WorldWideScience

Sample records for coronary calcium mass

  1. CT measurement of coronary calcium mass: impact on global cardiac risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Christoph R.; Majeed, Amal; Reiser, Maximilian F. [Ludwig-Maximilians-University Hospital Munich, Department of Clinical Radiology, Munich (Germany); Crispin, Alexander [University Hospital Munich, Department of Medical Data Processing, Biometry, and Epidemiology, Munich (Germany); Knez, Andreas; Boekstegers, Peter; Steinbeck, Gerhard [University Hospital Munich, Department of Cardiology, Munich (Germany); Schoepf, U. Joseph [Harvard Medical School, Department of Radiology, Brigham and Women' s Hospital, Boston, MA (United States)

    2005-01-01

    Coronary calcium mass percentiles can be derived from electron beam CT as well as from multidetector-row CT of all manufacturers. Coronary calcium mass may serve as a more individualized substitute for age for cardiac risk stratification. The aim was to investigate the potential impact of CT coronary calcium mass quantification on cardiac risk stratification using an adjusted Framingham score. Standardized coronary calcium mass was determined by multidetector-row CT in a total of 1,473 patients (1,038 male, 435 female). The impact on risk stratification of replacing the traditional Framingham age point score by a point score based on calcium mass relative to age was tested. Any coronary calcium found in males in the age group of 20-34 years and females in the age group of 20-59 years results in an increase of the Framingham score by 9 and 4-7 points, respectively. Only in males 65 years of age and older, none or minimal amounts of coronary calcium decrease the Framingham score by three points. The coronary calcium mass and age-related scoring system may have impact on the reassignment of patients with an intermediate Framingham risk to a lower or higher risk group. (orig.)

  2. 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

  3. Effect of Heart Rate and Body Mass Index on the Interscan and Interobserver Variability of Coronary Artery Calcium Scoring at Prospective ECG-Triggered 64-Slice CT

    Energy Technology Data Exchange (ETDEWEB)

    Horiguchi, Jun; Kiguchi, Masao; Fujioka, Chikako [Hiroshima University Hospital, Hiroshima (Japan); Matsuura, Noriaki; Yamamoto, Hideya; Kitagawa, Toshiro; Ito, Katsuhide [Hiroshima University, Hiroshima (Japan)

    2009-08-15

    To test the effects of heart rate, body mass index (BMI) and noise level on interscan and interobserver variability of coronary artery calcium (CAC) scoring on a prospective electrocardiogram (ECG)-triggered 64-slice CT. One hundred and ten patients (76 patients with CAC) were scanned twice on prospective ECG-triggered scans. The scan parameters included 120 kV, 82 mAs, a 2.5 mm thickness, and an acquisition center at 45% of the RR interval. The interscan and interobserver variability on the CAC scores (Agatston, volume, and mass) was calculated. The factors affecting the variability were determined by plotting it against heart rate, BMI, and noise level (defined as the standard deviation: SD). The estimated effective dose was 1.5 {+-} 0.2 mSv. The mean heart rate was 63 {+-} 12 bpm (range, 44-101 bpm). The patient BMIs were 24.5 {+-} 4.5 kg/m{sup 2} (range, 15.5-42.3 kg/m2). The mean and median interscan variabilities were 11% and 6%, respectively by volume, and 11% and 6%, respectively, by mass. Moreover, the mean and median of the algorithms were lower than the Agatston algorithm (16% and 9%, respectively). The mean and median interobserver variability was 10% and 4%, respectively (average of algorithms). The mean noise levels were 15 {+-} 4 Hounsfield unit (HU) (range, 8-25 HU). The interscan and interobserver variability was not correlated with heart rate, BMI, or noise level. The interscan and interobserver variability of CAC on a prospective ECG-triggered 64-slice CT with high image quality and 45% of RR acquisition is not significantly affected by heart rate, BMI, or noise level. The volume or mass algorithms show reduced interscan variability compared to the Agatston scoring (p < 0.05)

  4. Effects of particle size, slice thickness, and reconstruction algorithm on coronary calcium quantitation using ultrafast computed tomography

    Science.gov (United States)

    Tang, Weiyi; Detrano, Robert; Kang, Xingping; Garner, D.; Nickerson, Sharon; Desimone, P.; Mahaisavariya, Paiboon; Brundage, B.

    1994-05-01

    The recent emphasis on early diagnosis of coronary artery disease has stimulated research for a reliable and non-invasive screening method. Radiographically detectable coronary calcium has been shown to predict both pathologic and angiographic findings. Ultrafast computed tomography (UFCT), in quantifying coronary calcium, may become an accurate non-invasive method to evaluate the severity of coronary disease. The currently applied index of UFCT coronary calcium amount is the coronary calcium score of Agatston et al. This score has not been thoroughly evaluated as to its accuracy and dependence on scanning parameters. A potential drawback of the score is its dependence on predetermined CT number thresholds. In this investigation we used a chest phantom to determine the effects of particle size, slice thickness, and reconstruction algorithm on the coronary calcium score, and on the calcium mass estimated with a new method which is not dependent on thresholds.

  5. 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.

  6. Impact of iterative reconstruction on CT coronary calcium quantification

    DEFF Research Database (Denmark)

    Kurata, Akira; Dharampal, Anoeshka; Dedic, Admir;

    2013-01-01

    We evaluated the influence of sinogram-affirmed iterative reconstruction (SAFIRE) on the coronary artery calcium (CAC) score by computed tomography (CT).......We evaluated the influence of sinogram-affirmed iterative reconstruction (SAFIRE) on the coronary artery calcium (CAC) score by computed tomography (CT)....

  7. Relation of thoracic aortic and aortic valve calcium to coronary artery calcium and risk assessment.

    Science.gov (United States)

    Wong, Nathan D; Sciammarella, Maria; Arad, Yadon; Miranda-Peats, Romalisa; Polk, Donna; Hachamovich, Rory; Friedman, John; Hayes, Sean; Daniell, Anthony; Berman, Daniel S

    2003-10-15

    Aortic calcium, aortic valve calcium (AVC), and coronary artery calcium (CAC) have been associated with cardiovascular event risk. We examined the prevalence of thoracic aortic calcium (TAC) and AVC in relation to the presence and extent of CAC, cardiovascular risk factors, and estimated risk of coronary heart disease (CHD). In 2,740 persons without known CHD aged 20 to 79 years, CAC was assessed by electron beam- or multidetector-computed tomography. We determined the prevalence of TAC and AVC in relation to CAC, CHD risk factors, and predicted 10-year risk of CHD. A close correspondence of TAC and AVC was observed with CAC. TAC and AVC increased with age; by the eighth decade of life, the prevalence of TAC was similar to that of CAC (>80%), and 36% of men and 24% of women had AVC. Age, male gender, and low-density lipoprotein cholesterol were directly related to the likelihood of CAC, TAC, and AVC; higher diastolic blood pressure and cigarette smoking additionally predicted CAC. Body mass index and higher systolic and lower diastolic blood pressures were also related to TAC, and higher body mass index and lower diastolic blood pressure were related to AVC. Calculated risk of CHD increased with the presence of AVC and TAC across levels of CAC. TAC and AVC provided incremental value over CAC in association with the 10-year calculated risk of CHD. If longitudinal studies show an incremental value of aortic and aortic valve calcium over that of CAC for prediction of cardiovascular events, future guidelines for risk assessment incorporating CAC assessment may additionally incorporate the measurement of aortic and/or aortic valve calcium.

  8. 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

  9. 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.

  10. 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...

  11. Quantitative relationship between coronary calcium content and coronary flow reserve as assessed by integrated PET/CT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Curillova, Zelmira [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); VA Boston Healthcare System, Division of Cardiology, Department of Medicine, West Roxbury, MA (United States); Yaman, Bettina F.; Sitek, Arkadius; El Fakhri, Georges [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Dorbala, Sharmila [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Brigham and Women' s Hospital, Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Boston, MA (United States); Kwong, Raymond Y. [Harvard Medical School, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women' s Hospital, Boston, MA (United States); Brigham and Women' s Hospital, Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Boston, MA (United States); Anagnostopoulos, Constantinos [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Royal Brompton Hospital, Department of Nuclear Medicine, London (United Kingdom); Di Carli, Marcelo F. [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Harvard Medical School, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women' s Hospital, Boston, MA (United States); Brigham and Women' s Hospital, Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Boston, MA (United States); Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Boston, MA (United States)

    2009-10-15

    To evaluate the relationship between coronary artery calcium (CAC) and coronary vasodilator function. We evaluated 136 patients without known coronary artery disease (CAD) undergoing vasodilator stress {sup 82}Rb PET/CT and CAC scoring who showed normal myocardial perfusion. The CAC score, resting and hyperemic myocardial blood flow (MBF), coronary flow reserve (CFR) and coronary vascular resistance were analyzed. Global and regional CAC scores showed significant but weak inverse correlations with hyperemic MBF (r=-0.31 and r=-0.26, p{<=}0.0002 respectively) and CFR (r=-0.28 and r=-0.2, p{<=}0.001 respectively). With increasing CAC score, there was a modest stepwise decline in CFR on a per-patient basis (1.8{+-}0.5 vs 1.7{+-}0.5 vs 1.5{+-}0.4, p=0.048, with total CAC=0, 1-400 and >400, respectively) and on a per-vessel basis. In multivariable modeling only body mass index and CAC score were predictive of CFR. In patients with an intermediate likelihood of, but without overt, CAD, there is a statistically significant but weak inverse correlation between CAC content and coronary vasodilator function. The strength of this association weakens after adjusting CAC scores for age, gender and coronary risk factors. This suggests that CAC and coronary vasodilator function provide biologically different information regarding atherosclerosis. (orig.)

  12. Serum calcium levels are not associated with coronary heart disease

    Directory of Open Access Journals (Sweden)

    Jin Y

    2013-09-01

    Full Text Available Yuelong Jin,* Lianping He,* Quanhai Wang, Yan Chen, Xiaohua Ren, Hui Tang, Xiuli Song, Lingling Ding, Qin Qi, Zhiwei Huang, Jiegen Yu, Yingshui Yao Department of Preventive Medicine, Wannan Medical College, Wuhu, People's Republic of China *These authors contributed equally to this work Background: Numerous studies have reported that low calcium intake is related to a higher prevalence of cardiovascular disease. However, the relationship between serum calcium and coronary heart disease is unclear. The purpose of this study was to compare serum calcium levels in patients with coronary heart disease and those in healthy individuals. Methods: This retrospective, case-control study conducted in the People's Republic of China comprised 380 cases and 379 controls. Serum calcium levels, blood lipids, and anthropometric measurements were measured in both groups. The Student's unpaired t-test or Chi-square test was used to compare differences between cases and controls. Pearson's partial correlation coefficient was used to determine the association between serum calcium, blood lipids, and blood pressure in both groups. Results: Our results indicate that the average level of serum calcium in cases was higher than in controls. Serum calcium levels showed no correlation with any parameter except for triglycerides in either group. Conclusion: Overall, these data suggest that serum calcium has no influence on coronary heart disease or triglyceride levels in the general population. Keywords: serum calcium, hypertension, blood lipids

  13. 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

  14. Observer variability in the assessment of CT coronary angiography and coronary artery calcium score: substudy of the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial.

    Science.gov (United States)

    Williams, Michelle C; Golay, Saroj K; Hunter, Amanda; Weir-McCall, Jonathan R; Mlynska, Lucja; Dweck, Marc R; Uren, Neal G; Reid, John H; Lewis, Steff C; Berry, Colin; van Beek, Edwin J R; Roditi, Giles; Newby, David E; Mirsadraee, Saeed

    2015-01-01

    Observer variability can influence the assessment of CT coronary angiography (CTCA) and the subsequent diagnosis of angina pectoris due to coronary heart disease. We assessed 210 CTCAs from the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial for intraobserver and interobserver variability. Calcium score, coronary angiography and image quality were evaluated. Coronary artery disease was defined as none (70%) luminal stenosis and classified as no (70%) coronary artery disease. Post-CTCA diagnosis of angina pectoris due to coronary heart disease was classified as yes, probable, unlikely or no. Patients had a mean body mass index of 29 (28, 30) kg/m(2), heart rate of 58 (57, 60)/min and 62% were men. Intraobserver and interobserver agreements for the presence or absence of coronary artery disease were excellent (95% agreement, κ 0.884 (0.817 to 0.951) and good (91%, 0.791 (0.703 to 0.879)). Intraobserver and interobserver agreement for the presence or absence of angina pectoris due to coronary heart disease were excellent (93%, 0.842 (0.918 to 0.755) and good (86%, 0.701 (0.799 to 0.603)), respectively. Observer variability of calcium score was excellent for calcium scores below 1000. More segments were categorised as uninterpretable with 64-multidetector compared to 320-multidetector CTCA (10.1% vs 2.6%, pcoronary heart disease. NCT01149590.

  15. 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...

  16. Reduced calcium responsiveness characterizes contractile dysfunction following coronary microembolization.

    Science.gov (United States)

    Skyschally, Andreas; Gres, Petra; van Caster, Patrick; van de Sand, Anita; Boengler, Kerstin; Schulz, Rainer; Heusch, Gerd

    2008-11-01

    We addressed calcium responsiveness in microembolized myocardium at 6 h after coronary microembolization (ME). In anesthetized pigs calcium responsiveness was determined as the increase of a myocardial work index (WI; LV pressure development vs. wall thickening) in response to a graded intracoronary infusion of CaCl(2) at baseline and at 6 h after ME or placebo, respectively. At baseline, CaCl(2 )infusion increased WI in both groups (ME: 296 +/- 22 to 468 +/- 47 mmHg*mm; placebo: 324 +/- 24 to 485 +/- 38 mmHg*mm; mean +/- SEM). At 6 h after ME, WI was decreased by 159 +/- 16 mmHg*mm (P < 0.05 vs. baseline) and remained reduced at any calcium concentration, whereas it was unchanged with placebo. The calcium concentration in coronary blood necessary to achieve the half maximal increase in WI remained unchanged from baseline to 6 h and did not differ between placebo and ME. The ME-induced myocardial dysfunction is not related to an altered calcium sensitivity, but is characterized by a reduced maximal contractile force.

  17. Technical feasibility and validation of a coronary artery calcium scoring system using CT coronary angiography images

    Energy Technology Data Exchange (ETDEWEB)

    Pavitt, Christopher W. [Royal Brompton Hospital, Department of Cardiology, London (United Kingdom); Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Harron, Katie [Institute of Child Health, UCL, Centre for Paediatric Epidemiology and Biostatistics, London (United Kingdom); Lindsay, Alistair C.; Ray, Robin [Royal Brompton Hospital, Department of Cardiology, London (United Kingdom); Zielke, Sayeh; Rubens, Michael B. [Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Gordon, Daniel [Royal Marsden Hospital, Department of Physics, London (United Kingdom); Padley, Simon P. [Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Imperial College, Faculty of Medicine, London (United Kingdom); Nicol, Edward D. [Royal Brompton Hospital, Department of Cardiology, London (United Kingdom); Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Imperial College, Faculty of Medicine, London (United Kingdom)

    2016-05-15

    We validate a novel CT coronary angiography (CCTA) coronary calcium scoring system. Calcium was quantified on CCTA images using a new patient-specific attenuation threshold: mean + 2SD of intra-coronary contrast density (HU). Using 335 patient data sets a conversion factor (CF) for predicting CACS from CCTA scores (CCTAS) was derived and validated in a separate cohort (n = 168). Bland-Altman analysis and weighted kappa for MESA centiles and Agatston risk groupings were calculated. Multivariable linear regression yielded a CF: CACS = (1.185 x CCTAS) + (0.002 x CCTAS x attenuation threshold). When applied to CCTA data sets there was excellent correlation (r = 0.95; p < 0.0001) and agreement (mean difference -10.4 [95 % limits of agreement -258.9 to 238.1]) with traditional calcium scores. Agreement was better for calcium scores below 500; however, MESA percentile agreement was better for high risk patients. Risk stratification was excellent (Agatston groups k = 0.88 and MESA centiles k = 0.91). Eliminating the dedicated CACS scan decreased patient radiation exposure by approximately one-third. CCTA calcium scores can accurately predict CACS using a simple, individualized, semiautomated approach reducing acquisition time and radiation exposure when evaluating patients for CAD. This method is not affected by the ROI location, imaging protocol, or tube voltage strengthening its clinical applicability. (orig.)

  18. 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.

  19. 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

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

    NARCIS (Netherlands)

    Xie, Xueqian; Greuter, Marcel J. W.; Groen, Jaap M.; de Bock, Geertruida H.; Oudkerk, Matthijs; de Jong, Pim A.; Vliegenthart, Rozemarijn

    2013-01-01

    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 nontr

  1. A method for coronary artery calcium scoring using contrast-enhanced computed tomography

    DEFF Research Database (Denmark)

    Otton, James M; Lønborg, Jacob T; Boshell, David;

    2012-01-01

    Limitations to the coronary calcium score include its requirement for noncontrast imaging and radiation exposure that approaches current methods for contrast-enhanced CT angiography.......Limitations to the coronary calcium score include its requirement for noncontrast imaging and radiation exposure that approaches current methods for contrast-enhanced CT angiography....

  2. Application of Near Infrared Spectroscopy, Intravascular Ultrasound and the Coronary Calcium Score to Predict Adverse Coronary Events

    Science.gov (United States)

    2015-10-01

    Award Number: W81XWH-11-1-0831 TITLE: Application of Near Infrared Spectroscopy, Intravascular Ultrasound and the Coronary Calcium Score to...3. DATES COVERED 26-SEP-2014 to 25-SEP-2015 4. TITLE AND SUBTITLE Application of Near Infrared Spectroscopy, Intravascular Ultrasound and the...planned. 15. SUBJECT TERMS coronary artery disease, near infrared spectroscopy, calcium scoring, intravascular ultrasound 16. SECURIY CLASSIFICATION OF

  3. Calcium score of small coronary calcifications on multidetector computed tomography: Results from a static phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Groen, J.M., E-mail: jaap.groen@slaz.nl [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Kofoed, K.F., E-mail: kkofoed@dadlnet.dk [Department of Cardiology and Radiology, Rigshospitalet, University of Copenhagen (Denmark); Zacho, M., E-mail: dls332089@vip.cybercity.dk [Department of Cardiology and Radiology, Rigshospitalet, University of Copenhagen (Denmark); Vliegenthart, R., E-mail: r.vliegenthart@umcg.nl [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Willems, T.P., E-mail: t.p.willems@umcg.nl [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Greuter, M.J.W., E-mail: m.j.w.greuter@umcg.nl [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands)

    2013-02-15

    Introduction: 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 enables establishment of a calcium scoring protocol for MDCT that yields a calcium score comparable to the EBT values and to the physical mass. Materials and methods: A phantom containing 100 small calcifications ranging from 0.5 to 2.0 mm was scanned on EBT using a standard coronary calcium protocol. In addition, the phantom was scanned on a 320-row MDCT scanner using different scanning, reconstruction and scoring parameters (tube voltage 80–135 kV, slice thickness 0.5–3.0 mm, reconstruction kernel FC11–FC15 and threshold 110–150 HU). The Agatston and mass score of both modalities was compared and the influence of the parameters was assessed. Results: On EBT the Agatston and mass scores were between 0 and 20, and 0 and 3 mg, respectively. On MDCT the Agatston and mass scores were between 0 and 20, and 0 and 4 mg, respectively. All parameters showed an influence on the calcium score. The Agatston score on MDCT differed 52% between the 80 and 135 kV, 65% between 0.5 and 3.0 mm and 48% between FC11 and FC15. More calcifications were detected with a lower tube voltage, a smaller slice thickness, a sharper kernel and a lower threshold. Based on these observations an acquisition protocol with a tube voltage of 100 kV and two reconstructions protocols were defined with a FC12 reconstruction kernel; one with a slice thickness of 3.0 mm and a one with a slice thickness of 0.5 mm. This protocol yielded an Agatston score as close to the EBT as possible, but also a mass score as close to the physical phantom value as possible, respectively. Conclusion: With the new phantom one acquisition protocol and two reconstruction protocols can be defined which produces

  4. 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...

  5. Significance of noncalcified coronary plaque in asymptomatic subjects with low coronary artery calcium score: assessment with coronary computed tomography angiography.

    Science.gov (United States)

    Yoo, Dong Hyun; Chun, Eun Ju; Choi, Sang Il; Kim, Jeong A; Jin, Kwang Nam; Yeon, Tae-Jin; Choi, Dong-Ju

    2011-12-01

    We aimed to investigate the prevalence and severity of noncalcified coronary plaques (NCP) using coronary CT angiography (CCTA) and analyze predictors of significant coronary stenosis by NCP in asymptomatic subjects with low coronary artery calcium score (CACS). The institutional review board approved this retrospective study and all patients gave written, informed consent. The presence of plaque, severity of stenosis, plaque characteristics, and CACS were assessed in 7,515 asymptomatic subjects. We evaluated the prevalence and severity of NCP in subjects having low CACS (707 subjects; men with CACS from 1 to 50 and women from 1 to 10) in comparison to those having 0 CACS (6,040 subjects) as the reference standard. Conventional risk factors were assessed for predictors of NCP and significant stenosis by NCP. We also investigated the cardiac events of the patients through medical records. Compared to subjects with 0 CACS, those with low CACS showed higher prevalence of NCP (6.9% vs. 31.5%, P NCP (0.8% vs. 7.5%, P NCP included diabetes mellitus (DM), hypertension, and elevated low-density lipoprotein (LDL)-cholesterol (all P NCP were classified into the low to intermediate risk according to Framingham Risk Score. At the median follow up of 42 months (range: 3-60 months), cardiac events were significantly higher in the low CACS group compared to the 0 CACS group (2.6% vs. 0.27%, P NCP were higher as compared to subjects having zero CACS and predictors of significant stenosis by NCP were DM, hypertension and LDL-Cholesterol. Therefore, CCTA may be useful for risk stratification of coronary artery disease as added value over CACS in selected populations with low CACS who have predictors of significant NCP.

  6. Incremental value of the CT coronary calcium score for the prediction of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Genders, Tessa S.S. [Erasmus University Medical Center, Department of Epidemiology, P.O. Box 2040, CA, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Radiology, P.O. Box 2040, CA, Rotterdam (Netherlands); Pugliese, Francesca; Mollet, Nico R.; Meijboom, W. Bob; Weustink, Annick C.; Mieghem, Carlos A.G. van; Feyter, Pim J. de [Erasmus University Medical Center, Department of Radiology, P.O. Box 2040, CA, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Cardiology, P.O. Box 2040, CA, Rotterdam (Netherlands); Hunink, M.G.M. [Erasmus University Medical Center, Department of Epidemiology, P.O. Box 2040, CA, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Radiology, P.O. Box 2040, CA, Rotterdam (Netherlands); Harvard University, Department of Health Policy and Management, Harvard School of Public Health, Boston (United States)

    2010-10-15

    To validate published prediction models for the presence of obstructive coronary artery disease (CAD) in patients with new onset stable typical or atypical angina pectoris and to assess the incremental value of the CT coronary calcium score (CTCS). We searched the literature for clinical prediction rules for the diagnosis of obstructive CAD, defined as {>=}50% stenosis in at least one vessel on conventional coronary angiography. Significant variables were re-analysed in our dataset of 254 patients with logistic regression. CTCS was subsequently included in the models. The area under the receiver operating characteristic curve (AUC) was calculated to assess diagnostic performance. Re-analysing the variables used by Diamond and Forrester yielded an AUC of 0.798, which increased to 0.890 by adding CTCS. For Pryor, Morise 1994, Morise 1997 and Shaw the AUC increased from 0.838 to 0.901, 0.831 to 0.899, 0.840 to 0.898 and 0.833 to 0.899. CTCS significantly improved model performance in each model. Validation demonstrated good diagnostic performance across all models. CTCS improves the prediction of the presence of obstructive CAD, independent of clinical predictors, and should be considered in its diagnostic work-up. (orig.)

  7. 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.

  8. Calcium Isotope Analysis by Mass Spectrometry

    Science.gov (United States)

    Boulyga, S.; Richter, S.

