bifurcation angle in patients with diseased left coronary artery which was measured as 94.3° ± 16.5 is significantly larger than that in patients with normal left coronary artery, which was measured as 76.5° ± 15.9 (P<0.001. Irregular VIE appearances were found in 10 out of 11 patients with mixed plaques in the left anterior descending (LAD and left circumflex (LCx, while, in 29 patients with calcified plaques in the LAD and LCx, irregular VIE appearances were only noticed in 5 patients. Using 80° as a cut-off value to determine coronary artery disease, smooth VIE appearances were found in 95% of patients (18/19 with left bifurcation angle of less than 80°, while irregular VIE appearances were observed in nearly 50% of patients (15/31 with left bifurcation angle of more than 80°. This preliminary study shows that VIE appearances of the coronary lumen are directly related to the types of plaques.

  9. [Emergency coronary artery bypass grafting for acute myocardial infarction presenting as cardio-pulmonary arrest during a marathon race; report of a case].

    Science.gov (United States)

    Umeda, Yukio; Imaizumi, Matsuhisa; Okada, Waichiro; Yokoya, Hirokazu; Tanaka, Tsuneo

    2014-10-01

    We report a case of coronary artery bypass grafting for acute myocardial infarction which presented as cardio-pulmonary arrest during a marathon race. A 57-year-old man collapsed at the 18-km point in the Toyohashi half marathon. He was treated with an automated electrical defibrillator( AED) for ventricular fibrillation in an ambulance. Immediately after arriving at our emergency department, he was diagnosed with acute myocardial infarction by electrocardiography. Emergency coronary angiography revealed severe stenosis of the left anterior descending artery. Percutaneous coronary intervention was tried, but it was given up because calcification of the stenotic lesion was severe. He was then referred to our department for emergency coronary artery bypass grafting. Complete re-vascularization was accomplished and the patient has been doing well with no signs of angina.

  10. Woven right coronary artery: a case report and review of the literature.

    Science.gov (United States)

    Iyisoy, Atila; Celik, Turgay; Yuksel, U Cagdas; Isik, Ersoy

    2010-07-01

    Woven coronary artery is an extremely rare and is still not a clearly defined coronary anomaly in which epicardial coronary artery is divided into multiple thin channels at any segment of the coronary artery, and subsequently, these multiple channels merge again in a normal conduit. A few cases have been reported till now. In this case report, we present a 58-year-old male with a woven right coronary artery.

  11. Noninvasive assessment of coronary artery disease.

    Science.gov (United States)

    DePace, N L; Hakki, A H; Weinreich, D J; Iskandrian, A S

    1983-10-01

    This study determines whether a mathematical model can be used to assess noninvasively the extent of coronary artery disease (CAD). The model was based on stepwise multivariate discriminant analysis of data obtained in 99 patients from clinical and nonhemodynamic exercise variables, or from radionuclide determination of left ventricular function at rest or during exercise, or both. The extent of CAD was assessed by a scoring system and by the number of diseased vessels. The variables selected by this method (Q-wave infarction, exercise LV ejection fraction, change in systolic blood pressure from rest to exercise, sex and diabetes mellitus) yielded a predictive accuracy of 82% for the identification of patients with extensive CAD (score greater than or equal to 35). Slightly better results were achieved by a subgroup of 77 patients who had adequate exercise end points (exercise heart rate greater than or equal to 120 beats/min, or angina or ST depression during exercise). In these patients, the predictive accuracy was 84%. The model also identified patients with "light" CAD (score less than or equal to 10) with a predictive accuracy of 82%. Thus, noninvasive assessment of the extent of CAD is possible with a stepwise multivariate discriminant analysis of clinical, electrocardiographic and left ventricular function assessed by radionuclide ventriculography at rest and during exercise. The scoring system was superior to the conventional method of classifying patients according to the number of diseased vessels.