    2010-12-01

    The variations in the isotopic composition of calcium caused by fractionation in heterogeneous systems and by nuclear reactions can provide insight into numerous biological, geological, and cosmic processes, and therefore isotopic analysis finds a wide spectrum of applications in cosmo- and geochemistry, paleoclimatic, nutritional, and biomedical studies. The measurement of calcium isotopic abundances in natural samples has challenged the analysts for more than three decades. Practically all Ca isotopes suffer from significant isobaric interferences, whereas low-abundant isotopes can be particularly affected by neighboring major isotopes. The extent of natural variations of stable isotopes appears to be relatively limited, and highly precise techniques are required to resolve isotopic effects. Isotope fractionation during sample preparation and measurements and instrumental mass bias can significantly exceed small isotope abundance variations in samples, which have to be investigated. Not surprisingly, a TIMS procedure developed by Russell et al. (Russell et al., 1978. Geochim Cosmochim Acta 42: 1075-1090) for Ca isotope measurements was considered as revolutionary for isotopic measurements in general, and that approach is used nowadays (with small modifications) for practically all isotopic systems and with different mass spectrometric techniques. Nevertheless, despite several decades of calcium research and corresponding development of mass spectrometers, the available precision and accuracy is still not always sufficient to achieve the challenging goals. This presentation discusses figures of merits of presently used analytical methods and instrumentation, and attempts to critically assess their limitations. Additionally, the availability of Ca isotope reference materials will be discussed.

  9. Relationship between framingham risk score and coronary artery calcium score in asymptomatic Korean individuals

    Energy Technology Data Exchange (ETDEWEB)

    Heo, So Young; Park, Noh Hyuck; Park, Chan Sub; Seong, Su Ok [Dept. of Radiology, Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of)

    2016-02-15

    We explored the association between Framingham risk score (FRS) and coronary artery calcium score (CACS) in asymptomatic Korean individuals. We retrospectively analyzed 2216 participants who underwent routine health screening and CACS using the 64-slice multidetector computed tomography between January 2010 and June 2014. Relationship between CACS and FRS, and factors associated with discrepancy between CACS and FRS were analyzed. CACS and FRS were positively correlated (p < 0.0001). However, in 3.7% of participants with low coronary event risk and high CACS, age, male gender, smoker, hypertension, total cholesterol, diabetes mellitus, and body mass index (BMI; ≥ 35) were associated with the discrepancy. In the diagnostic prediction model for discrepancy, the receiver operating characteristic curve including factors associated with FRS, diastolic blood pressure (≥ 75 mm Hg), diabetes mellitus, and BMI (≥ 35) showed that the area under the curve was 0.854 (95% confidence interval, 0.819–0.890), indicating good sensitivity. Diabetes mellitus or obesity (BMI ≥ 35) compensate for the weakness of FRS and may be potential indicators for application of CACS in asymptomatic Koreans with low coronary event risk.

  10. Is calcium scoring of the coronary arteries necessary for proper management of asymptomatic subjects with classic risk factors?

    Science.gov (United States)

    Richard Conti, C

    2010-11-01

    In 2000, I wrote an editorial entitled, "Detecting Coronary Calcium."1 For the past several years there have been numerous publications on this subject. Recently, an article by Min et al, provided some important information about patients with a normal coronary calcium scan and the conversion from a zero calcium score to greater than zero. Copyright © 2010 Wiley Periodicals, Inc.

  11. Dual energy x-ray imaging and scoring of coronary calcium: physics-based digital phantom and clinical studies

    Science.gov (United States)

    Zhou, Bo; Wen, Di; Nye, Katelyn; Gilkeson, Robert C.; Wilson, David L.

    2016-03-01

    Coronary artery calcification (CAC) as assessed with CT calcium score is the best biomarker of coronary artery disease. Dual energy x-ray provides an inexpensive, low radiation-dose alternative. A two shot system (GE Revolution-XRd) is used, raw images are processed with a custom algorithm, and a coronary calcium image (DECCI) is created, similar to the bone image, but optimized for CAC visualization, not lung visualization. In this report, we developed a physicsbased, digital-phantom containing heart, lung, CAC, spine, ribs, pulmonary artery, and adipose elements, examined effects on DECCI, suggested physics-inspired algorithms to improve CAC contrast, and evaluated the correlation between CT calcium scores and a proposed DE calcium score. In simulation experiment, Beam hardening from increasing adipose thickness (2cm to 8cm) reduced Cg by 19% and 27% in 120kVp and 60kVp images, but only reduced Cg by <7% in DECCI. If a pulmonary artery moves or pulsates with blood filling between exposures, it can give rise to a significantly confounding PA signal in DECCI similar in amplitude to CAC. Observations suggest modifications to DECCI processing, which can further improve CAC contrast by a factor of 2 in clinical exams. The DE score had the best correlation with "CT mass score" among three commonly used CT scores. Results suggest that DE x-ray is a promising tool for imaging and scoring CAC, and there still remains opportunity for further DECCI processing improvements.

  12. 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.

  13. Automatic coronary calcium scoring in low-dose chest computed tomography

    NARCIS (Netherlands)

    Isgum, I.; Prokop, M.; Niemeijer, M.; Viergever, M.; Ginneken, B. van

    2012-01-01

    The calcium burden as estimated from non-ECGsynchronized CT exams acquired in screening of heavy smokers has been shown to be a strong predictor of cardiovascular events. We present a method for automatic coronary calcium scoring with low-dose, non-contrast-enhanced, non-ECG-synchronized chest CT. F

  14. Calcium isotope analysis by mass spectrometry.

    Science.gov (United States)

    Boulyga, Sergei F

    2010-01-01

    The variations in the isotopic composition of calcium caused by fractionation in heterogeneous systems and by nuclear reactions can provide insight into numerous biological, geological, and cosmic processes, and therefore isotopic analysis finds a wide spectrum of applications in cosmo- and geochemistry, paleoclimatic, nutritional, and biomedical studies. The measurement of calcium isotopic abundances in natural samples has challenged the analysts for more than three decades. Practically all Ca isotopes suffer from significant isobaric interferences, whereas low-abundant isotopes can be particularly affected by neighboring major isotopes. The extent of natural variations of stable isotopes appears to be relatively limited, and highly precise techniques are required to resolve isotopic effects. Isotope fractionation during sample preparation and measurements and instrumental mass bias can significantly exceed small isotope abundance variations in samples, which have to be investigated. Not surprisingly, a TIMS procedure developed by Russell et al. (Russell et al., 1978. Geochim Cosmochim Acta 42: 1075-1090) for Ca isotope measurements was considered as revolutionary for isotopic measurements in general, and that approach is used nowadays (with small modifications) for practically all isotopic systems and with different mass spectrometric techniques. Nevertheless, despite several decades of calcium research and corresponding development of mass spectrometers, the available precision and accuracy is still not always sufficient to achieve the challenging goals. The present article discusses figures of merits of presently used analytical methods and instrumentation, and attempts to critically assess their limitations. In Sections 2 and 3, mass spectrometric methods applied to precise stable isotope analysis and to the determination of (41)Ca are described. Section 4 contains a short summary of selected applications, and includes tracer experiments and the potential use

  15. Virtual non-contrast CT using dual energy spectral CT: Feasibility of coronary artery calcium scoring

    Energy Technology Data Exchange (ETDEWEB)

    Song, In Young; Yi, Jeong Geun; Park, Jeong Hee [Dept. of Radiology, Konkuk University School of Medicine, Seoul (Korea, Republic of); Lee, Sung Mok; Lee, Kyung Soo; Chung, Myung Jin [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-06-15

    To evaluate the feasibility of coronary artery calcium scoring based on three virtual noncontrast-enhanced (VNC) images derived from single-source spectral dual-energy CT (DECT) as compared with true noncontrast-enhanced (TNC) images. This prospective study was conducted with the approval of our Institutional Review Board. Ninety-seven patients underwent noncontrast CT followed by contrast-enhanced chest CT using single-source spectral DECT. Iodine eliminated VNC images were reconstructed using two kinds of 2-material decomposition algorithms (material density iodine-water pair [MDW], material density iodine-calcium pair [MDC]) and a material suppressed algorithm (material suppressed iodine [MSI]). Two readers independently quantified calcium on VNC and TNC images. The Spearman correlation coefficient test and Bland-Altman method were used for statistical analyses. Coronary artery calcium scores from all three VNC images showed excellent correlation with those from the TNC images (Spearman's correlation coefficient [ρ] = 0.94, 0.88, and 0.89 for MDW, MDC, and MSI, respectively; p < 0.001 for all pairs). Measured coronary calcium volumes from VNC images also correlated well with those from TNC images (ρ = 0.92, 0.87, and 0.91 for MDW, MDC, and MSI, respectively; p < 0.001 for all pairs). Among the three VNC images, coronary calcium from MDW correlated best with that from TNC. The coronary artery calcium scores and volumes were significantly lower from the VNC images than from the TNC images (p < 0.001 for all pairs). The use of VNC images from contrast-enhanced CT using dual-energy material decomposition/suppression is feasible for coronary calcium scoring. The absolute value from VNC tends to be smaller than that from TNC.

  16. 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 ...

  17. Evaluation of coronary calcium score in patients with normocalcemic primary hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Mesquita PN

    2017-06-01

    Full Text Available Patrícia Nunes Mesquita,1 Ana Paula Dornelas Leão Leite,2 Stella das Chagas Crisóstomo,1 Enio Veras Filho,1 Lucas da Cunha Xavier,1 Francisco Bandeira1 1Unit of Endocrinology, Diabetes and Bone Diseases, Hospital Agamenon Magalhães, 2Department of Radiology, University of Pernambuco, Cardiac Emergency Hospital of Pernambuco, Recife, Pernambuco, Brazil Rationale: Given that the diagnosis of primary hyperparathyroidism (PHPT is given at an increasingly less-symptomatic phase, and the literature data on the cardiovascular risk of patients with normocalcemic primary hyperparathyroidism (NPHPT are controversial, the coronary calcium score (CCS, which is correlated with coronary artery disease, may be useful for clarifying the association between cardiovascular risk and NPHPT.Objective: This research aims to describe the CCS and the clinical and laboratory variables of patients with NPHPT compared with a control group and to verify the presence of an association between NPHPT and CCS.Study population and methods: A questionnaire on anthropometric data (weight, height, waist circumference, and blood pressure was used, laboratory examinations (estimations of glucose, glycated hemoglobin [HbA1c], total cholesterol [TC] and its fractions, triglycerides, creatinine, calcium, parathyroid hormone, and 25-OH vitamin D were conducted, and computerized tomography was carried out to measure the CCS in 13 patients diagnosed with NPHPT and 16 controls.Results: There was no association between NPHPT and altered CCS (odds ratio [OR]: 0.27; 95% confidence interval [CI]: 0.05–1.26; p=0.095. Differences between the case and control groups were found in terms of body mass index (BMI (26.97 kg/m2 vs 31.53 kg/m2, respectively; p=0.044, HbA1c (5.59% vs 6.62%; p=0.000, and TC (188.07 mg/dL vs 220.64 mg/dL; p=0.088. After adjustment for potential confounders, no statistical significance was observed for the association between changes in CCS and presence of NPHPT

  18. Prognostic Value of Gai's Plaque Score and Agatston Coronary Artery Calcium Score for Functionally Significant Coronary Artery Stenosis

    Institute of Scientific and Technical Information of China (English)

    Chuang Zhang; Shuang Yang; Lu-Yue Gai; Zhi-Qi Han; Qian Xin; Xiao-Bo Yang; Jun-Jie Yang

    2016-01-01

    Background:The prognostic values of the coronary computed tomography angiography (CCTA) score for predicting future cardiovascular events have been previously demonstrated in numerous studies.However,few studies have used the rich information available from CCTA to detect functionally significant coronary lesions.We sought to compare the prognostic values of Gai's plaque score and the coronary artery calcium score (CACS) of CCTA for predicting functionally significant coronary lesions,using fractional flow reserve (FFR) as the gold standard.Methods:We retrospectively analyzed 107 visually assessed significant coronary lesions in 88 patients (mean age,59.6 ± 10.2 years;76.14% of males) who underwent CCTA,invasive coronary angiography,and invasive FFR measurement.An FFR <0.80 indicated hemodynamically significant coronary stenosis.Lesions were divided into two groups using an FFR cutoff value of 0.80.We compared Gai's plaque scores and CACS between the two groups and evaluated the correlations of these scores with FFR.The statistical methods included unpaired t-test,Mann-Whitney U-test,and Spearman's correlation coefficients.Results:Coronary lesions with FFR <0.80 had higher Gai's scores than those with FFR ≥0.80.Gai's score had the strongest correlation with FFR (r =-0.48,P < 0.01) and had a greater area under the curve =0.72 (95% confidence interval:0.61-0.82;P < 0.01) than the CACS of whole arteries and a single artery.Conclusions:Both CACS in a single artery and Gai's plaque score demonstrated a good capacity to assess functionally significant coronary artery stenosis when compared to the gold standard FFR.However,Gai's plaque score was more predictive of FFR <0.80.Gai's score can be easily calculated in daily clinical practice and could be used when considering revascularization.

  19. Relationship between Calcium Score and Myocardial Scintigraphy in the Diagnosis of Coronary Disease

    Science.gov (United States)

    Siqueira, Fabio Paiva Rossini; Mesquita, Claudio Tinoco; dos Santos, Alair Augusto Sarmet M. Damas; Nacif, Marcelo Souto

    2016-01-01

    Half the patients with coronary artery disease present with sudden death - or acute infarction as first symptom, making early diagnosis pivotal. Myocardial perfusion scintigraphy is frequently used in the assessment of these patients, but it does not detect the disease without flow restriction, exposes the patient to high levels of radiation and is costly. On the other hand, with less radiological exposure, calcium score is directly correlated to the presence and extension of coronary atherosclerosis, and also to the risk of cardiovascular events. Even though calcium score is a tried-and-true method for stratification of asymptomatic patients, its use is still reduced in this context, since current guidelines are contradictory to its use on symptomatic diseases. The aim of this review is to identify, on patients under investigation for coronary artery disease, the main evidence of the use of calcium score associated with functional evaluation and scintigraphy. PMID:27437867

  20. Feasibility of coronary calcium and stent image subtraction using 320-detector row CT angiography

    DEFF Research Database (Denmark)

    Fuchs, Andreas; Kühl, J Tobias; Chen, Marcus Y;

    2015-01-01

    . We defined target segments on CCTAconv as motion-free coronary segments with calcification or stent and low reader confidence. The effect of CCTAsub was assessed. No approval from the ethics committee was required according to Danish law. RESULTS: A total of 76 target segments were identified....... The use of coronary calcium image subtraction improved the reader confidence in 66% of these segments. In target segments, specificity (86% vs 65%; P

  1. Does coronary calcium scoring with a SCORE better predict significant coronary artery stenosis than without? Correlation with computed tomography coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Durhan, Gamze; Hazirolan, Tuncay; Karcaaltincaba, Musturay; Akata, Deniz [Hacettepe University Medical School, Department of Radiology, Ankara (Turkey); Sunman, Hamza; Aytemir, Kudret [Hacettepe University Medical School, Department of Cardiology, Ankara (Turkey); Karakaya, Jale; Karaagaoglu, Ergun [Hacettepe University, Department of Biostatistics, Ankara (Turkey)

    2014-12-03

    To determine effectiveness of coronary artery calcium score (CACS) alone and combined with Systematic Coronary Risk Evaluation (SCORE) in adult patients for significant coronary artery stenosis by using computed tomography coronary angiography (CTCA) as reference standard. Two thousand twenty-one patients with suspected coronary artery disease (CAD) underwent CACS test and CTCA. Patients were examined with dual-source CT and were grouped according to their age, gender, CACS, and estimated SCORE risk. Coronary plaque existence and degree of stenosis were assessed with CTCA. Sensitivity, specificity, and ROC curves were analyzed. CACS was the single independent variable in estimating relative risk of critical stenosis and had superior outcome when compared with SCORE risk in logistic regression and ROC curve. Area under the ROC curve was greatest in the interval between 50-59 years. When SCORE was combined with CACS in patients with zero CACS, percentage of significant stenosis increased from 1.4% to 7.0% in patients with high or very high SCORE risk, and decreased to 0.9 % in patients with low or moderate SCORE risk. CACS combination with SCORE risk predicts coronary artery stenosis. When CACS is zero, CTCA can be performed in patients with high or very high SCORE risk. (orig.)

  2. 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...

  3. Coronary calcium scores are systematically underestimated at a large chest size : A multivendor phantom study

    NARCIS (Netherlands)

    Willemink, Martin J.; Abramiuc, Bronislaw; den Harder, Annemarie M.; van der Werf, Niels R.; de Jong, Pim A.; Budde, Ricardo P. J.; Wildberger, Joachim E.; Vliegenthart, Rozemarijn; Willems, Tineke P.; Greuter, Marcel J. W.; Leiner, Tim

    2015-01-01

    Objective: To evaluate the effect of chest size on coronary calcium score (CCS) as assessed with new-generation CT systems from 4 major vendors. Methods: An anthropomorphic, small-sized (300 x 200 mm) chest phantom containing 100 small calcifications (diameters, 0.5-2.0 mm) was evaluated with and wi

  4. Evaluation of coronary artery calcium screening strategies focused on risk categories: the Dallas Heart Study.

    Science.gov (United States)

    Patel, Mahesh J; de Lemos, James A; McGuire, Darren K; See, Raphael; Lindsey, Jason B; Murphy, Sabina A; Grundy, Scott M; Khera, Amit

    2009-06-01

    A strategy using coronary artery calcium (CAC) screening to refine coronary heart disease risk assessment in moderately high risk (MHR) subjects (10-year risk 10%-20%) has been suggested. The potential impact of this strategy is unknown. Coronary artery calcium screening strategies focused on MHR subjects were modeled in 2,610 subjects aged 30 to 65 years undergoing Framingham risk scoring and CAC assessment in the Dallas Heart Study. The proportions of subjects eligible for imaging and reclassified from MHR to high risk (HR) (10-year risk >20%) based upon CAC scores were determined. Only 1.0% of women and 15.4% of men were at MHR by Framingham risk scoring and thus eligible for imaging, and MHR to HR using a CAC threshold > or = 400. Coronary artery calcium imaging targeting MHR subjects was also relatively inefficient (>100 women, 14.3 men scanned per subject reclassified). Restricting to an older age range (45-65 years) or expanding the MHR group to 6% to 20% risk had virtually no impact on risk assessment in women. In a secondary analysis, a proposed imaging strategy targeting promotion of subjects from lower risk to MHR was more efficient and had greater yield than current recommendations targeting promotion from MHR to HR. Coronary artery calcium screening strategies focused on MHR subjects will have a negligible impact on risk assessment in women and a modest impact in men. Further studies are needed to optimize the use of CAC screening as an adjunct to coronary heart disease risk assessment, especially for women and those at seemingly lower risk.

  5. Elevated NT-proBNP and coronary calcium score in relation to coronary artery disease in asymptomatic type 2 diabetic patients with elevated urinary albumin excretion rate

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Hansen, Peter R; Persson, Frederik;

    2011-01-01

    Elevated plasma N-terminal (NT)-proBNP levels and coronary calcium score (CCS) not only predicts myocardial ischaemia and coronary artery stenosis but also adverse cardiovascular events and mortality in type 2 diabetic patients with an increased urinary albumin excretion rate (UAER), whereas low...

  6. Measurement of coronary calcium scores by electron beam computed tomography or exercise testing as initial diagnostic tool in low-risk patients with suspected coronary artery disease

    NARCIS (Netherlands)

    Geluk, Christiane A.; Dikkers, Riksta; Perik, Patrick J.; Tio, Rene A.; Gotte, Marco J. W.; Hillege, Hans L.; Vliegenthart, Rozemarijn; Houwers, Janneke B.; Willems, Tineke P.; Oudkerk, Matthijs; Zijlstra, Felix

    2008-01-01

    We determined the efficiency of a screening protocol based on coronary calcium scores (CCS) compared with exercise testing in patients with suspected coronary artery disease (CAD), a normal ECG and troponin levels. Three-hundred-and-four patients were enrolled in a screening protocol including CCS b

  7. The coronary calcium score is a more accurate predictor of significant coronary stenosis than conventional risk factors in symptomatic patients

    DEFF Research Database (Denmark)

    Nicoll, R; Wiklund, U; Zhao, Y;

    2016-01-01

    risk factor assessment, computed tomographic coronary angiogram (CTCA) or conventional angiography and a CT scan for coronary artery calcium (CAC) scoring. 1539 (27.9%) patients had significant stenosis, 5.5% of whom had zero CAC. In 5074 patients, multiple binary regression showed the most important...... predictor of significant stenosis to be male gender (B=1.07) followed by diabetes mellitus (B=0.70) smoking, hypercholesterolaemia, hypertension, family history of CAD and age but not obesity. When the log transformed CAC score was included, it became the most powerful predictor (B=1.25), followed by male...... gender (B=0.48), diabetes, smoking, family history and age but hypercholesterolaemia and hypertension lost significance. The CAC score is a more accurate predictor of >50% stenosis than risk factors regardless of the means of assessment of stenosis. The sensitivity of risk factors, CAC score...

  8. Detection of coronary calcium with electron beam tomography in coronary artery disease; Stellenwert der Kalkbestimmung mit Elektronenstrahltomographie bei koronarer Herzkrankheit

    Energy Technology Data Exchange (ETDEWEB)

    Haberl, R.; Knez, A.; Becker, A. [Muenchen Univ. (Germany). Medizinische Klinik 1; Becker, C.; Bruening, R.; Reiser, M. [Muenchen Univ. (Germany). Inst. fuer Radiologische Diagnostik; Maass, A.; Steinbeck, G.

    1998-12-01

    Purpose: Coronary calcium is a powerful indicator of arteriosclerosis and can be detected very precisely with electron beam tomography. The method can be applied in patients with known coronary artery disease or in asymptomatic patients at risk of arteriosclerotic disease. Results: At the University of Munich we performed an EBT scan of the heart in 1100 patients within the last year. In 567 patients coronary angiography was performed also ({+-}3 days). Confirming previous reports in the literature, we found a correlation of the calcium score with the age and gender of the patients. Severe coronary artery disease (stenoses {>=} 75%) was associated with significantly more calcium than less severe CAD. The calcium score did not discriminate between one-, two- and three-vessel disease. The site of calcification does not correlate with the localization of stenoses. Thirty-three percent of the patients with significant coronary artery disease showed a normal age-adjusted calcium score; a total of 8.1% of patients with severe stenoses did not reveal any coronary calcification (score =0). With asymptomatic patients there are only a few studies available. Soft plaques cannot be detected with EBT, but in most patients soft plaques occur together with hard plaques. Our results show that spiral CT of the newest generation may also be used for calcium screening. There was an excellent correlation of the calcium scores of EBT and spiral CT at all levels of calcification. Discussion: Coronary calcium is a sensitive marker of coronary artery disease. In the clinical setting EBT is indicated in patients with known coronary artery disease (to evaluate prognosis), in patients who are unable to perform a stress test, and in patients with atypical chest pain. However, lack of calcification may be associated with severe stenoses in a minority of patients. The clinical value in asymptomatic patients needs to be defined: Randomized studies are necessary. We see a possible indication in

  9. Correlation between calcium and phosphate levels to calculus accumulation on coronary heart disease patients

    Science.gov (United States)

    Cahaya, Cindy; Masulili, Sri Lelyati C.; Lessang, Robert; Radi, Basuni

    2017-02-01

    Coronary Artery Disease (CAD) or Coronary Heart Disease (CHD) is a disease that happened because of blood flow being blocked by atherosclerosis. Atherosclerosis is a process of hardening of the arteries which characterized by thickening and loss of elasticity of the intimal layer of vascular wall, by lipid deposit. Periodontitis is a chronic multifactorial inflammatory disease caused by microorganism and characterized by progressive destruction of the tooth supporting apparatus leading to tooth loss. Many studies use saliva as a valuable source for clinically information, as an asset for early diagnosis, prognostic and reviewer for pascatherapy status. Dental calculus had happened as a consequence of saliva supersaturation by calcium and phosphate. Salivary flow rate and its composition influence the formation of calculus. Increasing salivary calcium levels is characteristic of periodontitis patients. An important hipotesis in Cardiology is chronic infections contribute in atherosclerosis. Objective: To analyse the correlation between calcium and phosphate levels in saliva to calculus accumulation on CHD patients. Result: Correlation analysis between salivary calcium levels with calculus accumulation in patients with CHD and non-CHD showed no significant p value, p=0.59 and p=0.518. Correlation analysis between salivary phosphate levels and calculus accumulation showed no significant p value, p=0.836 for CHD patients and p=0.484 for non-CHD patients. Conclusion: There are no correlation between calcium levels and phosphate levels with calculus accumulation in CHD patients. Further research need to be done.

  10. Prognostic value of coronary artery calcium score in patients with stable an-gina pectoris after percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Fang-Fang WANG; Jiang-Li HAN; Rong HE; Xiang-Zhu ZENG; Fu-Chun ZHANG; Li-Jun GUO; Wei GAO

    2014-01-01

    Objectives To evaluate the prognostic value of the coronary artery calcium (CAC) score in patients with stable angina pectoris (SAP) who underwent percutaneous coronary intervention (PCI). Methods A total of 334 consecutive patients with SAP who underwent first PCI following multi-slice computer tomography (MSCT) were enrolled from our institution between January 2007 and June 2012. The CAC score was calculated according to the standard Agatston calcium scoring algorithm. Complex PCI was defined as use of high pressure bal-loon, kissing balloon and/or rotablator. Procedure-related complications included dissection, occlusion, perforation, no/slow flow and emer-gency coronary artery bypass grafting. Main adverse cardiac events (MACE) were defined as a combined end point of death, non-fatal myo-cardial infarction, target lesion revascularization and rehospitalization for cardiac ischemic events. Results Patients with a CAC score>300 (n=145) had significantly higher PCI complexity (13.1%vs. 5.8%, P=0.017) and rate of procedure-related complications (17.2%vs. 7.4%, P=0.005) than patients with a CAC score≤300 (n=189). After a median follow-up of 22.5 months (4-72 months), patients with a CAC score≤300 differ greatly than those patients with CAC score>300 in cumulative non-events survival rates (88.9 vs. 79.0%, Log rank 4.577, P=0.032). After adjusted for other factors, the risk of MACE was significantly higher [hazard ratio (HR):4.3, 95%confidence inter-val (95%CI):2.4-8.2, P=0.038] in patients with a CAC score>300 compared to patients with a lower CAC score. Conclusions The CAC score is an independent predictor for MACE in SAP patients who underwent PCI and indicates complexity of PCI and proce-dure-related complications.

  11. Incremental prognostic utility of coronary CT angiography for asymptomatic patients based upon extent and severity of coronary artery calcium: Results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) Study

    NARCIS (Netherlands)

    I. Cho (Iksung); H.-J. Chang (Hyuk-Jae); B.T. Hartaigh (Bríain ó); S. Shin (Sanghoon); J.M. Sung (Ji Min); F.Y. Lin (Fay); S. Achenbach (Stephan); R. Heo (Ran); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); T.Q. Callister (Tracy); M. Al-Mallah (Mouaz); F. Cademartiri (Filippo); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); A.M. Dunning (Allison M.); A. Delago (Augustin); T.C. Villines (Todd); M. Hadamitzky (Martin); J. Hausleiter (Jörg); J. Leipsic (Jonathon); L.J. Shaw (Leslee); P.A. Kaufmann (Philipp A.); 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); J.K. Min (James K.)

    2015-01-01

    textabstractAim Prior evidence observed no predictive utility of coronary CT angiography (CCTA) over the coronary artery calcium score (CACS) and the Framingham risk score (FRS), among asymptomatic individuals. Whether the prognostic value of CCTA differs for asymptomatic patients, when stratified b

  12. Incremental prognostic utility of coronary CT angiography for asymptomatic patients based upon extent and severity of coronary artery calcium: Results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) Study

    NARCIS (Netherlands)

    I. Cho (Iksung); H.-J. Chang (Hyuk-Jae); B.T. Hartaigh (Bríain ó); S. Shin (Sanghoon); J.M. Sung (Ji Min); F.Y. Lin (Fay); S. Achenbach (Stephan); R. Heo (Ran); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); T.Q. Callister (Tracy); M. Al-Mallah (Mouaz); F. Cademartiri (Filippo); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); A.M. Dunning (Allison M.); A. Delago (Augustin); T.C. Villines (Todd); M. Hadamitzky (Martin); J. Hausleiter (Jörg); J. Leipsic (Jonathon); L.J. Shaw (Leslee); P.A. Kaufmann (Philipp A.); 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); J.K. Min (James K.)

    2015-01-01

    textabstractAim Prior evidence observed no predictive utility of coronary CT angiography (CCTA) over the coronary artery calcium score (CACS) and the Framingham risk score (FRS), among asymptomatic individuals. Whether the prognostic value of CCTA differs for asymptomatic patients, when stratified b

  13. Elevated NT-proBNP and coronary calcium score in relation to coronary artery disease in asymptomatic type 2 diabetic patients with elevated urinary albumin excretion rate

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Hansen, Peter R; Persson, Frederik;

    2011-01-01

    Elevated plasma N-terminal (NT)-proBNP levels and coronary calcium score (CCS) not only predicts myocardial ischaemia and coronary artery stenosis but also adverse cardiovascular events and mortality in type 2 diabetic patients with an increased urinary albumin excretion rate (UAER), whereas low...... levels are associated with low frequency of coronary artery disease (CAD) and good prognosis. The underlying causes of poor prognosis in patients with elevated NT-proBNP are not known; thus, we investigated the role of putative asymptomatic CAD in type 2 diabetic patients with UAER >30 mg/24 h...... and elevated P-NT-proBNP and/or CCS....

  14. SPECT myocardial perfusion imaging as an adjunct to coronary calcium score for the detection of hemodynamically significant coronary artery stenosis

    Directory of Open Access Journals (Sweden)

    von Ziegler Franz

    2012-12-01

    Full Text Available Abstract Background Coronary artery calcifications (CAC are markers of coronary atherosclerosis, but do not correlate well with stenosis severity. This study intended to evaluate clinical situations where a combined approach of coronary calcium scoring (CS and nuclear stress test (SPECT-MPI is useful for the detection of relevant CAD. Methods Patients with clinical indication for invasive coronary angiography (ICA were included into our study during 08/2005-09/2008. At first all patients underwent CS procedure as part of the study protocol performed by either using a multidetector computed tomography (CT scanner or a dual-source CT imager. CAC were automatically defined by dedicated software and the Agatston score was semi-automatically calculated. A stress-rest SPECT-MPI study was performed afterwards and scintigraphic images were evaluated quantitatively. Then all patients underwent ICA. Thereby significant CAD was defined as luminal stenosis ≥75% in quantitative coronary analysis (QCA in ≥1 epicardial vessel. To compare data lacking Gaussian distribution an unpaired Wilcoxon-Test (Mann–Whitney was used. Otherwise a Students t-test for unpaired samples was applied. Calculations were considered to be significant at a p-value of Results We consecutively included 351 symptomatic patients (mean age: 61.2±12.3 years; range: 18–94 years; male: n=240 with a mean Agatston score of 258.5±512.2 (range: 0–4214. ICA verified exclusion of significant CAD in 66/67 (98.5% patients without CAC. CAC was detected in remaining 284 patients. In 132/284 patients (46.5% with CS>0 significant CAD was confirmed by ICA, and excluded in 152/284 (53.5% patients. Sensitivity for CAD detection by CS alone was calculated as 99.2%, specificity was 30.3%, and negative predictive value was 98.5%. An additional SPECT in patients with CS>0 increased specificity to 80.9% while reducing sensitivity to 87.9%. Diagnostic accuracy was 84.2%. Conclusions In patients

  15. The impact of CT radiation dose reduction and iterative reconstruction algorithms from four different vendors on coronary calcium scoring

    Energy Technology Data Exchange (ETDEWEB)

    Willemink, Martin J.; Takx, Richard A.P.; Jong, Pim A. de; Budde, Ricardo P.J.; Schilham, Arnold M.R.; Leiner, Tim [Utrecht University Medical Center, Department of Radiology, Utrecht (Netherlands); Bleys, Ronald L.A.W. [Utrecht University Medical Center, Department of Anatomy, Utrecht (Netherlands); Das, Marco; Wildberger, Joachim E. [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands); Prokop, Mathias [Radboud University Nijmegen Medical Center, Department of Radiology, Nijmegen (Netherlands); Buls, Nico; Mey, Johan de [UZ Brussel, Department of Radiology, Brussels (Belgium)

    2014-09-15

    To analyse the effects of radiation dose reduction and iterative reconstruction (IR) algorithms on coronary calcium scoring (CCS). Fifteen ex vivo human hearts were examined in an anthropomorphic chest phantom using computed tomography (CT) systems from four vendors and examined at four dose levels using unenhanced prospectively ECG-triggered protocols. Tube voltage was 120 kV and tube current differed between protocols. CT data were reconstructed with filtered back projection (FBP) and reduced dose CT data with IR. CCS was quantified with Agatston scores, calcification mass and calcification volume. Differences were analysed with the Friedman test. Fourteen hearts showed coronary calcifications. Dose reduction with FBP did not significantly change Agatston scores, calcification volumes and calcification masses (P > 0.05). Maximum differences in Agatston scores were 76, 26, 51 and 161 units, in calcification volume 97, 27, 42 and 162 mm{sup 3}, and in calcification mass 23, 23, 20 and 48 mg, respectively. IR resulted in a trend towards lower Agatston scores and calcification volumes with significant differences for one vendor (P < 0.05). Median relative differences between reference FBP and reduced dose IR for Agatston scores remained within 2.0-4.6 %, 1.0-5.3 %, 1.2-7.7 % and 2.6-4.5 %, for calcification volumes within 2.4-3.9 %, 1.0-5.6 %, 1.1-6.4 % and 3.7-4.7 %, for calcification masses within 1.9-4.1 %, 0.9-7.8 %, 2.9-4.7 % and 2.5-3.9 %, respectively. IR resulted in increased, decreased or similar calcification masses. CCS derived from standard FBP acquisitions was not affected by radiation dose reductions up to 80 %. IR resulted in a trend towards lower Agatston scores and calcification volumes. (orig.)

  16. Pleural Mass Lesion Containing Calcium Sludge

    Directory of Open Access Journals (Sweden)

    Can Kurkcuoglu

    2012-01-01

    Full Text Available   A 30 year-old man was admitted with of chest pain. Had a x-ray and computed tomography showed calcified pleural mass . Lesions in the white-colored, dense mud was the consistency of the material.

  17. The impact of obesity on the relationship between epicardial adipose tissue, left ventricular mass and coronary microvascular function

    Energy Technology Data Exchange (ETDEWEB)

    Bakkum, M.J.; Danad, I.; Romijn, M.A.J.; Stuijfzand, W.J.A.; Leonora, R.M.; Rossum, A.C. van; Knaapen, P. [VU University Medical Center, Department of Cardiology, Amsterdam (Netherlands); Tulevski, I.I.; Somsen, G.A. [Cardiology Centers of the Netherlands, Amsterdam (Netherlands); Lammertsma, A.A.; Kuijk, C. van; Raijmakers, P.G. [VU University Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands)

    2015-09-15

    Epicardial adipose tissue (EAT) has been linked to coronary artery disease (CAD) and coronary microvascular dysfunction. However, its injurious effect may also impact the underlying myocardium. This study aimed to determine the impact of obesity on the quantitative relationship between left ventricular mass (LVM), EAT and coronary microvascular function. A total of 208 (94 men, 45 %) patients evaluated for CAD but free of coronary obstructions underwent quantitative [{sup 15}O]H{sub 2}O hybrid positron emission tomography (PET)/CT imaging. Coronary microvascular resistance (CMVR) was calculated as the ratio of mean arterial pressure to hyperaemic myocardial blood flow. Obese patients [body mass index (BMI) > 25, n = 133, 64 % of total] had more EAT (125.3 ± 47.6 vs 93.5 ± 42.1 cc, p < 0.001), a higher LVM (130.1 ± 30.4 vs 114.2 ± 29.3 g, p < 0.001) and an increased CMVR (26.6 ± 9.1 vs 22.3 ± 8.6 mmHg x ml{sup -1} x min{sup -1} x g{sup -1}, p < 0.01) as compared to nonobese patients. Male gender (β = 40.7, p < 0.001), BMI (β = 1.61, p < 0.001), smoking (β = 6.29, p = 0.03) and EAT volume (β = 0.10, p < 0.01) were identified as independent predictors of LVM. When grouped according to BMI status, EAT was only independently associated with LVM in nonobese patients. LVM, hypercholesterolaemia and coronary artery calcium score were independent predictors of CMVR. EAT volume is associated with LVM independently of BMI and might therefore be a better predictor of cardiovascular risk than BMI. However, EAT volume was not related to coronary microvascular function after adjustments for LVM and traditional risk factors. (orig.)

  18. Progression of Coronary Artery Calcium and Incident Heart Failure: The Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Bakhshi, Hooman; Ambale-Venkatesh, Bharath; Yang, Xiaoying; Ostovaneh, Mohammad R; Wu, Colin O; Budoff, Matthew; Bahrami, Hossein; Wong, Nathan D; Bluemke, David A; Lima, João A C

    2017-04-20

    Although the association between coronary artery calcium (CAC) and future heart failure (HF) has been shown previously, the value of CAC progression in the prediction of HF has not been investigated. In this study, we investigated the association of CAC progression with subclinical left ventricular (LV) dysfunction and incident HF in the Multi-Ethnic Study of Atherosclerosis. The Multi-Ethnic Study of Atherosclerosis is a population-based study consisting of 6814 men and women aged 45 to 84, free of overt cardiovascular disease at enrollment, who were recruited from 4 ethnicities. We included 5644 Multi-Ethnic Study of Atherosclerosis participants who had baseline and follow-up cardiac computed tomography and were free of HF and coronary heart disease before the second cardiac computed tomography. Mean (±SD) age was 61.7±10.2 years and 47.2% were male. The Cox proportional hazard models and multivariable linear regression models were deployed to determine the association of CAC progression with incident HF and subclinical LV dysfunction, respectively. Over a median follow-up of 9.6 (interquartile range: 8.8-10.6) years, 182 participants developed incident HF. CAC progression of 10 units per year was associated with 3% of increased risk of HF independent of overt coronary heart disease (P=0.008). In 2818 participants with available cardiac magnetic resonance images, CAC progression was associated with increased LV end diastolic volume (β=0.16; P=0.03) and LV end systolic volume (β=0.12; P=0.006) after excluding participants with any coronary heart disease. CAC progression was associated with incident HF and modestly increased LV end diastolic volume and LV end systolic volume at follow-up exam independent of overt coronary heart disease. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  19. Comparing coronary artery calcium and thoracic aorta calcium for prediction of all-cause mortality and cardiovascular events on low-dose non-gated computed tomography in a high-risk population of heavy smokers.

    NARCIS (Netherlands)

    Jacobs, P.C.; Prokop, M.; Graaf, Y. van der; Gondrie, M.J.; Janssen, K.J.; Koning, H.J. de; Isgum, I.; Klaveren, R.J.J. van; Oudkerk, M.; Ginneken, B. van; Mali, W.P.Th.

    2010-01-01

    BACKGROUND: Coronary artery calcium (CAC) and thoracic aorta calcium (TAC) can be detected simultaneously on low-dose, non-gated computed tomography (CT) scans. CAC has been shown to predict cardiovascular (CVD) and coronary (CHD) events. A comparable association between TAC and CVD events has yet t

  20. Comparing coronary artery calcium and thoracic aorta calcium for prediction of all-cause mortality and cardiovascular events on low-dose non-gated computed tomography in a high-risk population of heavy smokers

    NARCIS (Netherlands)

    Jacobs, Peter C.; Prokop, Mathias; van der Graaf, Yolanda; Gondrie, Martijn J.; Janssen, Kristel J.; de Koning, Harry J.; Isgum, Ivana; van Klaveren, Rob J.; Oudkerk, Matthijs; van Ginneken, Bram; Mali, Willem P.

    2010-01-01

    Background: Coronary artery calcium (CAC) and thoracic aorta calcium (TAC) can be detected simultaneously on low-dose, non-gated computed tomography (CT) scans. CAC has been shown to predict cardiovascular (CVD) and coronary (CHD) events. A comparable association between TAC and CVD events has yet t

  1. Achieving consistent image quality with dose optimization in 64-row multidetector computed tomography prospective ECG gated coronary calcium scoring.

    Science.gov (United States)

    Pan, Zilai; Pang, Lifang; Li, Jianying; Zhang, Huan; Yang, Wenjie; Ding, Bei; Chai, Weimin; Chen, Kemin; Yao, Weiwu

    2011-04-01

    To evaluate the clinical value of a body mass index (BMI) based tube current (mA) selection method for obtaining consistent image quality with dose optimization in MDCT prospective ECG gated coronary calcium scoring. A formula for selecting mA to achieve desired image quality based on patient BMI was established using a control group (A) of 200 MDCT cardiac patients with a standard scan protocol. One hundred patients in Group B were scanned with this BMI-dependent mA for achieving a desired noise level of 18 HU at 2.5 mm slice thickness. The CTDIvol and image noise on the ascending aorta for the two groups were recorded. Two experienced radiologists quantitatively evaluated the image quality using scores of 1-4 with 4 being the highest. The image quality scores had no statistical difference (P = 0.71) at 3.89 ± 0.32, 3.87 ± 0.34, respectively, for groups A and B of similar BMI. The image noise in Group A had linear relationship with BMI. The image noise in Group B using BMI-dependent mA was independent of BMI with average value of 17.9 HU and smaller deviations for the noise values than in Group A (2.0 vs. 2.9 HU). There was a 35% dose reduction with BMI-dependent mA selection method on average with the lowest effective dose being only 0.35 mSv for patient with BMI of 18.3. A quantitative BMI-based mA selection method in MDCT prospective ECG gated coronary calcium scoring has been proposed to obtain a desired and consistent image quality and provide dose optimization across patient population.

  2. Role of Coronary Calcium Scoring in the Assessment of Physiological Ischemia in Patients with Intermediate Stenosis

    Science.gov (United States)

    Horie, Kazunori; Kikuchi, Yuichi; Takizawa, Kaname; Inoue, Naoto

    2015-01-01

    Although coronary artery calcium (CAC) is an established marker of coronary atherosclerosis, whether it also reflects the physiological significance is unknown. This study aims to evaluate if CAC could indicate physiological ischemia in intermediate stenosis defined by an invasive fractional flow reserve (FFR). CAC score (CACS) derived from either whole coronary arteries or individual arteries was measured by computed tomography among patients with intermediate de novo lesions (percent diameter stenosis from 30% to less than 70%). All stenoses were evaluated by invasive FFR; lesions with an FFR ≤ 0.80 were considered significant. We enrolled 119 patients with 143 lesions. Of these, 42 lesions (29.4%) demonstrated significant ischemia by FFR measurement. FFR values had modest but significant correlations with CACS in individual arteries with intermediate stenosis (r = − 0.290; p stenosis had 71.4% sensitivity and 67.3% specificity as a predictor of significant ischemia at a cut off value of 145.9. Multivariable analysis showed that percent diameter stenosis and CACS in individual arteries with intermediate stenosis were independent predictors for significant ischemia. By net reclassification improvement analysis, CACS in individual arteries with intermediate stenosis provided incremental prediction for significant ischemia over minimum lumen diameter, percent diameter stenosis, and lesion length. CACS measured in each artery, but not the total CACS, provides additional information as to whether an angiographically intermediate stenosis within the artery is significant enough to cause myocardial ischemia. PMID:26648671

  3. Risk stratification of non-contrast CT beyond the coronary calcium scan.

    Science.gov (United States)

    Madaj, Paul; Budoff, Matthew J

    2012-01-01

    Coronary artery calcification (CAC) is a well-known marker for coronary artery disease and has important prognostic implications. CAC is able to provide clinicians with a reliable source of information related to cardiovascular atherosclerosis, which carries incremental information beyond Framingham risk. However, non-contrast scans of the heart provide additional information beyond the Agatston score. These studies are also able to measure various sources of fat, including intrathoracic (eg, pericardial or epicardial) and hepatic, both of which are thought to be metabolically active and linked to increased incidence of subclinical atherosclerosis as well as increased prevalence of type 2  diabetes. Testing for CAC is also useful in identifying extracoronary sources of calcification. Specifically, aortic valve calcification, mitral annular calcification, and thoracic aortic calcium (TAC) provide additional risk stratification information for cardiovascular events. Finally, scanning for CAC is able to evaluate myocardial scaring due to myocardial infarcts, which may also add incremental prognostic information. To ensure the benefits outweigh the risks of a scanning for CAC for an appropriately selected asymptomatic patient, the full utility of the scan should be realized. This review describes the current state of the art interpretation of non-contrast cardiac CT, which clinically should go well beyond coronary artery Agatston scoring alone.

  4. What does my patient's coronary artery calcium score mean? Combining information from the coronary artery calcium score with information from conventional risk factors to estimate coronary heart disease risk

    Directory of Open Access Journals (Sweden)

    Pletcher Mark J

    2004-08-01

    Full Text Available Abstract Background The coronary artery calcium (CAC score is an independent predictor of coronary heart disease. We sought to combine information from the CAC score with information from conventional cardiac risk factors to produce post-test risk estimates, and to determine whether the score may add clinically useful information. Methods We measured the independent cross-sectional associations between conventional cardiac risk factors and the CAC score among asymptomatic persons referred for non-contrast electron beam computed tomography. Using the resulting multivariable models and published CAC score-specific relative risk estimates, we estimated post-test coronary heart disease risk in a number of different scenarios. Results Among 9341 asymptomatic study participants (age 35–88 years, 40% female, we found that conventional coronary heart disease risk factors including age, male sex, self-reported hypertension, diabetes and high cholesterol were independent predictors of the CAC score, and we used the resulting multivariable models for predicting post-test risk in a variety of scenarios. Our models predicted, for example, that a 60-year-old non-smoking non-diabetic women with hypertension and high cholesterol would have a 47% chance of having a CAC score of zero, reducing her 10-year risk estimate from 15% (per Framingham to 6–9%; if her score were over 100, however (a 17% chance, her risk estimate would be markedly higher (25–51% in 10 years. In low risk scenarios, the CAC score is very likely to be zero or low, and unlikely to change management. Conclusion Combining information from the CAC score with information from conventional risk factors can change assessment of coronary heart disease risk to an extent that may be clinically important, especially when the pre-test 10-year risk estimate is intermediate. The attached spreadsheet makes these calculations easy.

  5. Automatic coronary artery calcium scoring in cardiac CT angiography using paired convolutional neural networks.

    Science.gov (United States)

    Wolterink, Jelmer M; Leiner, Tim; de Vos, Bob D; van Hamersvelt, Robbert W; Viergever, Max A; Išgum, Ivana

    2016-12-01

    The amount of coronary artery calcification (CAC) is a strong and independent predictor of cardiovascular events. CAC is clinically quantified in cardiac calcium scoring CT (CSCT), but it has been shown that cardiac CT angiography (CCTA) may also be used for this purpose. We present a method for automatic CAC quantification in CCTA. This method uses supervised learning to directly identify and quantify CAC without a need for coronary artery extraction commonly used in existing methods. The study included cardiac CT exams of 250 patients for whom both a CCTA and a CSCT scan were available. To restrict the volume-of-interest for analysis, a bounding box around the heart is automatically determined. The bounding box detection algorithm employs a combination of three ConvNets, where each detects the heart in a different orthogonal plane (axial, sagittal, coronal). These ConvNets were trained using 50 cardiac CT exams. In the remaining 200 exams, a reference standard for CAC was defined in CSCT and CCTA. Out of these, 100 CCTA scans were used for training, and the remaining 100 for evaluation of a voxel classification method for CAC identification. The method uses ConvPairs, pairs of convolutional neural networks (ConvNets). The first ConvNet in a pair identifies voxels likely to be CAC, thereby discarding the majority of non-CAC-like voxels such as lung and fatty tissue. The identified CAC-like voxels are further classified by the second ConvNet in the pair, which distinguishes between CAC and CAC-like negatives. Given the different task of each ConvNet, they share their architecture, but not their weights. Input patches are either 2.5D or 3D. The ConvNets are purely convolutional, i.e. no pooling layers are present and fully connected layers are implemented as convolutions, thereby allowing efficient voxel classification. The performance of individual 2.5D and 3D ConvPairs with input sizes of 15 and 25 voxels, as well as the performance of ensembles of these Conv

  6. Effect of healthy lifestyle behaviors on the association between leukocyte telomere length and coronary artery calcium.