  12. Spontaneous coronary artery dissection causing acute coronary syndrome in a young patient without risk factors

    Directory of Open Access Journals (Sweden)

    Parag Chevli

    2014-09-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a rare cause of acute myocardial infarction that is more common in younger patients (under age 50 and in women. Although the etiology is not known, some predisposing conditions to SCAD are well known and include Marfan syndrome, pregnancy and peripartum state, drug abuse, and some anatomical abnormalities of the coronary arteries such as aneurysms and severe kinking. We describe a case of SCAD in a young woman who presented with sudden onset of chest pain and was admitted for the treatment of acute coronary syndrome. The coronary angiography showed dissection of the left anterior descending artery. The patient underwent successful percutaneous transluminal coronary angioplasty and stent placement.

  13. Prognostic assessment of stable coronary artery disease as determined by coronary computed tomography angiography

    DEFF Research Database (Denmark)

    Nielsen, Lene H; Bøtker, Hans Erik; Sørensen, Henrik T

    2016-01-01

    AIMS: To examine the 3.5 year prognosis of stable coronary artery disease (CAD) as assessed by coronary computed tomography angiography (CCTA) in real-world clinical practice, overall and within subgroups of patients according to age, sex, and comorbidity. METHODS AND RESULTS: This cohort study i......, and comorbidity. CONCLUSION: Coronary artery disease determined by CCTA in real-world practice predicts the 3.5 year composite risk of late revascularization, myocardial infarction, and all-cause death across different groups of age, sex, or comorbidity burden.......AIMS: To examine the 3.5 year prognosis of stable coronary artery disease (CAD) as assessed by coronary computed tomography angiography (CCTA) in real-world clinical practice, overall and within subgroups of patients according to age, sex, and comorbidity. METHODS AND RESULTS: This cohort study...

  14. Minimally invasive cardiac surgery-coronary artery bypass graft.

    Science.gov (United States)

    Lemma, Massimo; Atanasiou, Thanos; Contino, Monica

    2013-01-01

    Coronary artery bypass graft (CABG) is among the most common operations performed in the world. Different surgical strategies can be used with different invasiveness. This paper describes a recent development of the technique that merges the advantages resulting from both the adoption of an 'off-pump no-touch aorta operation' and a 'complete arterial revascularization through a left minithoracotomy' in a single procedure. This operation is currently known with the acronym MICS (minimally invasive cardiac surgery)-CABG (minimally invasive cardiac surgery). It is an off-pump operation performed through a minithoracotomy in the fourth or fifth left intercostal space across the midclavicular line. The left internal thoracic artery (LITA) is harvested under direct vision using a special rib-retractor with multiple interchangeable thoracotomy blades, including blades to use with lift systems for proximal artery harvesting, while the right radial artery (RA) is harvested endoscopically. A Y-connection is made between the two arteries. The LITA is used to bypass the left anterior descending coronary artery, while the right RA is used on the obtuse marginal branches and/or the posterior descending coronary artery. A special coronary stabilizer and a heart positioner with a shaft for remote thoracic insertion are needed.

  15. High-resolution coronary MR angiography for evaluation of patients with anomalous coronary arteries: visualization of the intramural segment

    Energy Technology Data Exchange (ETDEWEB)

    Biko, David M. [UCSF Benioff Children' s Hospital Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Chung, Claudia; Chung, Taylor [UCSF Benioff Children' s Hospital Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); Hitt, David M. [Philips Healthcare, Cleveland, OH (United States); Kurio, Gregory [UCSF Benioff Children' s Hospital Oakland, Department of Cardiology, Oakland, CA (United States); Reinhartz, Olaf [UCSF Benioff Children' s Hospital Oakland, Department of Cardiac Surgery, Oakland, CA (United States)