    Science.gov (United States)

    Diaz, Vanessa A; Mainous, Arch G; Everett, Charles J; Schoepf, U Joseph; Codd, Veryan; Samani, Nilesh J; Samanii, Nilesh J

    2010-09-01

    The telomere length is an indicator of biologic aging, and shorter telomeres have been associated with coronary artery calcium (CAC), a validated indicator of coronary atherosclerosis. It is unclear, however, whether healthy lifestyle behaviors affect the relation between telomere length and CAC. In a sample of subjects aged 40 to 64 years with no previous diagnosis of coronary heart disease, stroke, diabetes mellitus, or cancer (n = 318), healthy lifestyle behaviors of greater fruit and vegetable consumption, lower meat consumption, exercise, being at a healthy weight, and the presence of social support were examined to determine whether they attenuated the association between a shorter telomere length and the presence of CAC. Logistic regression analyses controlling for age, gender, race/ethnicity, and Framingham risk score revealed that the relation between having shorter telomeres and the presence of CAC was attenuated in the presence of high social support, low meat consumption, and high fruit and vegetable consumption. Those with shorter telomeres and these characteristics were not significantly different from those with longer telomeres. Conversely, the subjects with shorter telomeres and less healthy lifestyles had a significantly increased risk of the presence of CAC: low fruit and vegetable consumption (odds ratio 3.30, 95% confidence interval 1.61 to 6.75), high meat consumption (odds ratio 3.33, 95% confidence interval 1.54 to 7.20), and low social support (odds ratio 2.58, 95% confidence interval 1.24 to 5.37). Stratification by gender yielded similar results for men; however, among women, only fruit and vegetable consumption attenuated the shorter telomere length and CAC relation. In conclusion, the results of the present study suggest that being involved in healthy lifestyle behaviors might attenuate the association between shorter telomere length and coronary atherosclerosis, as identified using CAC.

  7. 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.

  8. Relationship of thoracic aortic calcium to coronary calcium and its progression (from the Multi-Ethnic Study of Atherosclerosis [MESA]).

    Science.gov (United States)

    Rivera, Juan J; Nasir, Khurram; Katz, Ronit; Takasu, Junichiro; Allison, Matthew; Wong, Nathan D; Barr, R Graham; Carr, Jeffrey J; Blumenthal, Roger S; Budoff, Matthew J

    2009-06-01

    Thoracic aortic calcium (TAC) has been associated with a higher prevalence of coronary arterial calcium (CAC). The purpose of this study was to assess the relations between TAC and incident CAC and CAC progression in a cohort from the Multi-Ethnic Study of Atherosclerosis (MESA). MESA is a prospective cohort study of 6,814 participants free of clinical cardiovascular disease at entry who underwent noncontrast cardiac computed tomographic scanning at baseline examination and at a 2-year follow-up assessment. The independent associations between TAC and incident CAC in those without CAC at baseline and between TAC and CAC progression in those with CAC at baseline were investigated. The final study population consisted of 5,755 subjects (84%; mean age 62 +/- 10 years, 48% men) who had follow-up CAC scores an average of 2.4 years later. Incident CAC was significantly higher in those with TAC compared with those without TAC at baseline (11 per 100 patient-years vs 6 per 100 patient-years). Similarly, TAC was associated with a higher CAC change (p CAC at baseline. In analysis adjusted for demographics and follow-up duration, TAC was associated with incident CAC (relative risk 1.72, p CAC change (first quartile: relative risk 2.89, 95% confidence interval -3.16 to 8.95; fourth quartile: relative risk 24.21, 95% confidence interval 18.25 to 30.18). In conclusion, TAC is associated with the incidence and progression of CAC. The detection of TAC may improve risk stratification efforts. Future clinical outcomes studies are needed to support such an approach.

  9. Validation and Prognosis of Coronary Artery Calcium Scoring in Nontriggered Thoracic Computed Tomography Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Xie, X.Q.; Zhao, Yingru; de Bock, G.H.; de Jong, P.A.; Mali, W.P.; Oudkerk, M.; Vliegenthart, R.

    2013-01-01

    Background Coronary calcium score (CS), traditionally based on electrocardiography-triggered computed tomography (CT), predicts cardiovascular risk. Currently, nontriggered thoracic CT is extensively used, such as in lung cancer screening. The purpose of the study was to determine the correlation in

  10. The impact of CT radiation dose reduction and iterative reconstruction algorithms from four different vendors on coronary calcium scoring

    NARCIS (Netherlands)

    Willemink, M.J.; Takx, R.A.P.; Jong, P.A. de; Budde, R.P.; Bleys, R.L.; Das, M.; Wildberger, J.E.; Prokop, M.; Buls, N.; Mey, J. de; Schilham, A.M.; Leiner, T.

    2014-01-01

    o analyse the effects of radiation dose reduction and iterative reconstruction (IR) algorithms on coronary calcium scoring (CCS).Fifteen ex vivo human hearts were examined in an anthropomorphic chest phantom using computed tomography (CT) systems from four vendors and examined at four dose levels us

  11. Carotid artery stiffness, digital endothelial function, and coronary calcium in patients with essential thrombocytosis, free of overt atherosclerotic disease

    Directory of Open Access Journals (Sweden)

    Vrtovec Matjaz

    2017-05-01

    Full Text Available Patients with myeloproliferative neoplasms (MPNs are at increased risk for atherothrombotic events. Our aim was to determine if patients with essential thrombocytosis (ET, a subtype of MPNs, free of symptomatic atherosclerosis, have greater carotid artery stiffness, worse endothelial function, greater coronary calcium and carotid plaque burden than control subjects.

  12. High coronary artery calcium score affects clinical outcome despite normal stress myocardial perfusion imaging and normal left ventricular ejection fraction

    DEFF Research Database (Denmark)

    Madsen, Claus Juul; Andersen, Kim F; Zerahn, Bo

    2013-01-01

    Normal myocardial perfusion imaging (MPI) indicates a low risk for cardiac death and new ischaemic events. However, the impact of normal MPI combined with a high coronary artery calcium score (CACS) is not clear. The aims of this study were to evaluate the risk of severely elevated CACS...

  13. Accuracy and Radiation Dose Reduction Using Low-Voltage Computed Tomography Coronary Artery Calcium Scoring With Tin Filtration

    NARCIS (Netherlands)

    Tesche, Christian; De Cecco, Carlo N.; Vliegenthart, Rozemarijn; Albrecht, Moritz Moritz H.; Varga-Szemes, Akos; Duguay, Taylor M.; Ebersberger, Ullrich; Bayer, Richard R.; Canstein, Christian; Schmidt, Bernhard; Allmendinger, Thomas; Litwin, Sheldon E.; Morris, Pamela B.; Flohr, Thomas G.; Hoffmann, Ellen; Schoepf, U. Joseph

    2017-01-01

    This study prospectively investigated the accuracy and radiation dose reduction of CT coronary artery calcium scoring (CACS) using a 100 kVp acquisition protocol with tin filtration (Sn100 kVp) compared with the standard 120 kVp acquisition protocol; 70 patients (59% men, 62.1 10.7 years) who

  14. Relation of obstructive sleep apnea to coronary artery calcium in non-obese versus obese men and women aged 45-75 years.

    Science.gov (United States)

    Luyster, Faith S; Kip, Kevin E; Aiyer, Aryan N; Reis, Steven E; Strollo, Patrick J

    2014-12-01

    Sleep apnea and obesity are strongly associated, and both increase the risk for coronary artery disease. Several cross-sectional studies have reported discrepant results regarding the role obesity plays in the relation between sleep apnea and coronary artery calcium (CAC), a marker of subclinical coronary disease. The aim of the present study was to investigate the association between sleep apnea and the presence of CAC in a community cohort of middle-aged men and women without preexisting cardiovascular disease, stratified by body mass index (0. Sleep apnea was analyzed categorically using the apnea-hypopnea index. The sample was composed of primarily men (61%) and Caucasians (56%), with a mean age of 61 years. The prevalence of CAC was 76%. In participants with body mass indexes <30 kg/m(2) (n = 139), apnea-hypopnea index ≥15 (vs <5) was associated with 2.7-fold odds of having CAC, but the effect only approached significance. Conversely, in participants with body mass indexes ≥30 kg/m(2), sleep apnea was not independently associated with CAC. In conclusion, sleep apnea is independently associated with early atherosclerotic plaque burden in nonobese patients.

  15. Relation of Aortic Valve and Coronary Artery Calcium in Patients With Chronic Kidney Disease to the Stage and Etiology of the Renal Disease

    NARCIS (Netherlands)

    Piers, Lieuwe H.; Touw, Hugo R. W.; Gansevoort, Ron; Franssen, Casper F. M.; Oudkerk, Matthijs; Zijlstra, Felix; Tio, Rene A.

    2009-01-01

    Patients with chronic renal failure have increased cardiac calcium loads. Previous studies have investigated the prevalence and quantitative extent of aortic valve calcium (AVC) and coronary artery calcium (CAC) in patients with various stages of chronic kidney disease (CKD). However, the impact of

  16. Assessment of coronary atherosclerosis by cardiac image: complementary amount of the calcium score to myocardial perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Vitola, Joao Vicente; Cerci, Rodrigo J.; Zapparoli, Marcello, E-mail: joaovitola@quantamn.com.br [Quanta Diagnostico Nuclear, Curitiba, PR (Brazil)

    2011-04-15

    Over the last decades we have witnessed significant advances on diagnostic tools and management of patients with or suspected cardiovascular disease, and consequently a significant reduction in mortality. Nevertheless, cardiovascular disease remains the leader cause of death in many countries, including Brazil. Identifying the high risk patient is important, so we can intensify prevention strategies. Non invasive diagnostic tools have been developed to identify the high risk patient in need of a myocardial revascularization, notably using myocardial scintigraphy. However, many clinicians still question, what is the best management for a patient with traditional risk factors, who has a positive treadmill test result and a completely normal myocardial scintigraphy? What is the literature showing in relation to the role of coronary calcium score for these patients? In this article we will reflect over these issues which are so frequently encountered in daily cardiology practice. (author)

  17. Relation of Dietary Glycemic Index and Glycemic Load to Coronary Artery Calcium in Asymptomatic Korean Adults.

    Science.gov (United States)

    Choi, Yuni; Chang, Yoosoo; Ryu, Seungho; Cho, Juhee; Kim, Mi Kyung; Ahn, Younjhin; Lee, Jung Eun; Sung, Eunju; Kim, Boyoung; Ahn, Jiin; Kim, Chan-Won; Rampal, Sanjay; Zhao, Di; Zhang, Yiyi; Pastor-Barriuso, Roberto; Lima, Joao A C; Chung, Eun Chul; Shin, Hocheol; Guallar, Eliseo

    2015-08-15

    The relation between glycemic index, glycemic load, and subclinical coronary atherosclerosis is unknown. The aim of the study was to evaluate the associations between energy-adjusted glycemic index, glycemic load, and coronary artery calcium (CAC). This study was cross-sectional analysis of 28,429 asymptomatic Korean men and women (mean age 41.4 years) without a history of diabetes or cardiovascular disease. All participants underwent a health screening examination between March 2011 and April 2013, and dietary intake over the preceding year was estimated using a validated food frequency questionnaire. Cardiac computed tomography was used for CAC scoring. The prevalence of detectable CAC (CAC score >0) was 12.4%. In multivariable-adjusted models, the CAC score ratios (95% confidence intervals) comparing the highest to the lowest quintile of glycemic index and glycemic load were 1.74 (1.08 to 2.81; p trend = 0.03) and 3.04 (1.43 to 6.46; p trend = 0.005), respectively. These associations did not differ by clinical subgroups, including the participants at low cardiovascular risk. In conclusion, these findings suggest that high dietary glycemic index and glycemic load were associated with a greater prevalence and degree of CAC, with glycemic load having a stronger association.

  18. Impact of High Calcium Intake from Calcium Carbonate or Dairy on Cardiovascular Function, Coronary Artery Calcification and Coronary Artery Disease Burden in Ossabaw Miniature Swine

    OpenAIRE

    Phillips, Alyssa K.

    2013-01-01

    Recent secondary analyses have associated supplemental calcium use with increased risk for myocardial infarction and cardiovascular-related death in healthy, older adults. Subsequent concern over the safety of calcium supplements has spurred a calcium controversy, because calcium is a shortfall essential nutrient that is critical for bone health and a mainstay of osteoporosis prevention and treatment. The proposed mechanism by which calcium intake may detriment cardiovascular health is throug...

  19. Calcium isotope constraints on the end-Permian mass extinction.

    Science.gov (United States)

    Payne, Jonathan L; Turchyn, Alexandra V; Paytan, Adina; Depaolo, Donald J; Lehrmann, Daniel J; Yu, Meiyi; Wei, Jiayong

    2010-05-11

    The end-Permian mass extinction horizon is marked by an abrupt shift in style of carbonate sedimentation and a negative excursion in the carbon isotope (delta(13)C) composition of carbonate minerals. Several extinction scenarios consistent with these observations have been put forward. Secular variation in the calcium isotope (delta(44/40)Ca) composition of marine sediments provides a tool for distinguishing among these possibilities and thereby constraining the causes of mass extinction. Here we report delta(44/40)Ca across the Permian-Triassic boundary from marine limestone in south China. The delta(44/40)Ca exhibits a transient negative excursion of approximately 0.3 per thousand over a few hundred thousand years or less, which we interpret to reflect a change in the global delta(44/40)Ca composition of seawater. CO(2)-driven ocean acidification best explains the coincidence of the delta(44/40)Ca excursion with negative excursions in the delta(13)C of carbonates and organic matter and the preferential extinction of heavily calcified marine animals. Calcium isotope constraints on carbon cycle calculations suggest that the average delta(13)C of CO(2) released was heavier than -28 per thousand and more likely near -15 per thousand; these values indicate a source containing substantial amounts of mantle- or carbonate-derived carbon. Collectively, the results point toward Siberian Trap volcanism as the trigger of mass extinction.

  20. Coronary artery plaque burden and calcium scores in healthy men adhering to long-term wine drinking or alcohol abstinence.

    Science.gov (United States)

    Luz, P L da; Coimbra, S; Favarato, D; Albuquerque, C; Mochiduky, R I; Rochitte, C E; Hojaij, E; Gonsalves, C R L; Laurindo, F R

    2014-08-01

    Observational studies suggest there are clinical benefits to moderate red wine (RW) consumption. However, the effects on coronary vasculature and overall lifestyle are unclear. We investigated whether a lifestyle of regular long-term RW consumption is associated with changes in coronary plaque burden, calcium score, carotid intima/media thickness, endothelial function, and metabolic variables, compared with alcohol abstinence. Healthy volunteers were evaluated by coronary computed tomography angiography (CTA) as well as carotid and brachial artery ultrasound. Nutritional status, psychological status, and metabolic variables were assessed. The study included 101 drinkers [aged 58.9 ± 7.3 years (means ± SD)], from wine brotherhoods, and 104 abstainers, from Anglican, Evangelical and Catholic churches both in the city of São Paulo, Brazil. No significant differences in demographics were noted. Lesion prevalence per patient assessed by coronary CTA and classified as absent (0), 1-25, 26-49, and ≥ 50% stenosis was similar between groups. When analyzed by individual arteries, i.e., left anterior descending, circumflex, and right coronary, prevalence was also not different. On the other hand, calcium scores were higher among drinkers than abstainers (144.4 ± 362.2 vs 122.0 ± 370.3; Phistory of diabetes and exercised more. RW drinkers consumed 2127.9 ± 387.7 kcal/day while abstainers consumed 1836.0 ± 305.0 (Pwine drinkers displayed a similar plaque burden but greater calcium score than abstainers, despite a more atherogenic diet, and the mechanisms for the increased calcium scores in the former remain speculative.

  1. Deep convolutional neural networks for automatic coronary calcium scoring in a screening study with low-dose chest CT

    Science.gov (United States)

    Lessmann, Nikolas; Išgum, Ivana; Setio, Arnaud A. A.; de Vos, Bob D.; Ciompi, Francesco; de Jong, Pim A.; Oudkerk, Matthjis; Mali, Willem P. Th. M.; Viergever, Max A.; van Ginneken, Bram

    2016-03-01

    The amount of calcifications in the coronary arteries is a powerful and independent predictor of cardiovascular events and is used to identify subjects at high risk who might benefit from preventive treatment. Routine quantification of coronary calcium scores can complement screening programs using low-dose chest CT, such as lung cancer screening. We present a system for automatic coronary calcium scoring based on deep convolutional neural networks (CNNs). The system uses three independently trained CNNs to estimate a bounding box around the heart. In this region of interest, connected components above 130 HU are considered candidates for coronary artery calcifications. To separate them from other high intensity lesions, classification of all extracted voxels is performed by feeding two-dimensional 50 mm × 50 mm patches from three orthogonal planes into three concurrent CNNs. The networks consist of three convolutional layers and one fully-connected layer with 256 neurons. In the experiments, 1028 non-contrast-enhanced and non-ECG-triggered low-dose chest CT scans were used. The network was trained on 797 scans. In the remaining 231 test scans, the method detected on average 194.3 mm3 of 199.8 mm3 coronary calcifications per scan (sensitivity 97.2 %) with an average false-positive volume of 10.3 mm3 . Subjects were assigned to one of five standard cardiovascular risk categories based on the Agatston score. Accuracy of risk category assignment was 84.4 % with a linearly weighted κ of 0.89. The proposed system can perform automatic coronary artery calcium scoring to identify subjects undergoing low-dose chest CT screening who are at risk of cardiovascular events with high accuracy.

  2. Application of Near Infrared Spectroscopy, Intravascular Ultrasound and the Coronary Calcium Score to Predict Adverse Coronary Events

    Science.gov (United States)

    2012-10-01

    myocardial infarctions may occur in patients with minimal or no coronary artery disease on angiography. These observations, as well as post mortem ...diagnosis and treatment guidance for fixed obstructive coronary artery lesions . Contemporary research has shown that a significant proportion of...reveals areas in the coronary artery wall and in atherosclerotic lesions that contain pools of cholesterol and related compounds. These areas are felt to

  3. The salutary effect of dietary calcium on bone mass in a rat model of simulated weightlessness

    Science.gov (United States)

    Bikle, D. D.; Globus, R.; Halloran, B. P.; Morey-Holton, E.

    1985-01-01

    Whether supplementation of dietary calcium reduces the differences in bone mass of unweighed limbs and normally weighted limbs, and whether parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D (1,25(OH)2D) respond differently to dietary calcium in unweighted animals in comparison with pair-fed controls was studied. The hind limbs of rats were unweighted by a tail suspension method and diets containing 0.1% to 2.4% calcium. After 2 weeks serum calcium, phosphorus, PTH and 1,25(OH)2D intestinal calcium transport were determined and bone mass, ash weight, and calcium in the tibia, L-1 vertebra, and humerus were measured. No significant differences in body weights were observed among the various groups. Suspended rats maintained constant levels of serum calcium and phosphate over the wide range of dietary calcium. Serum PTH and 1,25(OH)2D and intestinal calcium transport fell as dietary calcium was increased. Bone calcium in the tibia and vertebra from suspended rats remained less than that from pair-fed control. It is suggested that although no striking difference between suspended and control animals was observed in response to dieteary calcium, increasing dietary calcium may reduce the negative impact of unloading on the calcium content of the unweighted bones. The salutary effect of high dietary calcium appears to be due to inhibition of bone resorption rather than to stimulation of bone formation.

  4. Coronary artery calcium screening : current status and recommendations from the European Society of Cardiac Radiology and North American Society for Cardiovascular Imaging

    NARCIS (Netherlands)

    Oudkerk, Matthijs; Stillman, Arthur E.; Halliburton, Sandra S.; Kalender, Willi A.; Moehlenkamp, Stefan; McCollough, Cynthia H.; Vliegenthart, Rozemarijn; Shaw, Leslee J.; Stanford, William; Taylor, Allen J.; van Ooijen, Peter M. A.; Wexler, Lewis; Raggi, Paolo

    2008-01-01

    Current guidelines and literature on screening for coronary artery calcium for cardiac risk assessment are reviewed for both general and special populations. It is shown that for both general and special populations a zero score excludes most clinically relevant coronary artery disease. The importan

  5. Measurement of coronary calcium scores or exercise testing as initial screening tool in asymptomatic subjects with ST-T changes on the resting ECG: An evaluation study

    NARCIS (Netherlands)

    C.A. Geluk (Christiane); R. Dikkers (Riksta); J.A. Kors (Jan); R.A. Tio (René); R.H.J.A. Slart (Riemer); R. Vliegenthart (Rozemarijn); H.L. Hillege (Hans); T.P. Willems (Tineke); P. de Jong (Paul); W.H. van Gilst (Wiek); M. Oudkerk (Matthijs); F. Zijlstra (Felix)

    2007-01-01

    textabstractBackground: Asymptomatic subjects at intermediate coronary risk may need diagnostic testing for risk stratification. Both measurement of coronary calcium scores and exercise testing are well established tests for this purpose. However, it is not clear which test should be preferred as in

  6. Coronary calcium visualization using dual energy chest radiography with sliding organ registration

    Science.gov (United States)

    Wen, Di; Nye, Katelyn; Zhou, Bo; Gilkeson, Robert C.; Wilson, David L.

    2016-03-01

    Coronary artery calcification (CAC) is the lead biomarker for atherosclerotic heart disease. We are developing a new technique to image CAC using ubiquitously ordered, low cost, low radiation dual energy (DE) chest radiography (using the two-shot GE Revolution XRd system). In this paper, we proposed a novel image processing method (CorCalDx) based on sliding organ registration to create a bone-image-like, coronary calcium image (CCI) that significantly reduces motion artifacts and improves CAC conspicuity. Experiments on images of a physical dynamic cardiac phantom showed that CorCalDx reduced 73% of the motion artifact area as compared to standard DE over a range of heart rates up to 90 bpm and varying x-ray radiation exposures. Residual motion artifact in the phantom CCI is greatly suppressed in gray level and area (0.88% of the heart area). In a Functional Measurement Test (FMT) with 20 clinical exams, image quality improvement of CorCalDx against standard DE (measured from -10 to +10) was significantly suggested (p<0.0001) by three radiologists for cardiac motion artifacts (7.2+/-2.1) and cardiac anatomy visibility (6.1+/-3.5). CorCalDx was always chosen best in every image tested. In preliminary assessments of 12 patients with 18 calcifications, 90% of motion artifact regions in standard DE results were removed in CorCalDx results, with 100% sensitivity of calcification detection, showing great potential of CorCalDx to improve CAC detection and grading in DE chest radiography.

  7. Distribution of coronary calcium score in healthy middle-aged Korean

    Energy Technology Data Exchange (ETDEWEB)

    Choe, Kyu Ok; Kim, Min Jung; Choi, Byoung Wook; Kim, Jung Ho; Noh, Ki Suh; Kim, Si Yon; Ko, Heung Kyu; Suh, Il [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-11-01

    To determine the prevalence and degree of CAC (coronary artery calcification) in appearently healthy middle-aged Koreans, and the relation of CAC to risk factors for atherosclerosis. A total of 289 apparently healthy personnel at Yonsei University (male: 170, female:119, age: mean(SD=54.9{+-}7.1 years)) underwent EBT (electron bean tomography). The risk factors for athero-sclerosis, which included diabetes mellitus, hypertension, smoking, a family history of precocious onset, obesity, hyperlipidemia, and high intraperitoneal fat, were scrutinized. One hundred and sixty-eight subjects (58%) had at least one risk factor. The CAC score was calculated for all subjects and for each coronary artery separately and was then analyzed by age and sex and in relation to the risk factors. The prevalence of CAC was 40% in men and 18.5% in women (mean score:29.7 vs. 9.9). The number of individuals who had one, two, or more than two risk factors was 141,41, and 19, respectively. The number of risk factors and the prevalence and score of CAC were significantly correlated (p=0.01, 0.02 respectively). The number of individuals with no risk factor, with without CAC, was 58(20.1%) and 103(35.6%), respectively, while the number with some risk factor, with or without CAC, was 38(13.1%) and 90(31.1%), respectively. The CAC score was significantly higher in the presence of hypertension, low HDL, or obesity(p=0.001, 0.049, and 0.068, respectively). Smoking appeared to have a borderline effect on the calcium score(p=0.118). This study should provide useful information for interpreting CAC scores and establishing a treatment strategy for Koreans. The comparison of our results with other studies will enable a better understanding of the process and risk factors of atherosclerosis in Koreans.

  8. Optimization of the scan protocol in the measurements of coronary artery calcium

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, L.C.G.; Lopes, R.T. [Coordenacao do Programa de Pos-graduacao em Engenharia (LIN/COPPE/UFRJ), RJ (Brazil). Lab. de Instrumentacao Nuclear; Gottlieb, I.; Carvalho, F.M. de [Clinica de Diagnostico por Imagem, Rio de Janeiro, RJ (Brazil); Kodlulovich, S., E-mail: simone@ird.gov.b [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Mecca, F.A. [Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ (Brazil)

    2011-07-01

    The aim of this study was to evaluate the influence of the tube current applied for studies of calcium score. The research was carried out in a private clinic of Rio de Janeiro, using a 64-slice MDCT scanner and an anthropomorphic cardiac CT phantom. In all images, the Agatston score, the volume and mass of the calcifications, and the noise for each current tube was determined. The average CT attenuation number obtained for all tube currents was 261.6 {+-} 3.2 HU for the CaHA density insert and -0.2 HU {+-} 2.0 for the water insert. The images obtained at lower tube currents were noisier and grainier than those obtained at higher tube currents. However no significant differences were found in the calcium measurements, which suggest a high potential of patient dose reduction, around 50%, without compromising diagnostic information. (author)

  9. Comparison of Frequency and Duration of Periodontal Disease With Progression of Coronary Artery Calcium in Patients With and Without Type 1 Diabetes Mellitus.

    Science.gov (United States)

    Groves, Daniel W; Krantz, Mori J; Hokanson, John E; Johnson, Lonnie R; Eckel, Robert H; Kinney, Gregory L; Rewers, Marian; Snell-Bergeon, Janet K; Alman, Amy C

    2015-09-15

    People with type 1 diabetes mellitus manifest a greater burden of both periodontal disease and coronary artery disease (CAD); however, little is known about their interrelation. Coronary artery calcium (CAC) measures subclinical atherosclerosis and predicts major adverse coronary events. The relation between periodontal disease and CAC progression in individuals with type 1 diabetes has not been previously described. We determined the prevalence and progression of CAC in relation to self-reported periodontal disease. Multivariate logistic and tobit regression models were used to examine the relation between periodontal disease duration and CAC progression and whether this relation differs by diabetes status after controlling for age, gender, total and high-density lipoprotein cholesterol, hypertension, smoking, body mass index (BMI), duration of diabetes, and baseline CAC. A total of 473 patients with type 1 diabetes and 548 without diabetes were followed for a mean of 6.1 years. At baseline, the prevalence and duration of periodontal disease did not differ between subjects with and without diabetes (14.5% vs 13.4%, p = 0.60; 6 vs 9 years, p = 0.18). Duration of periodontal disease was not significantly associated with baseline CAC prevalence. In patients with type 1 diabetes, periodontal disease duration was significantly related to CAC progression (p = 0.004) but not in subjects without diabetes (p = 0.63). In conclusion, this study suggests that periodontal disease is an independent predictor of long-term progression of CAC in patients with type 1 diabetes.

  10. Comparison of Frequency and Duration of Periodontal Disease with Progression of Coronary Artery Calcium in Patients with Type 1 Diabetes Mellitus versus Non-Diabetics

    Science.gov (United States)

    Groves, Daniel W.; Krantz, Mori J.; Hokanson, John E.; Johnson, Lonnie R.; Eckel, Robert H.; Kinney, Gregory L.; Rewers, Marian; Snell-Bergeon, Janet K.; Alman, Amy C.

    2016-01-01

    People with type 1 diabetes mellitus manifest a higher burden of both periodontal disease and coronary artery disease (CAD); however, little is known about their interrelation. Coronary artery calcium (CAC) measures subclinical atherosclerosis and predicts major adverse coronary events. The relation between periodontal disease and CAC progression in individuals with type 1 diabetes has not been previously described. We determined the prevalence and progression of CAC in relation to self-reported periodontal disease. Multivariate logistic and tobit regression models were used to examine the relation between periodontal disease duration and CAC progression and whether this relation differs by diabetes status after controlling for age, sex, total and high-density lipoprotein (HDL) cholesterol, hypertension, smoking, body mass index (BMI), duration of diabetes, and baseline CAC. A total of 473 individuals with type 1 diabetes and 548 non-diabetic individuals were followed for a mean of 6.1 years. At baseline, the prevalence and duration of periodontal disease did not differ between individuals with and without diabetes (14.5% vs. 13.4%, p=0.60; 6 vs. 9 years, p=0.18). Duration of periodontal disease was not significantly associated with baseline CAC prevalence. In type 1 diabetic individuals, periodontal disease duration was significantly related to CAC progression (p=0.004) but not among non-diabetic individuals (p=0.63). In conclusion, this study suggests that periodontal disease is an independent predictor of long-term progression of CAC in type 1 diabetic individuals. PMID:26189036

  11. Usefulness of Regional Distribution of Coronary Artery Calcium to Improve the Prediction of All-Cause Mortality

    OpenAIRE

    Tota-Maharaj, R; Joshi, PH; Budoff, MJ.; Whelton, SP; Zeb, I.; Rumberger, JA; Al-Mallah, MH; Blumenthal, RS; Nasir, K; Blaha, MJ

    2014-01-01

    © 2015 Elsevier Inc. Although the traditional Agatston coronary artery calcium (CAC) score is a powerful predictor of mortality, it is unknown if the regional distribution of CAC further improves cardiovascular risk prediction. We retrospectively studied 23,058 patients referred for Agatston CAC scoring, of whom 61% had CAC (n= 14,084). CAC distribution was defined as the number of vessels with CAC (0 to 4, including left main). For multivessel CAC, "diffuse" CAC was defined by decreasing per...

  12. Mild and moderate pre-dialysis chronic kidney disease is associated with increased coronary artery calcium

    Directory of Open Access Journals (Sweden)

    Budoff M

    2011-12-01

    Full Text Available Sion K Roy, Albert Cespedes, Dong Li, Tae-Young Choi, Matthew J BudoffDivision of Cardiology, Department of Medicine, Los Angeles Biomedical Research Center at Harbor-UCLA Medical Center, Torrance, California, USABackground: It is increasingly evident that patients with chronic kidney disease (CKD are more likely to die from heart disease than kidney failure. This study evaluated whether pre-dialysis CKD is an independent risk factor for coronary artery calcium (CAC.Methods: A total of 544 consecutive patients who underwent CAC scoring were analyzed. Eleven patients requiring hemodialysis were excluded. Patients were divided into three groups: normal glomerular filtration rate (GFR (GFR > 90 mL/min/1.73 m2, mild CKD (90 ≥ GFR > 60 mL/min/1.73 m2, and moderate CKD (60 ≥ GFR > 30 mL/min/1.73 m2. Continuous and categorical variables were compared using analysis of variance and the χ2 statistic. A multiple logistic regression model was used for detecting the association between total CAC score and GFR. An unadjusted model was used, followed by a second model adjusted for covariates known to be related to CAC. Another multivariable binary logistic model predicting the presence of CAC (>10 was performed and odds of incidence of CAC (>10 were calculated among the three GFR subgroups.Results: After adjustment for covariates, patients with mild CKD had mean CAC scores 175 points higher than those with the referent normal GFR (P = 0.048, while those with moderate CKD had mean CAC scores 693 points higher than the referent (P < 0.001. After adjustment for covariates, patients with mild CKD were found to be 2.2 times more likely (95% confidence interval 1.3–3.7, P = 0.004 and patients with moderate CKD were 6.4 times more likely (95% confidence interval 2.9–14.3, P < 0.001 to have incident CAC compared with the group with normal GFR.Conclusion: Mild and moderate pre-dialysis CKD are independent risk factors for increased mean and incident CAC

  13. Measurement of coronary calcium scores by electron beam computed tomography or exercise testing as initial diagnostic tool in low-risk patients with suspected coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Geluk, Christiane A.; Perik, Patrick J.; Tio, Rene A.; Goette, Marco J.W.; Hillege, Hans L.; Zijlstra, Felix [University Medical Center Groningen, Thoraxcenter, Department of Cardiology, Groningen (Netherlands); Dikkers, Riksta; Vliegenthart, Rozemarijn; Houwers, Janneke B.; Willems, Tineke P.; Oudkerk, Matthijs [University Medical Center Groningen, Department of Radiology, Groningen (Netherlands)

    2008-02-15

    We determined the efficiency of a screening protocol based on coronary calcium scores (CCS) compared with exercise testing in patients with suspected coronary artery disease (CAD), a normal ECG and troponin levels. Three-hundred-and-four patients were enrolled in a screening protocol including CCS by electron beam computed tomography (Agatston score), and exercise testing. Decision-making was based on CCS. When CCS{>=}400, coronary angiography (CAG) was recommended. When CCS<10, patients were discharged. Exercise tests were graded as positive, negative or nondiagnostic. The combined endpoint was defined as coronary event or obstructive CAD at CAG. During 12{+-}4 months, CCS{>=}400, 10-399 and <10 were found in 42, 103 and 159 patients and the combined endpoint occurred in 24 (57%), 14 (14%) and 0 patients (0%), respectively. In 22 patients (7%), myocardial perfusion scintigraphy was performed instead of exercise testing due to the inability to perform an exercise test. A positive, nondiagnostic and negative exercise test result was found in 37, 76 and 191 patients, and the combined endpoint occurred in 11 (30%), 15 (20%) and 12 patients (6%), respectively. Receiver-operator characteristics analysis showed that the area under the curve of 0.89 (95% CI: 0.85-0.93) for CCS was superior to 0.69 (95% CI: 0.61-0.78) for exercise testing (P<0.0001). In conclusion, measurement of CCS is an appropriate initial screening test in a well-defined low-risk population with suspected CAD. (orig.)

  14. Diagnostic performance of coronary CT angiography for stenosis detection according to calcium score: systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Dekker, Martijn A.M. den; Oudkerk, Matthijs; Vliegenthart, Rozemarijn [University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Department of Radiology, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); Smet, Kristof de [University of Brussels, Department of Radiology, Brussels (Belgium); Bock, Geertruida H. de [University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Department of Epidemiology, Groningen (Netherlands); Tio, Rene A. [University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen (Netherlands)

    2012-12-15

    A systematic review and meta-analysis to assess sensitivity and specificity of coronary CT angiography (CCTA) for significant stenosis at different degrees of coronary calcification. A literature search was performed including studies describing test characteristics of CCTA for significant stenosis, performed with at least 16-MDCT and according to calcium score (CS). Invasive coronary angiography was the reference standard. Pooled sensitivity and specificity of CCTA by CS categories and CT equipment were calculated. Of 14,121 articles, 51 studies reported on the impact of calcium scoring on diagnostic performance of CCTA and could be included in the systematic review. Twenty-seven of these studies (5,203 participants) were suitable for meta-analysis. On a patient-basis, sensitivity of CCTA for significant stenosis was 95.8, 95.6, 97.6 and 99.0% for CS 0-100, 101-400, 401-1,000 and >1,000 respectively. Specificity was 91.2, 88.2, 50.6 and 84.0% respectively. Specificity of CCTA was significantly lower for CS 401-1,000 due to lack of patients without significant stenosis. Sensitivity and specificity of 16-MDCT were significantly lower compared to more modern CT systems. Even in cases of severe coronary calcification, sensitivity and specificity of CCTA for significant stenosis are high. With 64-MDCT and newer CT systems, a CS cut-off for performing CCTA no longer seems indicated. (orig.)

  15. The Prognostic Value of Coronary Artery Calcium in the PROMISE Study.

    Science.gov (United States)

    Budoff, Matthew J; Mayrhofer, Thomas; Ferencik, Maros; Bittner, Daniel O; Lee, Kerry L; Lu, Michael T; Coles, Adrian; Jang, James J; Krishnam, Mayil S; Douglas, Pamela S; Hoffmann, Udo

    2017-08-28

    Background -Coronary artery calcium (CAC) is an established predictor of future major adverse atherosclerotic cardiovascular events in asymptomatic individuals. However limited data exist as to how CAC compares to functional testing (FT) in estimating prognosis in symptomatic patients. Methods -In the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial, patients with stable chest pain (or dyspnea) and intermediate pre-test probability for obstructive coronary artery disease (CAD) were randomized to FT (exercise electrocardiography, nuclear stress, or stress echocardiography) or anatomic testing. We evaluated those who underwent CAC testing as part of the anatomic evaluation (n=4,209) and compared to results of FT (n=4,602). We stratified CAC and FT results as normal or mildly, moderately or severely abnormal (for CAC: 0, 1-99 Agatston Score [AS], 100-400 AS and >400 AS, respectively; for FT: normal, mild=late positive treadmill, moderate=early positive treadmill or single-vessel ischemia and severe=large ischemic region abnormality). The primary endpoint was all-cause death, myocardial infarction or unstable angina hospitalization over a median follow-up of 26.1 months. Cox regression models were used to calculate hazard ratios and C-statistic to determine predictive and discriminatory value. Results - Overall, the distribution of normal or mildly, moderately or severely abnormal test results was significantly different between FT and CAC (FT = normal 3588 [78.0%], mild 432 [9.4%], moderate 217 [4.7%], severe 365 [7.9%]; CAC = normal 1,457 [34.6%], mild 1340 [31.8%], moderate 772 [18.3%], severe 640 [15.2%], p 0) whereas less than half of events occurred in patients with mild, moderate or severely abnormal FT (n=57/132; 43%) (pfair for both CAC and FT (c-statistic, 0.67 vs. 0.64). Coronary computed tomographic angiography provided significantly better prognostic information compared to FT and CAC testing (C-index: 0.72). Conclusion

  16. Adolescence: How do we increase intestinal calcium absorption to allow for bone mineral mass accumulation?

    Science.gov (United States)

    An increase in calcium absorptive efficiency (fractional absorption of dietary calcium) during adolescence is associated with a rapid increase in total body bone mineral mass (BMM) accumulation. This increase occurs across a range of calcium intakes. It appears to be principally mediated by hormonal...

  17. An automated multi-modal object analysis approach to coronary calcium scoring of adaptive heart isolated MSCT images

    Science.gov (United States)

    Wu, Jing; Ferns, Gordon; Giles, John; Lewis, Emma

    2012-02-01

    Inter- and intra- observer variability is a problem often faced when an expert or observer is tasked with assessing the severity of a disease. This issue is keenly felt in coronary calcium scoring of patients suffering from atherosclerosis where in clinical practice, the observer must identify firstly the presence, followed by the location of candidate calcified plaques found within the coronary arteries that may prevent oxygenated blood flow to the heart muscle. This can be challenging for a human observer as it is difficult to differentiate calcified plaques that are located in the coronary arteries from those found in surrounding anatomy such as the mitral valve or pericardium. The inclusion or exclusion of false positive or true positive calcified plaques respectively will alter the patient calcium score incorrectly, thus leading to the possibility of incorrect treatment prescription. In addition to the benefits to scoring accuracy, the use of fast, low dose multi-slice CT imaging to perform the cardiac scan is capable of acquiring the entire heart within a single breath hold. Thus exposing the patient to lower radiation dose, which for a progressive disease such as atherosclerosis where multiple scans may be required, is beneficial to their health. Presented here is a fully automated method for calcium scoring using both the traditional Agatston method, as well as the Volume scoring method. Elimination of the unwanted regions of the cardiac image slices such as lungs, ribs, and vertebrae is carried out using adaptive heart isolation. Such regions cannot contain calcified plaques but can be of a similar intensity and their removal will aid detection. Removal of both the ascending and descending aortas, as they contain clinical insignificant plaques, is necessary before the final calcium scores are calculated and examined against ground truth scores of three averaged expert observer results. The results presented here are intended to show the requirement and

  18. Relationships between coronary heart disease risk factors and serum ionized calcium in Kennedy Space Center Cohort

    Science.gov (United States)

    Goodwin, Lisa Ann; Frey, Mary Anne Bassett; Merz, Marion P.; Alford, William R.

    1987-01-01

    Kennedy Space Center (KSC) employees are reported to be at high risk for coronary heart disease (CHD). Risk factors for CHD include high serum total cholesterol levels, low levels of high-density lipoprotein cholesterol (HDLC), elevated triglyceride, smoking, inactivity, high blood pressure, being male, and being older. Higher dietary and/or serum calcium Ca(++) may be related to a lower risk for CHD. Fifty men and 37 women participated. Subjects were tested in the morning after fasting 12 hours. Information relative to smoking and exercise habits was obtained; seated blood pressures were measured; and blood drawn. KCS men had higher risk values than KCS women as related to HDLC, triglycerides, systolic blood pressure, and diastolic blood pressure. Smoking and nonsmoking groups did not differ for other risk factors or for serum Ca(++) levels. Exercise and sedentary groups differed in total cholesterol and triglyceride levels. Serum Ca(++) levels were related to age, increasing with age in the sedentary group and decreasing in the exercisers, equally for men and women. It is concluded that these relationships may be significant to the risk of CHD and/or the risk of bone demineralization in an aging population.

  19. Fatty Liver, Insulin Resistance, and Obesity: Relationships With Increase in Coronary Artery Calcium Over Time.

    Science.gov (United States)

    Sung, Ki-Chul; Ryu, Seungho; Lee, Jong-Young; Lee, Sung Ho; Cheong, Eun Sun; Wild, Sarah H; Byrne, Christopher D

    2016-06-01

    Nonalcoholic fatty liver disease, insulin resistance (IR), and obesity frequently coexist with type 2 diabetes mellitus (DM), but it is uncertain whether these risk factors for vascular disease contribute to a change in atherosclerosis over time, independently of DM status. We hypothesized that the combination of fatty liver, IR, and obesity would be associated with an increase in coronary artery calcium (CAC) score over time, independently of DM status, other cardiovascular risk factors, and medications. Data were analyzed from a South Korean occupational cohort of 2175 people. The outcome was increase in cardiac computed tomography CAC score between baseline and follow-up. Insulin resistance was defined by homeostatic model assessment of insulin resistance (HOMA-IR) ≥75th percentile and fatty liver by ultrasound. In 592 (27.2%) participants, CAC score increased from baseline (mean ± SD; mean age at baseline, 44.8 ± 5.5 years); and in 1583 subjects, CAC did not change or improved during follow-up (mean age, 41.6 ± 5.6 years). Diabetes mellitus, HOMA-IR, fatty liver, and obesity prevalence were all higher (all P obesity, and fatty liver was independently associated with increase in CAC score over time (hazard ratio: 2.46, 95% confidence interval: 1.50-4.03). The combination of fatty liver, IR, and obesity is associated with progression of atherosclerosis over time independently of DM, cardiovascular risk factors, and all medications for cardiovascular disease and DM. © 2016 Wiley Periodicals, Inc.

  20. Improving accuracy in coronary lumen segmentation via explicit calcium exclusion, learning-based ray detection and surface optimization

    Science.gov (United States)

    Lugauer, Felix; Zhang, Jingdan; Zheng, Yefeng; Hornegger, Joachim; Kelm, B. Michael

    2014-03-01

    Invasive cardiac angiography (catheterization) is still the standard in clinical practice for diagnosing coronary artery disease (CAD) but it involves a high amount of risk and cost. New generations of CT scanners can acquire high-quality images of coronary arteries which allow for an accurate identification and delineation of stenoses. Recently, computational fluid dynamics (CFD) simulation has been applied to coronary blood flow using geometric lumen models extracted from CT angiography (CTA). The computed pressure drop at stenoses proved to be indicative for ischemia-causing lesions, leading to non-invasive fractional flow reserve (FFR) derived from CTA. Since the diagnostic value of non-invasive procedures for diagnosing CAD relies on an accurate extraction of the lumen, a precise segmentation of the coronary arteries is crucial. As manual segmentation is tedious, time-consuming and subjective, automatic procedures are desirable. We present a novel fully-automatic method to accurately segment the lumen of coronary arteries in the presence of calcified and non-calcified plaque. Our segmentation framework is based on three main steps: boundary detection, calcium exclusion and surface optimization. A learning-based boundary detector enables a robust lumen contour detection via dense ray-casting. The exclusion of calcified plaque is assured through a novel calcium exclusion technique which allows us to accurately capture stenoses of diseased arteries. The boundary detection results are incorporated into a closed set formulation whose minimization yields an optimized lumen surface. On standardized tests with clinical data, a segmentation accuracy is achieved which is comparable to clinical experts and superior to current automatic methods.

  1. A fully automated multi-modal computer aided diagnosis approach to coronary calcium scoring of MSCT images

    Science.gov (United States)

    Wu, Jing; Ferns, Gordon; Giles, John; Lewis, Emma

    2012-03-01

    Inter- and intra- observer variability is a problem often faced when an expert or observer is tasked with assessing the severity of a disease. This issue is keenly felt in coronary calcium scoring of patients suffering from atherosclerosis where in clinical practice, the observer must identify firstly the presence, followed by the location of candidate calcified plaques found within the coronary arteries that may prevent oxygenated blood flow to the heart muscle. However, it can be difficult for a human observer to differentiate calcified plaques that are located in the coronary arteries from those found in surrounding anatomy such as the mitral valve or pericardium. In addition to the benefits to scoring accuracy, the use of fast, low dose multi-slice CT imaging to perform the cardiac scan is capable of acquiring the entire heart within a single breath hold. Thus exposing the patient to lower radiation dose, which for a progressive disease such as atherosclerosis where multiple scans may be required, is beneficial to their health. Presented here is a fully automated method for calcium scoring using both the traditional Agatston method, as well as the volume scoring method. Elimination of the unwanted regions of the cardiac image slices such as lungs, ribs, and vertebrae is carried out using adaptive heart isolation. Such regions cannot contain calcified plaques but can be of a similar intensity and their removal will aid detection. Removal of both the ascending and descending aortas, as they contain clinical insignificant plaques, is necessary before the final calcium scores are calculated and examined against ground truth scores of three averaged expert observer results. The results presented here are intended to show the feasibility and requirement for an automated scoring method to reduce the subjectivity and reproducibility error inherent with manual clinical calcium scoring.

  2. Zero Calcium Score as a Filter for Further Testing in Patients Admitted to the Coronary Care Unit with Chest Pain.

    Science.gov (United States)

    Correia, Luis Cláudio Lemos; Esteves, Fábio P; Carvalhal, Manuela; Souza, Thiago Menezes Barbosa de; Sá, Nicole de; Correia, Vitor Calixto de Almeida; Alexandre, Felipe Kalil Beirão; Lopes, Fernanda; Ferreira, Felipe; Noya-Rabelo, Márcia

    2017-06-12

    The accuracy of zero coronary calcium score as a filter in patients with chest pain has been demonstrated at the emergency room and outpatient clinics, populations with low prevalence of coronary artery disease (CAD). To test the gatekeeping role of zero calcium score in patients with chest pain admitted to the coronary care unit (CCU), where the pretest probability of CAD is higher than that of other populations. Patients underwent computed tomography for calcium scoring, and obstructive CAD was defined by a minimum 70% stenosis on invasive angiography. In 146 patients studied, the prevalence of CAD was 41%. A zero calcium score was present in 35% of the patients. The sensitivity and specificity of zero calcium score yielded a negative likelihood ratio of 0.16. After logistic regression adjustment for pretest probability, zero calcium score was independently associated with lower odds of CAD (OR = 0.12, 95%CI = 0.04-0.36), increasing the area under the ROC curve of the clinical model from 0.76 to 0.82 (p = 0.006). Zero calcium score provided a net reclassification improvement of 0.20 (p = 0.0018) over the clinical model when using a pretest probability threshold of 10% for discharging without further testing. In patients with pretest probability valores preditivos negativos do escore zero. Em 146 pacientes estudados, a prevalência de DAC foi 41% e o escore de cálcio zero foi demonstrado em 35% deles. A sensibilidade e a especificidade para escore de cálcio zero resultaram numa razão de verossimilhança negativa de 0,16. Após ajuste com um escore clínico com a regressão logística para a probabilidade pré-teste, o escore de cálcio zero foi preditor independente associado a baixa probabilidade de DAC (OR = 0,12, IC95% = 0,04-0,36), aumentando a área abaixo da curva ROC do modelo clínico de 0,76 para 0,82 (p = 0,006). Considerando a probabilidade de DAC valor preditivo negativo de 90%. Em pacientes com probabilidade pré-teste valor preditivo negativo foi

  3. Alpha-chlorofatty Acid and coronary artery or aorta calcium scores in women with systemic lupus erythematosus. A pilot study.