    2015-08-15

    Anomalous origin of the coronary artery from the contralateral coronary sinus is a rare coronary anomaly associated with sudden death. The inter-arterial course is most closely associated with sudden death, but it has been suggested that the presence of an intramural segment of a right anomalous coronary is associated with more symptoms and therefore may be an important criterion for intervention in these patients. To demonstrate that MR angiography can accurately determine the presence or absence of an intramural segment in an anomalous coronary artery. All studies of children who underwent MR angiography for the evaluation of an anomalous coronary artery were retrospectively reviewed by two pediatric radiologists in consensus. Criteria for an intramural anomalous coronary artery were the presence of a small or slit-like ostium and the relative smaller size of the proximal intramural portion of the coronary artery in relation to the more distal epicardial coronary artery. The anomalous coronary artery was classified as not intramural if these two findings were absent. These findings were correlated with operative reports confirming the presence or absence of an intramural segment. Twelve patients (86%) met MR angiography criteria for the presence of an intramural course. Only 2 patients (14%) met MR angiography criteria for a non-intramural course. When correlating with intraoperative findings, MR angiography was successful in distinguishing between intramural and non-intramural anomalous coronary arteries in all cases (P = 0.01). MR angiography may be able to reliably identify the intramural segment of an anomalous coronary artery in older children using the imaging criteria of a small or slit-like ostium and relative decrease in size of the proximal portion of the anomalous coronary artery compared to the distal portion of the anomalous coronary artery. Determining the presence of the intramural segment may help with surgical planning and may be an important

  16. An abdominal aortic calcification as a RISK FACTOR FOR cardio -cerebral events in patients with peripheral arterial

    Directory of Open Access Journals (Sweden)

    V. A. Zelinskiy

    2012-01-01

    Full Text Available Background. The patients with abdominal aortic calcification have a high risk of cardiocerebral events, but the pathways of them have not been reported so far. The goal of our study was to assess the structure and function of myocardium and to determine the morphological features of carotid artery atherosclerosis in patients with abdominal aortic calcification.Materials and methods. A total of 167 executive patients with peripheral arterial disease were enrolled in study. The study group included 85 patients with abdominal aortic calcification (men – 95.3 %; age median was – 66.6 ± 12. Control group included 82 patients without objective signs of abdominal aortic calcification. Abdominal aortic calcification was detected by CT imaging. All patients have undergone echocardiography and duplex scanning of carotid arteries.Results. Prevalence and severity of ischemic heart disease and cerebrovascular disease were statistically significant higher in patients with abdominal aortic calcification (91.7, 65.8 % vs. 67, 37.3 % (р < 0.01. We have found statistically significant differences between groupsin heart structure and function. A high left ventricular wall thickness (р < 0.01, left atrium dilation (р < 0.01 and enhanced of left ventricular mass (р < 0.05, ejection fraction reduction (р < 0.05 and more common diastolic dysfunction (р < 0.05 were determined inpatients with abdominal aortic calcification. An intima-media thickness of the common carotid artery was significantly higher in study group patients (1.38 ± 0.07 mm vs. 1.14 ± 0.06 mm (р < 0.001.Conclusion. Our findings suggested that abdominal aortic calcification is main reason of hypertrophy and dilation in the left heart due to enhanced peripheral resistance. Hypertrophy and dilation in the left heart is provided a high risk of cardiovascular events in patients withabdominal aortic calcification.

  17. Giant aneurysm of the left anterior descending coronary artery in a pediatric patient with Behcet's disease.

    Science.gov (United States)

    Cook, Amanda L; Rouster-Stevens, Kelly; Williams, Derek A; Hines, Michael H

    2010-07-01

    Behcet's disease is a rare autoimmune vasculitis characterized by oral aphthosis, genital ulcers, and ocular and cutaneous lesions. Vascular involvement usually affects the veins more commonly than the arteries, and coronary arterial involvement is extremely rare. We report an adolescent with Behcet's disease who developed a large pseudoaneurysm of the left anterior descending coronary artery requiring a coronary arterial bypass graft.