    Science.gov (United States)

    Mahieu, Mary A; Guild, Camelia P; Albert, Carolyn J; Kondos, George T; Carr, James J; Edmundowicz, Daniel; Ford, David A; Ramsey-Goldman, Rosalind

    2014-09-01

    Alpha-chlorofatty acid (α-ClFA) is one product of myeloperoxidase activity in vivo during atherogenesis and may be a biomarker for cardiovascular disease (CVD). We investigated if serum α-ClFA is associated with subclinical CVD as measured by coronary artery and aorta calcium scores (CAC and AC, respectively) in women with and without systemic lupus erythematosus (SLE). This pilot project analyzed baseline data from 173 women with SLE and 186 women without SLE participating in a 5-year longitudinal investigation of the Study of Lupus Vascular and Bone Long-term Endpoints (SOLVABLE). Data collection included demographic information, CVD and SLE risk factors, and laboratory assessments. Alpha-ClFA was measured in stored serum by liquid chromatography-mass spectrometry. CAC and AC were measured by computed tomography. Outcome measures were CAC and AC present (CAC > 0 or AC > 0) versus absent (CAC = 0 or AC = 0). Associations between risk factors and CAC or AC were tested with descriptive statistics and multivariate analyses. Women with SLE had higher α-ClFA levels than women without SLE (42.0 fmol/25 µl ± 37.3 vs 34.5 fmol/25 µl ± 21.9; p = 0.020). In analyses including individual CVD risk factors, having SLE was independently associated with the presence of CAC (OR 3.42, 95% CI 1.72 to 6.78) but not AC. Alpha-ClFA was not associated with the presence of CAC or AC in patients with SLE. SLE, but not serum α-ClFA, was associated with the presence of CAC in this pilot project.

  4. Coronary artery plaque burden and calcium scores in healthy men adhering to long-term wine drinking or alcohol abstinence

    Directory of Open Access Journals (Sweden)

    P.L. da Luz

    2014-08-01

    Full Text Available Observational studies suggest there are clinical benefits to moderate red wine (RW consumption. However, the effects on coronary vasculature and overall lifestyle are unclear. We investigated whether a lifestyle of regular long-term RW consumption is associated with changes in coronary plaque burden, calcium score, carotid intima/media thickness, endothelial function, and metabolic variables, compared with alcohol abstinence. Healthy volunteers were evaluated by coronary computed tomography angiography (CTA as well as carotid and brachial artery ultrasound. Nutritional status, psychological status, and metabolic variables were assessed. The study included 101 drinkers [aged 58.9±7.3 years (means±SD], from wine brotherhoods, and 104 abstainers, from Anglican, Evangelical and Catholic churches both in the city of São Paulo, Brazil. No significant differences in demographics were noted. Lesion prevalence per patient assessed by coronary CTA and classified as absent (0, 1-25, 26-49, and ≥50% stenosis was similar between groups. When analyzed by individual arteries, i.e., left anterior descending, circumflex, and right coronary, prevalence was also not different. On the other hand, calcium scores were higher among drinkers than abstainers (144.4±362.2 vs 122.0±370.3; P<0.01. However, drinkers reported less history of diabetes and exercised more. RW drinkers consumed 2127.9±387.7 kcal/day while abstainers consumed 1836.0±305.0 (P<0.0001. HDL cholesterol was significantly higher among drinkers compared to abstainers (46.9±10.9 vs 39.5±9.0 mg/dL; P<0.001, while fasting plasma glucose was lower (97.6±18.2 vs 118.4±29.6 mg/dL; P<0.02. Liver enzymes were normal in both groups. In conclusion, long-term wine drinkers displayed a similar plaque burden but greater calcium score than abstainers, despite a more atherogenic diet, and the mechanisms for the increased calcium scores in the former remain speculative.

  5. Coronary artery plaque burden and calcium scores in healthy men adhering to long-term wine drinking or alcohol abstinence

    Energy Technology Data Exchange (ETDEWEB)

    Luz, P.L. da; Coimbra, S.; Favarato, D.; Albuquerque, C. [Divisão de Cardiologia Clínica, Instituto do Coração (Incor), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Mochiduky, R.I.; Rochitte, C.E. [Divisão de Radiologia, Instituto do Coração (Incor), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Hojaij, E. [Serviço de Psicologia, Instituto do Coração (Incor), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Gonsalves, C.R.L. [Serviço Nutricional, Instituto do Coração (Incor), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Laurindo, F.R. [Laboratório de Biologia Vascular, Instituto do Coração (Incor), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil)

    2014-07-04

    Observational studies suggest there are clinical benefits to moderate red wine (RW) consumption. However, the effects on coronary vasculature and overall lifestyle are unclear. We investigated whether a lifestyle of regular long-term RW consumption is associated with changes in coronary plaque burden, calcium score, carotid intima/media thickness, endothelial function, and metabolic variables, compared with alcohol abstinence. Healthy volunteers were evaluated by coronary computed tomography angiography (CTA) as well as carotid and brachial artery ultrasound. Nutritional status, psychological status, and metabolic variables were assessed. The study included 101 drinkers [aged 58.9±7.3 years (means±SD)], from wine brotherhoods, and 104 abstainers, from Anglican, Evangelical and Catholic churches both in the city of São Paulo, Brazil. No significant differences in demographics were noted. Lesion prevalence per patient assessed by coronary CTA and classified as absent (0), 1-25, 26-49, and ≥50% stenosis was similar between groups. When analyzed by individual arteries, i.e., left anterior descending, circumflex, and right coronary, prevalence was also not different. On the other hand, calcium scores were higher among drinkers than abstainers (144.4±362.2 vs 122.0±370.3; P<0.01). However, drinkers reported less history of diabetes and exercised more. RW drinkers consumed 2127.9±387.7 kcal/day while abstainers consumed 1836.0±305.0 (P<0.0001). HDL cholesterol was significantly higher among drinkers compared to abstainers (46.9±10.9 vs 39.5±9.0 mg/dL; P<0.001), while fasting plasma glucose was lower (97.6±18.2 vs 118.4±29.6 mg/dL; P<0.02). Liver enzymes were normal in both groups. In conclusion, long-term wine drinkers displayed a similar plaque burden but greater calcium score than abstainers, despite a more atherogenic diet, and the mechanisms for the increased calcium scores in the former remain speculative.

  6. 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)

  7. Calcium Mass Balance during Citrate Hemodialysis: A Randomized Controlled Trial Comparing Normal and Low Ionized Calcium Target Ranges

    Science.gov (United States)

    Orsag, Alesa; Ponikvar, Rafael; Buturovic-Ponikvar, Jadranka

    2016-01-01

    Background Regional citrate anticoagulation (RCA) during hemodialysis interferes with calcium homeostasis. Optimal ionized calcium (iCa) target range during RCA and consequent calcium balance are unknown. Methods In a randomized controlled trial (ACTRN12613001029785) 30 chronic hemodialysis patients were assigned to normal (1.1–1.2 mmol/) or low (0.95–1.05 mmol/l) iCa target range during a single hemodialysis with RCA. The primary outcome was calcium mass balance during the procedure, using a partial spent dialysate collection method; magnesium mass balance was also measured. Intact parathormone (iPTH), total calcium (tCa) and magnesium were measured before and after procedures. Results Mean iCa during procedures was significantly different in the two groups (1.12±0.06 in normal and 1.06±0.07 mmol/l in low iCa group, p <0.001), resulting in different tCa (2.18±0.22 vs. 1.95±0.17, p = 0.003) after the procedure. Mean delivered calcium during the procedure was 58.3±4.8 mmol in the normal and 51.5±8.2 mmol in the low iCa group (p = 0.010), which resulted in a significantly higher mean positive calcium mass balance of 14.6±8.3 mmol (584±333 mg) per procedure in normal as compared to 7.2±8.5 mmol (290±341 mg) in low iCa group (p = 0.024). Linear mixed effects model showed a significant interaction effect of time and iCa target range group on iPTH, i.e. a significant increase in iPTH in the low as compared to normal iCa target group (p = 0.008). Magnesium mass balance was mildly negative and comparable in both groups. Conclusions Low iCa target range resulted in a significantly less positive calcium mass balance, but in a significant increase in iPTH. To achieve a more neutral calcium balance, we recommend allowing a mild hypocalcemia during hemodialysis with RCA, especially when it is used for prolonged periods. PMID:28030601

  8. Combining Body Mass Index With Measures of Central Obesity in the Assessment of Mortality in Subjects With Coronary Disease

    DEFF Research Database (Denmark)

    Coutinho, Thais; Goel, Kashish; Corrêa de Sá, Daniel

    2013-01-01

    This study sought to assess the mortality risk of patients with coronary artery disease (CAD) based ona combination of body mass index (BMI) with measures of central obesity.......This study sought to assess the mortality risk of patients with coronary artery disease (CAD) based ona combination of body mass index (BMI) with measures of central obesity....

  9. Very high coronary artery calcium score with normal myocardial perfusion SPECT imaging is associated with a moderate incidence of severe coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Yuoness, Salem A.; Goha, Ahmed M.; Romsa, Jonathan G.; Akincioglu, Cigdem; Warrington, James C.; Datta, Sudip; Gambhir, Sanjay; Urbain, Jean-Luc C.; Vezina, William C. [London Health Sciences Centre, Department of Nuclear Medicine, London, ON (Canada); Massel, David R. [London Health Sciences Centre, Division of Cardiology, London, ON (Canada); Martell, Rafael [Private Practice, London, ON (Canada)

    2015-09-15

    Myocardial perfusion imaging (MPI) has limitations in the presence of balanced multivessel disease (MVD) and left main (LM) coronary artery disease, occasionally resulting in false-normal results despite the high cardiovascular risk associated with this condition. The purpose of this study was to assess the incidence of severe coronary artery disease (CAD) in the presence of a very high Agatston coronary artery calcium (CAC) score (>1,000) in stable symptomatic patients without known CAD but with normal MPI results. A total of 2,659 prospectively acquired consecutive patients were referred for MPI and evaluation of CAC score by CT. Of this patient population, 8 % (222/2,659) had ischemia without myocardial infarction (MI) on MPI and 11 % (298/2,659) had abnormal MPI (MI and/or ischemia). On presentation 1 % of the patients (26/2,659) were symptomatic, had a CAC score >1,000 and normal MPI results. The definition of normal MPI was strict and included a normal hemodynamic response without ischemic ECG changes and normal imaging, particularly absence of transient ischemic dilation. All of these 26 patients with a CAC score >1,000 and normal MPI findings underwent cardiac catheterization. Of these 26 patients, 58 % (15/26) had severe disease (≥70 % stenosis) leading to revascularization. Of this group, 47 % (7/15) underwent percutaneous intervention, and 53 % (8/15) underwent coronary artery bypass grafting. All of these 15 patients had either MVD (14/15) or LM coronary artery disease (1/15), and represented 0.6 % (15/2,659) of all referred patients (95 % CI 0.3 - 0.9 %). The majority, 90 % (8/9), had severe CAD with typical chest pain. A very high CAC score (>1,000) with normal MPI in a small subset of symptomatically stable patients was associated with a moderate incidence of severe CAD (95 % CI 37 - 77 %). Larger studies and/or a meta-analysis of small studies are needed to more precisely estimate the incidence of CAD in this population. This study also supports

  10. Prediction of coronary artery calcium progression by FDG uptake of large arteries in asymptomatic individuals

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sang-Geon; Park, Ki Seong; Kim, Jahae; Song, Ho-Chun [Chonnam National University Hospital, Department of Nuclear Medicine, Gwang-ju (Korea, Republic of); Kang, Sae-Ryung; Kwon, Seong Young; Jabin, Zeenat; Kim, Young Jae; Jeong, Geum-Cheol; Song, Minchul; Min, Jung-Joon; Bom, Hee-Seung [Chonnam National University Hwasun Hospital, Department of Nuclear Medicine, Hwasun-gun, Jeollanam-do (Korea, Republic of); Seon, Hyun Ju [Chonnam National University Hwasun Hospital, Department of Radiology, Hwasun-gun, Jeollanam-do (Korea, Republic of)

    2017-01-15

    The purpose of this study is to evaluate whether fluorodeoxyglucose (FDG) uptake of the large arteries can predict coronary artery calcium (CAC) progression in asymptomatic individuals. Ninety-six asymptomatic individuals who underwent FDG positron emission tomography (PET) and CAC scoring on the same day for health screening and follow-up CAC scoring ≥1 year after baseline studies (mean 4.3 years) were included. Vascular FDG uptake was measured and corrected for blood pool activity to obtain peak and average target-to-blood pool ratios (TBRpeak and TBRavg, respectively) for the carotid arteries, and ascending and abdominal aorta. CAC scores at baseline and follow-up of each individual were measured and absolute CAC change (ΔCAC), annual CAC change (ΔCAC/year), and annual CAC change rate (ΔCAC%/year) were calculated. CAC progression was defined as ΔCAC >0 for individuals with negative baseline CAC; ΔCAC/year ≥10 for those with baseline CAC of 0

  11. CT coronary angiography is feasible for the assessment of coronary artery disease in chronic dialysis patients, despite high average calcium scores.

    Directory of Open Access Journals (Sweden)

    Mihály K de Bie

    Full Text Available PURPOSE: Significant obstructive coronary artery disease (CAD is common in asymptomatic dialysis patients. Identifying these high risk patients is warranted and may improve the prognosis of this vulnerable patient group. Routine catheterization of incident dialysis patients has been proposed, but is considered too invasive. CT-angiography may therefore be more appropriate. However, extensive coronary calcification, often present in this patient group, might hamper adequate lumen evaluation. The objective of this study was to assess the feasibility of CT-angiography in this patient group. METHODS: For this analysis all patients currently participating in the ICD2 trial (ISRCTN20479861, with no history of PCI or CABG were included. The major epicardial vessels were evaluated on a segment basis (segment 1-3, 5-8, 11 and 13 by a team consisting of an interventional and an imaging specialist. Segments were scored as not significant, significant and not interpretable. RESULTS: A total of 70 dialysis patients, with a mean age of 66±8 yrs and predominantly male (70% were included. The median calcium score was 623 [79, 1619]. Over 90% of the analyzed segments were considered interpretable. The incidence of significant CAD on CT was 43% and was associated with cardiovascular events during follow-up. The incidence of cardiovascular events after 2-years follow-up: 36% vs. 0% in patients with no significant CAD (p<0.01. CONCLUSION: Despite the high calcium scores CT-angiography is feasible for the evaluation of the extent of CAD in dialysis patients. Moreover the presence of significant CAD on CT was associated with events during follow-up.

  12. Relation of Coronary Artery Calcium Score and Risk of Cancer (from a Danish Population-Based Follow-up Study in Patients Who Underwent Cardiac Computed Tomography)

    DEFF Research Database (Denmark)

    Vinter, Nicklas; Christesen, Amanda M.S.; Mortensen, Leif S.

    2017-01-01

    of 28,549 cancer-free patients identified in the Western Denmark Heart Registry. All patients underwent cardiac computed tomography for measurement of CACS for suspected coronary artery disease. The outcome was an incident cancer diagnosis: total, tobacco-related, lung, prostate, breast, and colorectal......Evidence of a causal link between atherosclerosis and cancer is sparse and conflicting. Therefore, we examined the association between extent of coronary atherosclerosis determined by coronary artery calcium score (CACS) and risk of cancer. We conducted a historical population-based cohort study...

  13. Economic analysis of the use of coronary calcium scoring as an alternative to stress ECG in the non-invasive diagnosis of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Raman, Vivek [Brighton and Sussex University Hospitals, Brighton (United Kingdom); Royal Sussex County Hospital, Brighton (United Kingdom); McWilliams, Eric T.M. [Conquest Hospital, Hastings (United Kingdom); Holmberg, Stephen R.M.; Miles, Ken [Brighton and Sussex University Hospitals, Brighton (United Kingdom)

    2012-03-15

    To conduct an economic analysis (EA) of coronary calcium scoring (CCS) using a 0 score, as alternative to stress electrocardiography (sECG) in diagnosing coronary artery disease (CAD). A decision tree was constructed to compare four strategies for investigation of suspected CAD previously assessed in the formulation of clinical guidelines for the United Kingdom (UK) to two new strategies incorporating CCS. Sensitivity (96%; 95% CI 95.4-96.4%) and specificity (40%; 95% CI 38.7-41.4%) values for CCS were derived from a meta-analysis of 10,760 patients. Other input variables were obtained from a previous EA and average prices for hospital procedures in the UK. A threshold of pound 30,000/Quality-adjusted Life Year (QALY) was considered cost-effective. Using net monetary benefit calculations, CCS-based strategies were found to be cost-effective compared to sECG equivalents at all assessed prevalence of CAD. Using CCS prior to myocardial perfusion scintigraphy (MPS) and catheter angiography (CA) was found to be cost-effective at pre-test probabilities (PTP) below 30%. Adoption of CCS as an alternative to sECG in investigating suspected stable angina in low PTP population (<30%) would be cost-effective. In patients with PTP of CAD >30%, proceeding to MPS or CA would be more cost-effective than performing either CCS or sECG. (orig.)

  14. [Childhood body mass index and the risk of coronary heart disease in adulthood

    DEFF Research Database (Denmark)

    Baker, Jennifer Lyn; Olsen, L.W.; Sørensen, Thorkild I.A.

    2008-01-01

    The severity of the long term consequences of the current childhood obesity epidemic on coronary heart disease is unknown. Therefore we investigated the association between body mass index (BMI) at ages 7-13 years and heart disease in adulthood among 276,835 Danish schoolchildren. We found...... that higher BMI during this period of childhood is associated with an increased risk of any, non-fatal and fatal heart disease in adulthood. Worldwide, as children are becoming heavier, our findings suggest that greater numbers of children are at risk of having coronary heart disease in adulthood...

  15. Chronic myocardial infarction detection and characterization during coronary artery calcium scoring acquisitions.

    LENUS (Irish Health Repository)

    Rodríguez-Granillo, Gastón A

    2012-01-05

    Hypoenhanced regions on multidetector CT (MDCT) coronary angiography correlate with myocardial hyperperfusion. In addition to a limited capillary density, chronic myocardial infarction (MI) commonly contains a considerable amount of adipose tissue.

  16. Coronary calcium screening with dual-source CT: reliability of ungated, high-pitch chest CT in comparison with dedicated calcium-scoring CT

    Energy Technology Data Exchange (ETDEWEB)

    Hutt, Antoine; Faivre, Jean-Baptiste; Remy, Jacques; Remy-Jardin, Martine [CHRU et Universite de Lille, Department of Thoracic Imaging, Hospital Calmette (EA 2694), Lille (France); Duhamel, Alain; Deken, Valerie [CHRU et Universite de Lille, Department of Biostatistics (EA 2694), Lille (France); Molinari, Francesco [Centre Hospitalier General de Tourcoing, Department of Radiology, Tourcoing (France)

    2016-06-15

    To investigate the reliability of ungated, high-pitch dual-source CT for coronary artery calcium (CAC) screening. One hundred and eighty-five smokers underwent a dual-source CT examination with acquisition of two sets of images during the same session: (a) ungated, high-pitch and high-temporal resolution acquisition over the entire thorax (i.e., chest CT); (b) prospectively ECG-triggered acquisition over the cardiac cavities (i.e., cardiac CT). Sensitivity and specificity of chest CT for detecting positive CAC scores were 96.4 % and 100 %, respectively. There was excellent inter-technique agreement for determining the quantitative CAC score (ICC = 0.986). The mean difference between the two techniques was 11.27, representing 1.81 % of the average of the two techniques. The inter-technique agreement for categorizing patients into the four ranks of severity was excellent (weighted kappa = 0.95; 95 % CI 0.93-0.98). The inter-technique differences for quantitative CAC scores did not correlate with BMI (r = 0.05, p = 0.575) or heart rate (r = -0.06, p = 0.95); 87.2 % of them were explained by differences at the level of the right coronary artery (RCA: 0.8718; LAD: 0.1008; LCx: 0.0139; LM: 0.0136). Ungated, high-pitch dual-source CT is a reliable imaging mode for CAC screening in the conditions of routine chest CT examinations. (orig.)

  17. Risk stratification of non-contrast CT beyond the coronary calcium scan

    OpenAIRE

    Madaj, Paul; Budoff, Matthew J.

    2012-01-01

    Coronary artery calcification (CAC) is a well-known marker for coronary artery disease and has important prognostic implications. CAC is able to provide clinicians with a reliable source of information related to cardiovascular atherosclerosis, which carries incremental information beyond Framingham risk. However, non-contrast scans of the heart provide additional information beyond the Agatston score. These studies are also able to measure various sources of fat, including intrathoracic (eg,...

  18. Coronary artery calcium score using electron beam tomography in the patients with acute obstructive coronary arterial disease : comparative study within asymptomatic high-risk group of atherosclerosis and chronic obstructive coronary arterial disease group

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Seok Jong; Choi, Byoung Wook; Choe, Kyu Ok [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-04-01

    To compare, through analysis of the coronary artery calcium (CAC) score and the risk factors for atherosclerosis, the characteristics of acute coronary syndrome between an asymptomatic high-risk group of atherosclerosis patients and a chronic coronary arterial obstructive disease(CAOD) group. The CAC scores of an asymptomatic high-risk group of atherosclerosis patients (group I, n=284), a chronic CAOD croup (group II, n=39) and an acute coronary syndrome group (group III, n=21) were measured by electron beam tomography. Forty-seven patients with CAOD from groups II and III underwent coronary angiography, and we scrutinized age, sex and risk factors including diabetes mellitus, hypertension, obesity, smoking, hypercholesterolemia and low high-density lipoproteinemia. The numbers of stenotic coronary arterial branches and degree of stenosis revealed by coronary angiography were also recorded. We determined the differences between the three groups in terms of CAC score and the risk factors, the relationship between CAC score and risk factors, and the characteristic features of each type of CAOD group. The mean CA score of group III (135.1) was not statistically different from that of group I (135.7) or group II (365.8). Among patients aged below 50, the mean CAC score of group III (127.4) was significantly higher than that of group I (6.2), (p=0.0006). The mean CAC score at the sixth decade was also significantly different between group I(81.5) and group II (266.9). The mean age of group III (54.2 years) was significantly lower than that of group I (58.1 years) (p=0.047) and of group II (60.1) (p=0.022). There was significant correlation between the number of stenotic coronary arterial branches and log(CAC +1) (p<.01). The square root of the CAC score and the maximal degree of stenosis was also well correlated (p<.01). There was no difference in the mean number of risk factors among the three groups, though the incidence of smoking in group III was significantly

  19. Calcium

    Science.gov (United States)

    ... in luck if you like sardines and canned salmon with bones. Almond milk. previous continue Working Calcium ... drinks, and cereals. Other Considerations for Building Bones Vitamin D is essential for calcium absorption, so it's ...

  20. 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

  1. Association between circulating vitamin K1 and coronary calcium progression in community-dwelling adults: the Multi-Ethnic Study of Atherosclerosis

    Science.gov (United States)

    While animal studies found vitamin K treatment reduced vascular calcification, human data are limited. Using a case-cohort design, we determined the association between vitamin K status and coronary artery calcium (CAC) progression in the Multi-ethnic Study of Atherosclerosis. Serum phylloquinone (v...

  2. The prospective association of Chlamydia pneumoniae and four otherpathogens with development of coronary artery calcium: TheMulti-Ethnic Study of Atherosclerosis (MESA)

    NARCIS (Netherlands)

    B. Laek (Babray); M. Szklo (Moyses); R.L. McClelland (Robyn); J. Ding (Jinhui); M.Y. Tsai (Michael); D.A. Bluemke (David); R.P. Tracy (Russell); K. Matsushita (Kunihiro)

    2013-01-01

    textabstractObjective: Previous basic and cross-sectional studies obtained conflicting results regarding the association of pathogens with coronary artery calcium (CAC). The aim of this study is to prospectively evaluate this association in a population-based cohort. Methods: We examined 5744

  3. The prospective association of Chlamydia pneumoniae and four otherpathogens with development of coronary artery calcium: TheMulti-Ethnic Study of Atherosclerosis (MESA)

    NARCIS (Netherlands)

    B. Laek (Babray); M. Szklo (Moyses); R.L. McClelland (Robyn); J. Ding (Jinhui); M.Y. Tsai (Michael); D.A. Bluemke (David); R.P. Tracy (Russell); K. Matsushita (Kunihiro)

    2013-01-01

    textabstractObjective: Previous basic and cross-sectional studies obtained conflicting results regarding the association of pathogens with coronary artery calcium (CAC). The aim of this study is to prospectively evaluate this association in a population-based cohort. Methods: We examined 5744 indivi

  4. Correlation between body mass index and the risk factors and severity of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Jing LI

    2011-04-01

    Full Text Available Objective To assess the correlation between body mass index and the risk factors and severity of coronary artery disease.Methods Five thousand two hundred and ninety-four patients with suspected coronary artery disease,who underwent coronary angiography from Jan.2001 to Mar.2007 at 20 medical centers in China,were enrolled in the present study.The patients were divided into normal,overweight and obesity group,and body mass index(BMI,blood pressure(BP,blood glucose,serum total cholesterol(TC,triglyceride(TG,low-density lipoprotein cholesterol(LDL-C and high-density lipoprotein cholesterol(HDL-C were measured.The correlation between BMI and the risk factors and severity of coronary artery disease(CAD was analyzed.And the correlation between gender in different BMI group and CAD rick factors was also evaluated.Results The BMI was correlated with BP,TC,blood glucose,age and HDL-C(P 0.05 in male group.The BMI was correlated with BP,TC,TG,LDL-C and high blood glucose(P 0.05 in female group.Logistic regression analysis showed that hypertension was a prominent predictor of overweight and obesity(OR=2.102,95%CI 1.762~2.509.Conclusion BMI is significantly correlated with blood glucose,BP,TG,TC,LDL-C and HDL-C,but it is not an independent risk factor for CAD.

  5. Incremental prognostic utility of coronary CT angiography for asymptomatic patients based upon extent and severity of coronary artery calcium: results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) Study

    Science.gov (United States)

    Cho, Iksung; Chang, Hyuk-Jae; Ó Hartaigh, Bríain; Shin, Sanghoon; Sung, Ji Min; Lin, Fay Y.; Achenbach, Stephan; Heo, Ran; Berman, Daniel S.; Budoff, Matthew J.; Callister, Tracy Q.; Al-Mallah, Mouaz H.; Cademartiri, Filippo; Chinnaiyan, Kavitha; Chow, Benjamin J.W.; Dunning, Allison M.; DeLago, Augustin; Villines, Todd C.; Hadamitzky, Martin; Hausleiter, Joerg; Leipsic, Jonathon; Shaw, Leslee J.; Kaufmann, Philipp A.; Cury, Ricardo C.; Feuchtner, Gudrun; Kim, Yong-Jin; Maffei, Erica; Raff, Gilbert; Pontone, Gianluca; Andreini, Daniele; Min, James K.

    2015-01-01

    Aim Prior evidence observed no predictive utility of coronary CT angiography (CCTA) over the coronary artery calcium score (CACS) and the Framingham risk score (FRS), among asymptomatic individuals. Whether the prognostic value of CCTA differs for asymptomatic patients, when stratified by CACS severity, remains unknown. Methods and results From a 12-centre, 6-country observational registry, 3217 asymptomatic individuals without known coronary artery disease (CAD) underwent CACS and CCTA. Individuals were categorized by CACS as: 0–10, 11–100, 101–400, 401–1000, >1000. For CCTA analysis, the number of obstructive vessels—as defined by the per-patient presence of a ≥50% luminal stenosis—was used to grade the extent and severity of CAD. The incremental prognostic value of CCTA over and above FRS was measured by the likelihood ratio (LR) χ2, C-statistic, and continuous net reclassification improvement (NRI) for prediction, discrimination, and reclassification of all-cause mortality and non-fatal myocardial infarction. During a median follow-up of 24 months (25th–75th percentile, 17–30 months), there were 58 composite end-points. The incremental value of CCTA over FRS was demonstrated in individuals with CACS >100 (LRχ2, 25.34; increment in C-statistic, 0.24; NRI, 0.62, all P 0.05). For subgroups with CACS >100, the utility of CCTA for predicting the study end-point was evident among individuals whose CACS ranged from 101 to 400; the observed predictive benefit attenuated with increasing CACS. Conclusion Coronary CT angiography provides incremental prognostic utility for prediction of mortality and non-fatal myocardial infarction for asymptomatic individuals with moderately high CACS, but not for lower or higher CACS. PMID:25205531

  6. Cost-effectiveness of coronary artery calcium testing for coronary heart and cardiovascular disease risk prediction to guide statin allocation: the Multi-Ethnic Study of Atherosclerosis (MESA).

    Science.gov (United States)

    Roberts, Eric T; Horne, Aaron; Martin, Seth S; Blaha, Michael J; Blankstein, Ron; Budoff, Matthew J; Sibley, Christopher; Polak, Joseph F; Frick, Kevin D; Blumenthal, Roger S; Nasir, Khurram

    2015-01-01

    The Multi-Ethnic Study of Atherosclerosis (MESA) showed that the addition of coronary artery calcium (CAC) to traditional risk factors improves risk classification, particularly in intermediate risk asymptomatic patients with LDL cholesterol levels statin. Treatment based on CAC was compared to (1) treatment of all intermediate-risk patients, and (2) treatment on the basis of United States guidelines. We developed a Markov model of first coronary heart disease (CHD) and cardiovascular disease (CVD) events. We modeled statin treatment in intermediate risk patients with CAC≥1 and CAC≥100, with different intensities of statins based on the CAC score. We compared these CAC-based treatment strategies to a "treat all" strategy and to treatment according to the Adult Treatment Panel III (ATP III) guidelines. Clinical and economic outcomes were modeled over both five- and ten-year time horizons. Outcomes consisted of CHD and CVD events and Quality-Adjusted Life Years (QALYs). Sensitivity analyses considered the effect of higher event rates, different CAC and statin costs, indirect costs, and re-scanning patients with incidentalomas. We project that it is both cost-saving and more effective to scan intermediate-risk patients for CAC and to treat those with CAC≥1, compared to treatment based on established risk-assessment guidelines. Treating patients with CAC≥100 is also preferred to existing guidelines when we account for statin side effects and the disutility of statin use. Compared to the alternatives we assessed, CAC testing is both effective and cost saving as a risk-stratification tool, particularly if there are adverse effects of long-term statin use. CAC may enable providers to better tailor preventive therapy to patients' risks of CVD.

  7. Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals

    Science.gov (United States)

    Min, James K.; Labounty, Troy M.; Gomez, Millie J.; Achenbach, Stephan; Al-Mallah, Mouaz; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk-Jae; Cheng, Victor; Chinnaiyan, Kavitha M.; Chow, Benjamin; Cury, Ricardo; Delago, Augustin; Dunning, Allison; Feuchtner, Gudrun; Hadamitzky, Martin; Hausleiter, Jorg; Kaufmann, Philipp; Kim, Yong-Jin; Leipsic, Jonathon; Lin, Fay Y.; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J.; Villines, Todd C.; Berman, Daniel S.

    2015-01-01

    Background Coronary artery disease (CAD) diagnosis by coronary computed tomographic angiography (CCTA) is useful for identification of symptomatic diabetic individuals at heightened risk for death. Whether CCTA-detected CAD enables improved risk assessment of asymptomatic diabetic individuals beyond clinical risk factors and coronary artery calcium scoring (CACS) remains unexplored. Methods From a prospective 12-center international registry of 27,125 individuals undergoing CCTA, we identified 400 asymptomatic diabetic individuals without known CAD. Coronary stenosis by CCTA was graded as 0%, 1–49%, 50–69%, and ≥70%. CAD was judged on a per-patient, per-vessel and per-segment basis as maximal stenosis severity, number of vessels with ≥50% stenosis, and coronary segments weighted for stenosis severity (segment stenosis score), respectively. We assessed major adverse cardiovascular events (MACE) – inclusive of mortality, nonfatal myocardial infarction (MI), and late target vessel revascularization ≥90 days (REV) – and evaluated the incremental utility of CCTA for risk prediction, discrimination and reclassification. Results Mean age was 60.4 ± 9.9 years; 65.0% were male. At a mean follow-up 2.4 ± 1.1 years, 33 MACE occurred (13 deaths, 8 MI, 12 REV) [8.25%; annualized rate 3.4%]. By univariate analysis, per-patient maximal stenosis [hazards ratio (HR) 2.24 per stenosis grade, 95% confidence interval (CI) 1.61–3.10, p < 0.001], increasing numbers of obstructive vessels (HR 2.30 per vessel, 95% CI 1.75–3.03, p < 0.001) and segment stenosis score (HR 1.14 per segment, 95% CI 1.09–1.19, p < 0.001) were associated with increased MACE. After adjustment for CAD risk factors and CACS, maximal stenosis (HR 1.80 per grade, 95% CI 1.18–2.75, p = 0.006), number of obstructive vessels (HR 1.85 per vessel, 95% CI 1.29–2.65, p < 0.001) and segment stenosis score (HR 1.11 per segment, 95% CI 1.05–1.18, p < 0.001) were associated with increased risk of

  8. Automatic coronary calcium scoring in cardiac CT angiography using convolutional neural networks

    NARCIS (Netherlands)

    Wolterink, Jelmer M.; Leiner, Tim; Viergever, Max A.; Isgum, I

    2015-01-01

    The amount of coronary artery calcification (CAC) is a strong and independent predictor of cardiovascular events. Non-contrast enhanced cardiac CT is considered a reference for quantification of CAC. Recently, it has been shown that CAC may be quantified in cardiac CT angiography (CCTA). We present

  9. 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...

  10. Cinnamaldehyde and cinnamaldehyde-containing micelles induce relaxation of isolated porcine coronary arteries: role of nitric oxide and calcium

    Directory of Open Access Journals (Sweden)

    Raffai G

    2014-05-01

    Full Text Available Gábor Raffai,1 Byungkuk Kim,1 Sanga Park,1 Gilson Khang,1 Dongwon Lee,1 Paul M Vanhoutte1,21World Class University, Department of BIN Fusion Technology, Chonbuk National University, Jeonju, Jeonbuk, South Korea; 2Department of Pharmacology and Pharmacy and State Key Laboratory for Pharmaceutical Biotechnology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Special Administrative Region, ChinaBackground and purpose: Cinnamaldehyde, a major component of cinnamon, induces the generation of reactive oxygen species and exerts vasodilator and anticancer effects, but its short half-life limits its clinical use. The present experiments were designed to compare the acute relaxing properties of cinnamaldehyde with those of self-assembling polymer micelles either loaded with cinnamaldehyde or consisting of a polymeric prodrug [poly(cinnamaldehyde] that incorporates the compound in its backbone.Methods: Rings of porcine coronary arteries were contracted with the thromboxane A2 receptor agonist U46619 or 40 mM KCl, and changes in isometric tension were recorded.Results: Cinnamaldehyde induced concentration-dependent but endothelium-independent, nitric oxide synthase (NOS-independent, cyclooxygenase-independent, soluble guanylyl cyclase (sGC-independent, calcium-activated potassium-independent, and TRPA1 channel-independent relaxations. Cinnamaldehyde also inhibited the contractions induced by 40 mM KCl Ca2+ reintroduction in 40 mM KCl Ca2+-free solution or by the Ca2+ channel opener Bay K8644. Cinnamaldehyde-loaded control micelles induced complete, partly endothelium-dependent relaxations sensitive to catalase and inhibitors of NOS or sGC, but not cyclooxygenase or TRPA1, channels. Cinnamaldehyde-loaded micelles also inhibited contractions induced by 40 mM KCl Ca2+ reintroduction or Bay K8644. Poly(cinnamaldehyde micelles induced only partial, endothelium-dependent relaxations that were reduced by inhibitors of NOS or sGC and by

  11. 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

  12. Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals

    NARCIS (Netherlands)

    J.K. Min (James); T.M. LaBounty (Troy); M. Gomez (Millie); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); M.J. Budoff (Matthew); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); V.Y. Cheng (Victor); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); R.C. Cury (Ricardo); A. Delago (Augustin); A.M. Dunning (Allison); G.M. Feuchtner (Gudrun); M. Hadamitzky (Martin); J. Hausleiter (Jörg); P.A. Kaufmann (Philipp); Y-J. Kim (Yong-Jin); J. Leipsic (Jonathon); F.Y. Lin (Fay); E. Maffei (Erica); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); D.S. Berman (Daniel)

    2014-01-01

    textabstractBackground: Coronary artery disease (CAD) diagnosis by coronary computed tomographic angiography (CCTA) is useful for identification of symptomatic diabetic individuals at heightened risk for death. Whether CCTA-detected CAD enables improved risk assessment of asymptomatic diabetic indiv

  13. Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals

    NARCIS (Netherlands)

    J.K. Min (James); T.M. LaBounty (Troy); M. Gomez (Millie); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); M.J. Budoff (Matthew); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); V.Y. Cheng (Victor); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); R.C. Cury (Ricardo); A. Delago (Augustin); A.M. Dunning (Allison); G.M. Feuchtner (Gudrun); M. Hadamitzky (Martin); J. Hausleiter (Jörg); P.A. Kaufmann (Philipp); Y-J. Kim (Yong-Jin); J. Leipsic (Jonathon); F.Y. Lin (Fay); E. Maffei (Erica); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); D.S. Berman (Daniel)

    2014-01-01

    textabstractBackground: Coronary artery disease (CAD) diagnosis by coronary computed tomographic angiography (CCTA) is useful for identification of symptomatic diabetic individuals at heightened risk for death. Whether CCTA-detected CAD enables improved risk assessment of asymptomatic diabetic indiv

  14. Diagnostic accuracy of dual-source CT coronary angiography: The effect of average heart rate, heart rate variability, and calcium score in a clinical perspective

    Energy Technology Data Exchange (ETDEWEB)

    Long-Jiang Zhang; Zhuo-Li Zhang; Chang-Sheng Zhou; Guang-Ming Lu (Dept. of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing Univ., Nanjing (China)), e-mail: cjr.luguangming@vip.163.com; Sheng-Yong Wu (Medical Imaging Inst. of Tianjin, Tianjin (China)); Jing Wang; Shi-Sen Jiang (Dept. of Cardiology, Jinling Hospital, Clinical School of Medical College, Nanjing Univ., Nanjing (China)); Ying Lu (Dept. of Radiology and Biomedical Imaging, Univ. of California, San Francisco, CA (United States))

    2010-09-15

    Background: Dual-source CT coronary angiography (CTCA) has been used to detect coronary artery disease; however, the factors with potential to affect its diagnostic accuracy remain to be defined. Purpose: To prospectively evaluate the accuracy of dual-source CTCA in diagnosing coronary artery stenosis according to conventional coronary angiography (CAG), and the effect of average heart rate, heart rate variability, and calcium score on the accuracy of CTCA. Material and Methods: A total of 113 patients underwent both dual-source CTCA and CAG. The results were used to evaluate the findings in dual-source CTCA to assess the accuracy in the diagnosis of =50% (significant stenosis) and >75% (severe stenosis) of coronary artery according to those by CAG. Patients were divided into subgroups according to their heart rate (HR), HR variability (HRV), and calcium score, and the accuracy of CTCA was further evaluated. The chi-square test was used to analyze the difference in sensitivity and specificity for the detection of =50% and >75% coronary stenosis among subgroups. The generalized estimation equation method was used in per-vessel analysis to adjust for within-patient correlation. Results: In all, 113 patients had 338 vessels and 1661 segments evaluated by CAG. Dual-source CTCA displayed 1527 segments (91.9%). Among them, 1468 segments (calcium score by CAG score 1, n=1018; score 2, n=270; score 3, n=180) were assessable in CTCA. On a per-patient analysis, the sensitivity and specificity of CTCA were 93.9% and 93.5% for significant stenosis and 86.9% and 98.1% for severe stenosis. On a per-vessel basis, the sensitivity and specificity were 90.2% and 97.1% for significant and 83.3% and 98.1% for severe stenosis. On a per-segment analysis, the sensitivity and specificity were 90.2% and 97.1% for significant and 83.3% and 98.1% for severe stenosis. Average HR had no effect on the sensitivity and specificity of CTCA (P>0.05); whereas HRV and calcium score had some effect on

  15. Calcium Antagonists and Hypertension: Role of co-existent coronary disease, impaired renal function and diabetes

    NARCIS (Netherlands)

    G. Wagener (Gilbert)

    2007-01-01

    textabstractIt is generally accepted that blood pressure lowering drugs improve the prognosis of patients with elevated blood pressure. The dihydropyridine calcium antagonist nifedipine is a widely used blood pressure lowering drug. In the mid-1990ties questions were raised on the safety of the

  16. Usefulness of an Echocardiographic Composite Cardiac Calcium Score to Predict Death in Patients With Stable Coronary Artery Disease (from the Heart and Soul Study).

    Science.gov (United States)

    Saha, Sandeep A; Beatty, Alexis L; Mishra, Rakesh K; Whooley, Mary A; Schiller, Nelson B

    2015-07-01

    Mitral annular calcium and aortic valve sclerosis on transthoracic echocardiography (TTE) are independently associated with cardiovascular (CV) events in patients with coronary artery disease (CAD). However, the prognostic value of calcific deposits at multiple sites is unknown. We performed TTEs in a prospective cohort of 595 outpatients with stable CAD and graded the severity of calcific deposition at 6 sites: mitral annulus, aortic valve, aortic ring, sinotubular junction, papillary muscle tip, and left main coronary artery. For each site with moderate calcific deposition or greater, 1 point was given to generate a composite cardiac calcium score (maximum of 6). The primary end point was the occurrence of CV events-a composite of death, myocardial infarction, stroke, transient ischemic attack, and heart failure. The association of the composite calcium score with CV events was evaluated using multivariate Cox proportional hazards models. Over a median follow-up of 4.2 years, 205 CV events occurred. Participants with a composite calcium score ≥2 had a higher risk of CV events (11.1 events/100 person-years) than those with a score of 0 (5.5 events/100 person-years, unadjusted hazard ratio [HR] 2.01, p coronary revascularization, diastolic blood pressure, estimated glomerular filtration rate, and serum phosphorus level, the risk of death remained higher in participants with a composite calcium score of ≥2 compared with those with a score of 0 (adjusted HR 1.76, 95% confidence interval 1.10 to 2.81, p = 0.02). In conclusion, a simple TTE-derived composite cardiac calcium score was independently predictive of death in patients with pre-existing CAD.

  17. Cost-effectiveness of coronary artery calcium testing for coronary heart and cardiovascular disease risk prediction to guide statin allocation: the Multi-Ethnic Study of Atherosclerosis (MESA.

    Directory of Open Access Journals (Sweden)

    Eric T Roberts

    Full Text Available The Multi-Ethnic Study of Atherosclerosis (MESA showed that the addition of coronary artery calcium (CAC to traditional risk factors improves risk classification, particularly in intermediate risk asymptomatic patients with LDL cholesterol levels <160 mg/dL. However, the cost-effectiveness of incorporating CAC into treatment decision rules has yet to be clearly delineated.To model the cost-effectiveness of CAC for cardiovascular risk stratification in asymptomatic, intermediate risk patients not taking a statin. Treatment based on CAC was compared to (1 treatment of all intermediate-risk patients, and (2 treatment on the basis of United States guidelines.We developed a Markov model of first coronary heart disease (CHD and cardiovascular disease (CVD events. We modeled statin treatment in intermediate risk patients with CAC≥1 and CAC≥100, with different intensities of statins based on the CAC score. We compared these CAC-based treatment strategies to a "treat all" strategy and to treatment according to the Adult Treatment Panel III (ATP III guidelines. Clinical and economic outcomes were modeled over both five- and ten-year time horizons. Outcomes consisted of CHD and CVD events and Quality-Adjusted Life Years (QALYs. Sensitivity analyses considered the effect of higher event rates, different CAC and statin costs, indirect costs, and re-scanning patients with incidentalomas.We project that it is both cost-saving and more effective to scan intermediate-risk patients for CAC and to treat those with CAC≥1, compared to treatment based on established risk-assessment guidelines. Treating patients with CAC≥100 is also preferred to existing guidelines when we account for statin side effects and the disutility of statin use.Compared to the alternatives we assessed, CAC testing is both effective and cost saving as a risk-stratification tool, particularly if there are adverse effects of long-term statin use. CAC may enable providers to better tailor

  18. Relation of Anxiety and Depressive Symptoms to Coronary Artery Calcium (from the ELSA-Brasil Baseline Data).

    Science.gov (United States)

    Santos, Itamar S; Bittencourt, Marcio S; Rocco, Priscila T; Pereira, Alexandre C; Barreto, Sandhi M; Brunoni, André R; Goulart, Alessandra C; Blaha, Michael J; Lotufo, Paulo A; Bensenor, Isabela M

    2016-07-15

    Previous studies of the association between symptoms of anxiety or depression and coronary artery calcium (CAC) have produced heterogeneous results. Our aim was to investigate whether psychopathological symptoms were associated with CAC in a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline. We analyzed data from 4,279 ELSA-Brasil subjects (aged 35 to 74 years) from the São Paulo site without previous cardiovascular disease who underwent CAC score assessment at baseline. Prevalent CAC was defined as a CAC score >0. Anxiety and depressive symptoms were assessed using the Clinical Interview Schedule-Revised (CIS-R). We built binary logistic regression models to determine whether CIS-R scores, anxiety, or depression were associated with prevalent CAC. Prevalent CAC was found in 1,211 subjects (28.3%). After adjustment for age and gender, a direct association between CIS-R scores and prevalent CAC was revealed (odds ratio for 1-SD increase: 1.12; 95% confidence interval [CI] 1.04 to 1.22). This association persisted after multivariate adjustment (odds ratio for 1-SD increase 1.11; 95% CI 1.02 to 1.20). No independent associations were found for specific diagnoses of anxiety or depression and prevalent CAC. In post hoc models, a significant interaction term (p = 0.019) suggested a stronger association in older subjects. In conclusion, psychopathological symptoms were directly associated with coronary atherosclerosis in the ELSA-Brasil baseline in adjusted models, and this association seems to be stronger in older subjects. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. 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...

  20. Right coronary wall cmr in the older asymptomatic advance cohort: positive remodeling and associations with type 2 diabetes and coronary calcium

    Directory of Open Access Journals (Sweden)

    Courtney Brian K

    2010-12-01

    Full Text Available Abstract Background Coronary wall cardiovascular magnetic resonance (CMR is a promising noninvasive approach to assess subclinical atherosclerosis, but data are limited in subjects over 60 years old, who are at increased risk. The purpose of the study was to evaluate coronary wall CMR in an asymptomatic older cohort. Results Cross-sectional images of the proximal right coronary artery (RCA were acquired using spiral black-blood coronary CMR (0.7 mm resolution in 223 older, community-based patients without a history of cardiovascular disease (age 60-72 years old, 38% female. Coronary measurements (total vessel area, lumen area, wall area, and wall thickness had small intra- and inter-observer variabilities (r = 0.93~0.99, all p Conclusions Right coronary wall CMR in asymptomatic older subjects showed increased coronary atherosclerosis in subjects with type 2 diabetes as well as coronary calcification. Coronary wall CMR may contribute to the noninvasive assessment of subclinical coronary atherosclerosis in older, at-risk patient groups.