  18. Total Arterial Minimally Invasive Direct Coronary Artery Bypass Surgery Facilitated by the Trinity Clip Connector

    NARCIS (Netherlands)

    Stecher, David; Bronkers, Glenn; Höfer, Imo E.|info:eu-repo/dai/nl/267105649; Pasterkamp, Gerard|info:eu-repo/dai/nl/138488304; Buijsrogge, Marc P|info:eu-repo/dai/nl/24420098X

    2015-01-01

    OBJECTIVE: This pilot study evaluated the feasibility of total arterial minimally invasive direct coronary artery bypass surgery by using the Trinity Clip anastomotic connector in an acute porcine model. METHODS: In 3 pigs, the left and right internal thoracic arteries (LITA and RITA) were harvested

  19. Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnosis with CT Angiography

    Directory of Open Access Journals (Sweden)

    Guray Oncel

    2013-01-01

    Full Text Available Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA is a rare congenital anomaly. It is associated with early infant mortality and sudden death in adults. Traditionally, ALCAPA has been diagnosed by angiography or autopsy; however, the development of cardiac computed tomography (CT and magnetic resonance imaging (MRI has allowed noninvasive evaluation of the coronary anatomy by direct visualization of the origin of the left coronary artery (LCA from the pulmonary artery. We report a case of 10-year-old girl who has been on follow up for dilated cardiomyopathy for 4 years. The definitive diagnosis of ALCAPA is reached by multislice computed tomography (MSCT. The MSCT scan showed an anomalous origin of LCA from the pulmonary trunk, with a tortuous and dilated right coronary artery and right-to-left collateralization. Consequently, the patient was successfully treated with surgery.

  20. Single coronary artery with origin of right coronary artery from left circumflex in a patient with ventricular tachycardia: a case report

    Directory of Open Access Journals (Sweden)

    Sanjeev Sanghvi

    2016-03-01

    Full Text Available Only a few cases of a single coronary artery (CA have been described. Almost all cases reported so far also had associated atherosclerotic coronary artery or valvular heart disease. We present a 48 years old male with atypical chest pain with an episode of Ventricular Tachycardia (VT on treadmill test (TMT. Coronary angiography (CAG showed a single Left coronary artery (LCA with Right coronary artery (RCA arising from left circumflex artery (LCX without any atherosclerotic disease. [Int J Res Med Sci 2016; 4(3.000: 960-962

  1. Anterior Spinal Artery Syndrome Following Coronary Artery Bypass Grafting: a Case Report.

    Science.gov (United States)

    Mirhosseini, Seyed Mohsen; Meghdadi, Soheil; Moghaddam, Ali Sanjari

    2017-01-01

    We present a patient with unstable angina candidate for coronary artery bypass grafting. Saphenous vein graft was used in obtuse marginal and left internal mammary artery to left anterior descending artery properly. After surgery, the patient experienced flaccid paralysis of lower limb and impaired sensation of touch and warmth of knee and below. A computed tomography angiogram of lower limbs and thoracolumbar magnetic resonance imaging showed no abnormality. Based on the symptom, clinical diagnosis of anterior spinal artery syndrome was considered. The artery of Adamkiewicz is an important supplier to the anterior spinal artery. Internal thoracic mammary artery, used in coronary artery bypass grafting, is suspected as a collateral supplier of the artery of Adamkiewicz and has been accused for cause of spinal infarction.

  2. Smoking and hyperlipidemia are important risk factors for coronary artery spasm

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Objective To investigate the role of coronary artery spasm in the etiology of chest pain lacking significant coronary stenosis and to identify the clinical risk factors related to coronary artery spasm. Methods Two hundred and seventy five patients with chest pain, but without significant coronary artery stenosis underwent the intracoronary acetylcholine test. Coronary artery spasm was diagnosed while coronary artery stenosis increased to 90% and was accompanied by the usual chest pain with or without ischemic changes on electrocardiogram. Logistic regression was employed to investigate the relationships between coronary artery spasm and sex, age, hypertension, diabetes mellitus, smoking, hyperlipidemia and results of electrocardiographic treadmill stress test. Left ventricular ejection fraction and end diastolic pressure were compared between spasm group and non-spasm group. Results Coronary artery spasm was detected in 103 out of 271 patients, a rate of 38%. Logistic regression analysis showed that smoking and hyperlipidemia increased the relative risk of coronary artery spasm 4.2 times and 2.3 times, respectively. There was a significantly negative relationship between diabetes mellitus and coronary artery spasm. Furthermore, there was no coronary artery spasm detected in left ventricular ejection fraction and end diastolic pressure. Conclusions Coronary artery spasm was one of the important etiological factors for patients with chest pain but no coronary artery stenosis. Smoking and hyperlipidemia were the main clinical risk factors for coronary artery spasm.

  3. Hostility, Anger and Risk of Coronary Artery Atherosclerosis

    Directory of Open Access Journals (Sweden)

    E Masoudnia

    2011-02-01

    Full Text Available Introduction: The previous researches about the etiology of coronary artery atherosclerosis have accentuated on clinical and medical risk factors, such as cigarette smoking, hypertension, diabetes mellitus, hyperlipidemia, positive family background, myocardial ischemia history in family, atherogenic diet, increase of A lipoprotein, inflammatory factors such as increase of cross-reactive protein and so on. Although factors in behavioral medicine are recognized as an independent risk factor in coronary artery atherosclerosis, few researches have been done on hostility and anger. The aim of this study was to determine the difference between normal people(Control group and people with coronary artery atherosclerosis(Case group with regards to hostility and anger. Methods: This study was performed as a case-control design. Data was collected from seventy-seven patients with coronary artery atherosclerosis who had referred to Afshar Hospital Professional Heart Clinic in Yazd city and seventy-eight normal people were used as control. Two groups completed the Buss and Perry Aggression Questionnaire(BPAQ to measure their hostility and anger. Results: The results of the analysis showed that there was a statistically significant difference regarding hostility(p<.05 and anger(p<.001 between the two groups. Hierarchical multiple logistic regression analysis showed that the sociodemographic and clinical variables(step 1 explained 35.5 % to 47.4%, while hostility and anger(step 2 explained 6.7% to 9% of the variance in incidence of coronary artery atherosclerosis. Conclusion: Hostility and anger are strong risk factors for coronary artery atherosclerosis or CAD in Iran. Therefore, in order to decrease the incidence rate of coronary artery atherosclerosis in Iran, alongside medical interventions, attention should also be paid towards behavioral interventions in order to modify hostile and angrily behavior.

  4. Off-pump Coronary Endarterectomy and Bypass Grafting in Patients With Diffuse Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    Chen Xin; Xu Ming; Jiang Yinshuo; Sui Kaihu; Qiu Zhibing; Wang Liming; Liu Peisheng

    2006-01-01

    Objectives To summarize our preliminary experience on off-pump coronary endarterectomy and bypass grafting in patients with diffuse coronary artery disease. Methods Over a 3-year period, 53 patients (41 male) with diffuse coronary artery disease underwent off-pump coronary endarterectomy and bypass grafting at our institution.Patients' age ranged from 55 to 79 years. Prior to surgery, 70% of patients were in CCS angina class 2 (n=5) or 3 (n=32), and nearly half of them (26/53) had history of myocardial infarction. Most patients (n=50) had triple vessel lesions, with left main stem involvement in 9. Their left ventricular ejection fraction ranged from 26% to 65% (mean 52%). At the end of operation, a flow-meter was routinely applied to measure the perfusion flow of each postendarterectomy graft. Results In total, 70 endarterectomies were performed in 53 patients, including 38 in left anterior descending artery (LAD), 8 in circumflex artery and 24 in right coronary artery. Four operations were emergency or urgent in nature. Five patients received on-lay venous patch after endarterectomy in LAD, followed by left internal mammary artery (LIMA) grafting on the patch. The graft conduits included 53 LIMAs and 2 radial arteries,and saphenous veins in others. Mean number of grafts per patient was 3.75. The overall index of completeness of revascularization reached 1.03±0.07. There was no death in this group of patients during their post-operative hospital stay (mean duration = 9 days).Intra-operatively, 63 (90%) out of the 70 grafts after coronary endarterectomy showed satisfactory flow. Two patients had perioperative myocardial infarctions but neither experienced significant hemodynamic deteriations. Conclusions Off-pump coronary endarterectomy with bypass grafting is technically feasible and can be performed safely in patients with diffuse coronary artery disease. This strategy may help to improve the completeness of myocardial revascularization.

  5. Association of ischemic stroke to coronary artery disease using computed tomography coronary angiography

    DEFF Research Database (Denmark)

    Jensen, Jesper Møller; Medina, Hector; Nørgaard, Bjarne Linde;

    2012-01-01

    BACKGROUND: While patients with coronary artery disease (CAD) and cerebrovascular disease share similar risk factor profiles, data on whether IS can be considered a "CAD equivalent" are limited. We aimed to determine whether ischemic stroke is an independent predictor of CAD by using cardiac...... increase odds of having coronary artery plaque (odds ratio [OR] 4.9, P4 segments of plaque than 0-4 segments as compared to patients without stroke (OR 18.3, P...

  6. Coronary artery bypass and superior vena cava syndrome.

    Science.gov (United States)

    Thomas, T V; Masrani, K; Thomas, J L

    1999-01-01

    Superior vena cava syndrome is the obstruction of the superior vena cava or its main tributaries by benign or malignant lesions. The syndrome causes edema and engorgement of the vessels on the face, neck, and arms, nonproductive cough, and dyspnea. We discuss the case of a 48-year-old obese diabetic woman who was admitted with unstable angina. She had previously been diagnosed with superior vena cava syndrome. Urgent coronary artery bypass grafting was necessary Although thousands of coronary artery bypasses are performed every year, there are not many reports on patients with superior vena cava syndrome who successfully undergo cardiopulmonary bypass and coronary artery grafting with an internal mammary artery as the conduit. The results of the case and alternative recommended methods are discussed.

  7. Nonalcoholic Hepatic Steatosis Is a Strong Predictor of High-Risk Coronary-Artery Plaques as Determined by Multidetector CT.

    Directory of Open Access Journals (Sweden)

    Kazuhiro Osawa

    Full Text Available Nonalcoholic fatty liver disease is associated with a risk of coronary artery disease (e.g., diabetes mellitus, dyslipidemia, metabolic syndrome. We evaluated whether nonalcoholic hepatic steatosis is associated with high-risk plaques as assessed by multidetector computed tomography (CT.This retrospective study involved 414 participants suspected of having coronary artery disease. Nonalcoholic hepatic steatosis was defined as a liver-to-spleen fat ratio of <1.0 and the presence and appropriate characteristics of coronary-artery plaques as assessed by coronary CT angiography. High-risk plaques were identified, as were low-density plaques, positive remodeling, and spotty calcification.Compared with patients who did not have nonalcoholic hepatic steatosis, patients with nonalcoholic hepatic steatosis had more low-density plaques (21% vs. 44%, p<0.01, positive remodeling (41% vs. 58%, p = 0.01, and spotty calcification (12% vs. 36%, p<0.01. The number of high-risk plaques in patients with nonalcoholic hepatic steatosis was greater than in those without nonalcoholic hepatic steatosis (p<0.01. Patients with nonalcoholic hepatic steatosis were more likely to have high-risk plaques than were those with only an elevated level of visceral adipose tissue (≥86 cm2; 35% vs. 16%, p<0.01. Multivariate analyses that included nonalcoholic hepatic steatosis, amount of visceral adipose tissue, and the presence/absence of traditional risk factors demonstrated that nonalcoholic hepatic steatosis was an independent predictor of high-risk plaques (odds ratio: 4.60; 95% confidence interval: 1.94-9.07, p<0.01.Diagnosis of nonalcoholic hepatic steatosis may be of value when assessing the risk of coronary artery disease.

  8. Coronary 64-slice CT angiography predicts outcome in patients with known or suspected coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Gaemperli, Oliver; Valenta, Ines; Schepis, Tiziano [University Hospital Zurich NUK C 32, Cardiovascular Center, Zurich (Switzerland); Husmann, Lars; Scheffel, Hans; Desbiolles, Lotus; Leschka, Sebastian; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich NUK C 32, Cardiovascular Center, Zurich (Switzerland); University of Zurich, Zurich Center for Integrative Human Physiology (ZIHP), Zurich (Switzerland)

    2008-06-15

    The aim of this study was to assess the prognostic value of 64-slice CT angiography (CTA) in patients with known or suspected coronary artery disease (CAD). Sixty-four-slice coronary CTA was performed in 220 patients [mean age 63 {+-} 11 years, 77 (35%) female] with known or suspected CAD. CTA images were analyzed with regard to the presence and number of coronary lesions. Patients were followed-up for the occurrence of the following clinical endpoints: death, nonfatal myocardial infarction, unstable angina, and coronary revascularization. During a mean follow-up of 14 {+-} 4 months, 59 patients (27%) reached at least one of the predefined clinical endpoints. Patients with abnormal coronary arteries on CTA (i.e., presence of coronary plaques) had a 1st-year event rate of 34%, whereas in patients with normal coronary arteries no events occurred (event rate, 0%, p < 0.001). Similarly, obstructive lesions ({>=}50% luminal narrowing) on CTA were associated with a high first-year event rate (59%) compared to patients without stenoses (3%, p < 0.001). The presence of obstructive lesions was a significant independent predictor of an adverse cardiac outcome. Sixty-four-slice CTA predicts cardiac events in patients with known or suspected CAD. Conversely, patients with normal coronary arteries on CTA have an excellent mid-term prognosis. (orig.)

  9. Pregnancy risks in women with pre-existing coronary artery disease, or following acute coronary syndrome

    NARCIS (Netherlands)

    Burchill, Luke J.; Lameijer, Heleen; Roos-Hesselink, Jolien W.; Grewal, Jasmine; Ruys, Titia P. E.; Kulikowski, Julia D.; Burchill, Laura A.; Oudijk, M. A.; Wald, Rachel M.; Colman, Jack M.; Siu, Samuel C.; Pieper, Petronella G.; Silversides, Candice K.

    2015-01-01

    Objective The objective of this study was to determine outcomes in pregnant women with pre-existing coronary artery disease (CAD) or following an acute coronary syndrome (ACS) including myocardial infarction (MI). Background The physiological changes of pregnancy can contribute to myocardial ischaem

  10. Circulating endothelial cells in coronary artery disease and acute coronary syndrome

    NARCIS (Netherlands)

    Schmidt, David E; Manca, Marco; Höfer, Imo E

    2015-01-01

    Circulating endothelial cells (CECs) have been put forward as a promising biomarker for diagnosis and prognosis of coronary artery disease and acute coronary syndromes. This review entails current insights into the physiology and pathobiology of CECs, including their relationship with circulating en

  11. Drug therapy or coronary angioplasty for the treatment of coronary artery disease : New insights

    NARCIS (Netherlands)

    Amoroso, G; Van Boven, AJ; Crijns, HJGM

    2001-01-01

    Background In the last decade percutaneous transluminal coronary angioplasty has become a very popular strategy For the treatment of coronary artery disease, although its efficacy in reducing ischemic events and the subsequent need for revascularization has yet to be proved. Methods We reviewed the

  12. Impaired Fasting Glucose and Diabetes as Predictors for Radial Artery Calcification in End Stage Renal Disease Patients

    Directory of Open Access Journals (Sweden)

    Katarzyna Janda

    2013-01-01

    Full Text Available Objective. The objective of the study was to assess the relationship between selected clinical and biochemical parameters of end stage renal disease (ESRD patients and arterial calcification. Material