  1. Coronary heart disease incidence in women by waist circumference within categories of body mass index.

    Science.gov (United States)

    Canoy, Dexter; Cairns, Benjamin J; Balkwill, Angela; Wright, F Lucy; Green, Jane; Reeves, Gillian; Beral, Valerie

    2013-10-01

    High body mass index (BMI) and large waist circumference are separately associated with increased coronary heart disease (CHD) risk but these measures are highly correlated. Their separate associations with incident CHD, cross-classifying one variable by the other, are less investigated in large-scale studies. We examined these associations in a large UK cohort (the Million Women Study), which is a prospective population-based study. We followed 496,225 women (mean age 60 years) with both waist circumference and BMI measurements who had no vascular disease or cancer. Adjusted relative risk and 20-year cumulative CHD incidence (first coronary hospitalization or death) from age 55 to 74 years were calculated using Cox regression. Plasma apolipoproteins were assayed in 6295 randomly selected participants. There were 10,998 incident coronary events after mean follow up of 5.1 years. Within each BMI category (waist circumference; within each waist circumference category (waist circumference waist circumference ≥80 cm, with 1 in 8 (95% confidence interval 1 in 7 to 9) women developing CHD over the same period. Similar associations for apolipoprotein B to A1 ratio across adiposity categories were observed, particularly in non-obese women. Our conclusions were that both waist circumference and BMI are independently associated with incident CHD.

  2. Prognostic Value of Risk Factors, Calcium Score, Coronary CTA, Myocardial Perfusion Imaging, and Invasive Coronary Angiography in Kidney Transplantation Candidates

    DEFF Research Database (Denmark)

    Winther, Simon; Svensson, My; Jørgensen, Hanne Skou

    2017-01-01

    , but only CACS predicted MACE. Combining risk factors with CACS identified a very-low-risk cohort with a MACE event rate of 2.1%, and a 1.0% mortality rate per year. Of the diagnostic modalities, coronary CTA and ICA significantly predicted MACE, but only coronary CTA predicted death. In contrast, SPECT...

  3. Restriction of the referral of patients with stable angina for CT coronary angiography by clinical evaluation and calcium score: impact on clinical decision making.

    Science.gov (United States)

    Dharampal, Anoeshka S; Rossi, Alexia; Dedic, Admir; Cademartiri, Filippo; Papadopoulou, Stella L; Weustink, Annick C; Ferket, Bart S; Boersma, Eric; Meijboom, Willem B; Galema, Tjebbe W; Nieman, Koen; de Feyter, Pim J; Krestin, Gabriel P

    2013-10-01

    To investigate the value of the calcium score (CaSc) plus clinical evaluation to restrict referral for CT coronary angiography (CTCA) by reducing the number of patients with an intermediate probability of coronary artery disease (CAD). We retrospectively included 1,975 symptomatic stable patients who underwent clinical evaluation and CaSc calculation and CTCA or invasive coronary coronary angiography (ICA). The outcome was obstructive CAD (≥50 % diameter narrowing) assessed by ICA or CTCA in the absence of ICA. We investigated two models: (1) clinical evaluation consisting of chest pain typicality, gender, age, risk factors and ECG and (2) clinical evaluation with CaSc. Discrimination of the two models was compared. The stepwise reclassification of patients with an intermediate probability of CAD (10-90 %) after clinical evaluation followed by clinical evaluation with CaSc was assessed by clinical net reclassification improvement (NRI). Discrimination of CAD was significantly improved by adding CaSc to the clinical evaluation (AUC: 0.80 vs. 0.89, P < 0.001). CaSc and CTCA could be avoided in 9 % using model 1 and an additional 29 % of CTCAs could be avoided using model 2. Clinical NRI was 57 %. CaSc plus clinical evaluation may be useful in restricting further referral for CTCA by 38 % in symptomatic stable patients with suspected CAD. • CT calcium scores (CaSc) could proiritise referrals for CT coronary angiography (CTCA) • CaSc provides an incremental discriminatory value of CAD compared with clinical evaluation • Risk stratification is better when clinical evaluation is combined with CaSc • Appropriate use of clinical evaluation and CaSc helps avoid unnecessary CTCA referrals.

  4. Long-term Prognosis for Individuals with Hypertension Undergoing Coronary Artery Calcium Scoring

    Science.gov (United States)

    Valenti, Valentina; Hartaigh, Bríain ó; Heo, Ran; Schulman-Marcus, Joshua; Cho, Iksung; Kalra, Dan K.; Truong, Quynh A.; Giambrone, Ashley E; Gransar, Heidi; Callister, Tracy Q.; Shaw, Leslee J.; Lin, Fay Y.; Chang, Hyuk-Jae; Sciarretta, Sebastiano; Min, James K

    2014-01-01

    Background To examine the performance of coronary artery calcification (CAC) for stratifying long-term risk of death in asymptomatic hypertensive patients. Methods and Results 8905 consecutive asymptomatic individuals without cardiovascular disease or diabetes who underwent CAC testing (mean age 53.3±10.5, 59.3% male) were followed for a mean of 14 years and categorized on the background of hypertension (in accordance with the 2014 Guidelines from the Joint National Committee 8) as well as age above or below 60 years. The prevalence and severity of CAC was higher for those with versus without hypertension (P<0.001), and the extent increased proportionally with advancing age (P<0.001). Following adjustment, the presence of CAC in patients above and below the age of 60 years was associated with worse prognosis for hypertensive (HR 7.74 [95% CI: 5.15-11.63] and HR 3.18 [95% CI: 2.42-4.19]) and normotensive (HR 4.83 [95% CI: 3.18-7.33] and HR 2.14 [95% CI: 1.61-2.85]), respectively. A zero CAC score was associated with a lower but persisting risk of mortality for hypertensives over the age of 60 years (HR 2.48 [95% CI: 1.50-4.08]); albeit, attenuating for those below the age of 60 years (P=0.09). In a “low risk” hypertensive population, a combined presence of hypertension and any CAC was associated with an almost five-fold (HR 4.68 [95% CI: 2.22-9.87]) risk of death. Conclusion Among asymptomatic hypertensive individuals, the presence and extent of CAC effectively identified individuals at heightened risk of mortality beyond conventional cardiovascular risk. PMID:25863296

  5. Anatomy and function relation in the coronary tree: from bifurcations to myocardial flow and mass.

    Science.gov (United States)

    Kassab, Ghassan S; Finet, Gerard

    2015-01-01

    The study of the structure-function relation of coronary bifurcations is necessary not only to understand the design of the vasculature but also to use this understanding to restore structure and hence function. The objective of this review is to provide quantitative relations between bifurcation anatomy or geometry, flow distribution in the bifurcation and degree of perfused myocardial mass in order to establish practical rules to guide optimal treatment of bifurcations including side branches (SB). We use the scaling law between flow and diameter, conservation of mass and the scaling law between myocardial mass and diameter to provide geometric relations between the segment diameters of a bifurcation, flow fraction distribution in the SB, and the percentage of myocardial mass perfused by the SB. We demonstrate that the assessment of the functional significance of an SB for intervention should not only be based on the diameter of the SB but also on the diameter of the mother vessel as well as the diameter of the proximal main artery, as these dictate the flow fraction distribution and perfused myocardial mass, respectively. The geometric and flow rules for a bifurcation are extended to a trifurcation to ensure optimal therapy scaling rules for any branching pattern.

  6. Coronary calcium score scans for attenuation correction of quantitative PET/CT {sup 13}N-ammonia myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Burkhard, Nina; Herzog, Bernhard A.; Husmann, Lars; Pazhenkottil, Aju P.; Burger, Irene A.; Buechel, Ronny R.; Valenta, Ines; Wyss, Christophe A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); University of Zurich, Zurich Center for Integrative Human Physiology, Zurich (Switzerland)

    2010-03-15

    The aim of this study was to evaluate whether ECG-triggered coronary calcium scoring (CCS) scans can be used for attenuation correction (AC) to quantify myocardial blood flow (MBF) and coronary flow reserve (CFR) assessed by PET/CT with {sup 13}N-ammonia. Thirty-five consecutive patients underwent a {sup 13}N-ammonia PET/CT scan at rest and during standard adenosine stress. MBF values were calculated using AC maps obtained from the ECG-triggered CCS scan during inspiration and validated against MBF values calculated using standard non-gated transmission scans for AC. CFR was calculated as the ratio of hyperaemic over resting MBF. In all 35 consecutive patients intraobserver variability was assessed by blinded repeat analysis for both AC methods. There was an excellent correlation between CT AC and CCS for global MBF values at rest (n = 35, r = 0.94, p < 0.001) and during stress (n = 35, r = 0.97, p < 0.001) with narrow Bland-Altman (BA) limits of agreement (-0.21 to 0.10 ml/min per g and -0.41 to 0.30 ml/min per g) as well as for global CFR (n = 35, r = 0.96, p < 0.001, BA -0.27 to 0.34). The excellent correlation was preserved on the segmental MBF analysis for both rest and stress (n = 1190, r = 0.93, p < 0.001, BA -0.60 to 0.50) and for CFR (n = 595, r = 0.87, p < 0.001, BA -0.71 to 0.74). In addition, reproducibility proved excellent for global CFR by CT AC (n = 35, r = 0.91, p < 0.001, BA -0.42-0.58) and CCS scans (n = 35, r = 0.94, p < 0.001, BA -0.34-0.45). Use of attenuation maps from CCS scans allows accurate quantitative MBF and CFR assessment with {sup 13}N-ammonia PET/CT. (orig.)

  7. High-Yield Method for Isolation and Culture of Endothelial Cells from Rat Coronary Blood Vessels Suitable for Analysis of Intracellular Calcium and Nitric Oxide Biosynthetic Pathways

    Directory of Open Access Journals (Sweden)

    Nistri Silvia

    2002-01-01

    Full Text Available We describe here a method for isolating endothelial cells from rat heart blood vessels by means of coronary microperfusion with collagenase. This methods makes it possible to obtain high amounts of endothelial cells in culture which retain the functional properties of their in vivo counterparts, including the ability to uptake fluorescently-labeled acetylated low-density lipoproteins and to respond to vasoactive agents by modulating intracellular calcium and by upregulating intrinsic nitric oxide generation. The main advantages of our technique are: (i good reproducibility, (ii accurate sterility that can be maintained throughout the isolation procedure and (iii high yield of pure endothelial cells, mainly due to microperfusion and temperature-controlled incubation with collagenase which allow an optimal distribution of this enzyme within the coronary vascular bed.

  8. Cardiac troponin T and CK-MB mass release after visually successful percutaneous transluminal coronary angioplasty in stable angina pectoris

    DEFF Research Database (Denmark)

    Ravkilde, J; Nissen, H; Mickley, H

    1994-01-01

    The incidence of cardiac troponin T (Tn-T) and creatine kinase (CK) isoenzyme MB mass release was studied in 23 patients with stable angina pectoris undergoing visually successful percutaneous transluminal coronary angioplasty (PTCA). Serial blood samples were drawn for measurement of serum Tn...

  9. Birth weight, childhood body mass index and risk of coronary heart disease in adults: combined historical cohort studies

    DEFF Research Database (Denmark)

    Andersen, Lise Geisler; Ängquist, Lars Henrik; Eriksson, Johan G

    2010-01-01

    Low birth weight and high childhood body mass index (BMI) is each associated with an increased risk of coronary heart disease (CHD) in adult life. We studied individual and combined associations of birth weight and childhood BMI with the risk of CHD in adulthood....

  10. Alveolar bone mass in pre- and postmenopausal women with serum calcium as a marker: A comparative study

    Directory of Open Access Journals (Sweden)

    Amitha Ramesh

    2011-01-01

    Conclusion: Postmenopausal women exhibit a reduced alveolar bone mass and lowered levels of serum total calcium with the increasing age. These changes may be useful indicators for low skeletal bone mineral density or osteoporosis.

  11. Impact of Body Mass Index on In-Hospital Outcomes after Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Bahram Sohrabi

    2013-02-01

    Full Text Available Objectives: The aim of current study is to evaluate relation between body mass index (BMI and in-hospital outcome in patients undergoing percutaneous coronary intervention (PCI.Background: Relation between body mass indexes (BMI with percutaneous coronary intervention (PCI has shown in different studies. Recent studies suggested a paradox relation between different BMI values and outcome in certain patients.Methods: In this prospective study, 1134 patients (81.7% male, 18.3% female with mean age of 58.18±11.16 years whom undergone PCI between January 2011 and December 2011 were chosen and their BMI and disease outcome was studied. Classification of BMI was: healthy weight (18.5 to 24.9 kg/m2, overweight (25 to 29.9 kg/m2, moderate obesity (30 to 34.9 kg/m2 and severe obesity (over 35 kg/m2. Baseline patient characteristics and in-hospital outcome were compared among BMI categories.Results: Major adverse cardiac events (MACE were significantly higher in patients with overweight and moderate obesity than two other groups. There was no difference in mortality, reinfarction, revascularisation, stroke and bleeding events among the 4 groups. Being overweight is an independent factor associated to in-hospital MACE (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.17 to 0.73, p=0.01 and mortality rate (OR 0.20, 95%CI 0.04 to 0.85, p=0.03.Conclusion: BMI overall is not correlated to in-hospital MACE and mortality; however, overweight patients are at reduced risk for MACE and mortality.

  12. The influence of body mass index and gender on coronary arterial attenuation with fixed iodine load per body weight at dual-source CT coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Xiaomei; Zhu, Yinsu; Xu, Hai; Tang, Lijun; Xu, Yi [Dept. of Radiology, the First Affiliated Hospital of Nanjing Medical Univ., Nanjing, Jiangsu (China)], E-mail: lijun.tang@hotmail.com

    2012-07-15

    Background. Most of current coronary CT angiography protocols are not adapted to body weight (BW) or cardiac output and no literature about influence of gender on coronary attenuation are reported with administration of a fixed iodine load per BW. Purpose. To determine the influence of body mass index (BMI) and gender on coronary arterial attenuation if contrast material dose is linearly adjusted to a patient's BW at dual-source CT coronary angiography (DSCT-CA). Material and Methods. A total of 207 consecutive patients (mean age 60.6 years) undergoing DSCT-CA were included. Contrast material (370 mg I/mL) dose calculation was randomly categorized into two groups (Group1: 1.10 mL/kg for men and women; Group 2: men 1.10 mL/kg, women 0.99 mL/kg) and flow rate was calculated as dose was divided by scan time plus 8 s. Mean arterial attenuations between men and women were compared with respect to attenuations of ascending aorta (AA) above coronary ostia, left main coronary artery (LM), proximal segments of right coronary artery (RCA), left anterior descending (LAD), and left circumflex artery (LCX) in two groups, respectively. Attenuations of coronary arteries were correlated with BW and BMI with simple linear regression. Results. The mean attenuations of AA, LM, RCA, LAD, and LCX were 407.8 {+-} 53.6 HU, 412.6 {+-} 55.4 HU, 411.4 {+-} 64.3 HU, 399.1 {+-} 56.7 HU, and 399.1 {+-} 60.2 HU, respectively, and there were no significant differences between men and women in group 1 (AA, P = 0.571; LM, P = 0.670; RCA, P = 0.737; LAD, P = 0.439, and LCX, P = 0.888). In group 2, the mean attenuations of AA, LM, RCA, LAD, and LCX in men were significantly higher than those in women (AA, P = 0.008; LM, P = 0.025; RCA, P = 0.017; LAD, P = 0.015, and LCX, P = 0.002). Positive linear regression between BW and attenuations of AA (R{sup 2} = 0.047, P = 0.02), LM (R{sup 2} = 0.036, P = 0.04), RCA (R{sup 2} = 0.080, P < 0.01), LAD (R{sup 2} = 0.078, P < 0.01), and LCX (R{sup 2} = 0

  13. Heat mass transfer model of fouling process of calcium carbonate on heat transfer surface

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    A new heat mass transfer model was developed to predict the fouling process of calcium carbonate on heat transfer surface. The model took into account not only the crystallization fouling but also the particle fouling which was formed on the heat transfer surface by the suspension particles of calcium carbonate in the su- persaturated solution. Based on experimental results of the fouling process, the deposition and removal rates of the mixing fouling were expressed. Furthermore, the coupling effect of temperature with the fouling process was considered in the physics model. As a result the fouling resistance varying with time was obtained to describe the fouling process and the prediction was compared with experimental data under same conditions. The results showed that the present model could give a good prediction of fouling process, and the deviation was less than 15% of the experimental data in most cases. The new model is credible to predict the fouling process.

  14. Diagnostic performance of coronary CT angiography for stenosis detection according to calcium score : systematic review and meta-analysis

    NARCIS (Netherlands)

    den Dekker, Martijn; de Smet, K.; de Bock, G.H.; Tio, R.A.; Oudkerk, M.; Vliegenthart, R.

    2012-01-01

    Objectives A systematic review and meta-analysis to assess sensitivity and specificity of coronary CT angiography (CCTA) for significant stenosis at different degrees of coronary calcification. Methods A literature search was performed including studies describing test characteristics of CCTA for

  15. 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.

  16. A 15-year warranty period for asymptomatic individuals without coronary artery calcium: a prospective follow-up of 9715 individuals

    Science.gov (United States)

    Valenti, Valentina; Hartaigh, Bríain ó; Heo, Ran; Cho, Iksung; Schulman-Marcus, Joshua; Gransar, Heidi; Truong, Quynh A.; Shaw, Leslee J.; Knapper, Joseph; Kelkar, Anita A.; Sandesara, Pratik; Lin, Fay Y.; Sciarretta, Sebastiano; Chang, Hyuk-Jae; Callister, Tracy Q.; Min, James K

    2015-01-01

    Objective To examine long-term prognosis of a zero coronary artery calcium (CAC) score among asymptomatic individuals and its associated warranty period. Background Emerging evidence supports CAC=0 as a favorable cardiovascular short-to-intermediate term prognostic factor. Methods 9715 individuals undergoing CAC imaging were stratified by age, Framingham risk score (FRS) and Adult Treatment Panel III (NCEP ATP III) categories and followed for a mean of 14.6 (12.9–16.8) years. Cox regression, area under the receiver operating characteristic curve (AUC) and net reclassification information (NRI) were used to assess all-cause mortality, discrimination and reclassification of CAC=0 compared with FRS and NCEP ATP III, respectively. A warranty period was pre-defined as <1% annual mortality rate. Vascular age was estimated by linear regression. Results Among 4864 individuals with baseline CAC=0 (mean age 52.1±10.8 years; 57.9% male), 229 deaths occurred. The warranty period of CAC=0 was almost 15 years for individuals at low and intermediate risk with no significant differences regarding age and gender. CAC=0 was associated with a vascular age of 1, 10, 20, and 30 years below chronologic age for individuals between 50–59, 60–69, 70–79, and ≥80 years, respectively. CAC score was the strongest predictor of death (HR 2.67, 95% CI 2.29–3.11) that enabled discrimination and consistent reclassification beyond FRS (AUC 0.71 vs. 0.64, p<0.001) and NCEP ATP III (AUC 0.72 vs. 0.64, p<0.001). Conclusions CAC=0 confers a 15-year warranty period against mortality among individuals at low-to-intermediate risk, which is unaffected by age or gender. Furthermore, in individuals considered at high-risk by clinical risk scores the presence of CAC=0 confers better survival than in individuals at low-to-intermediate risk but with any CAC. PMID:26189116

  17. Use of coronary calcium score scans from stand-alone multislice computed tomography for attenuation correction of myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Schepis, Tiziano; Gaemperli, Oliver; Koepfli, Pascal [University Hospital Zurich, Clinic of Nuclear Medicine, Nuclear Cardiology, Zurich (Switzerland); University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); Rueegg, Christine; Burger, Cyrill [University Hospital Zurich, Clinic of Nuclear Medicine, Nuclear Cardiology, Zurich (Switzerland); Leschka, Sebastian; Desbiolles, Lotus; Husmann, Lars; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Clinic of Nuclear Medicine, Nuclear Cardiology, Zurich (Switzerland); University of Zurich, Centre for Integrative Human Physiology, Zurich (Switzerland); University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland)

    2007-01-15

    To evaluate the use of CT attenuation maps, generated from coronary calcium scoring (CCS) scans at in- and expiration with a 64-slice CT scanner, for attenuation correction (AC) of myocardial perfusion SPECT images. Thirty-two consecutive patients underwent{sup 99m}Tc-tetrofosmin gated adenosine stress/rest SPECT scan on an Infinia Hawkeye SPECT-CT device (GE Medical Systems) followed by CCS and CT angiography on a 64-slice CT. AC of the iteratively reconstructed images was performed with AC maps obtained: (a) from the ''Hawkeye'' low-resolution X-ray CT facility attached to the Infinia camera (IRAC); (b) from the CCS scan acquired on a 64-slice CT scanner during maximal inspiration (AC{sub INSP}) and (c) during normal expiration (AC{sub EXP}). Automatically determined uptake values of stress scans (QPS, Cedars Medical Sinai) from AC{sub INSP} and AC{sub EXP} were compared with IRAC. Agatston score (AS) values using AC{sub INSP}versus AC{sub EXP} were also compared. AC{sub INSP} and AC{sub EXP} resulted in identical findings versus IRAC by visual analysis. A good correlation for uptake values between IRAC and AC{sub INSP} was found (apex, r=0.92; anterior, r=0.85; septal, r=0.91; lateral, r=0.86; inferior, r=0.90; all p<0.0001). The correlation was even closer between IRAC and AC{sub EXP} (apex, r=0.97; anterior, r=0.91; septal, r=0.94; lateral, r=0.92; inferior, r=0.97; all p<0.0001). The mean AS during inspiration (319{+-}737) and expiration(317{+-}778) was comparable (p=NS). Attenuation maps from CCS allow accurate AC of SPECT MPI images. AC{sub EXP} proved superior to AC{sub INSP}, suggesting that in hybrid scans CCS may be performed during normal expiration to allow its additional use for AC of SPECT MPI. (orig.)

  18. Less increase of CT-based calcium scores of the coronary arteries : Effect three years after breast-conserving radiotherapy using breath-hold.

    Science.gov (United States)

    Mast, M E; Heijenbrok, M W; van Kempen-Harteveld, M L; Petoukhova, A L; Scholten, A N; Wolterbeek, R; Schreur, J H M; Struikmans, H

    2016-10-01

    The aim of this prospective longitudinal study was to compare coronary artery calcium (CAC) scores determined before the start of whole breast irradiation with those determined 3 years afterwards. Changes in CAC scores were analysed in 99 breast cancer patients. Three groups were compared: patients receiving left- and right-sided radiotherapy, and those receiving left-sided radiotherapy with breath-hold. We analysed overall CAC scores and left anterior descending (LAD) and right coronary artery (RCA) CAC scores. Between the three groups, changes of the value of the LAD minus the RCA CAC scores of each individual patient were also compared. Three years after breath-hold-based whole breast irradiation, a less pronounced increase of CAC scores was noted. Furthermore, LAD minus RCA scores in patients treated for left-sided breast cancer without breath-hold were higher when compared to LAD minus RCA scores of patients with right-sided breast cancers and those with left-sided breast cancer treated with breath-hold. Breath-hold in breast-conserving radiotherapy leads to a less pronounced increase of CT-based CAC scores. Therefore, breath-hold probably prevents the development of radiation-induced coronary artery disease. However, the sample size of this study is limited and the follow-up period relatively short.

  19. 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

  20. Effects of first and second generation calcium channel blockers on diastolic function of the failing hamster heart: relationship with coronary flow changes.

    Science.gov (United States)

    Beaucage, Pierre; Massicotte, Julie; Boileau, Jean-François; Dumont, Louis

    2003-07-01

    Calcium channel blockers (CCBs) have variable efficacy in the treatment of heart failure. We hypothesized that modulation of left ventricular diastolic pressure (LVDP) may play a role in the variable efficacy of CCBs in this condition. Isolated perfused hearts from 200- to 250-day-old UM-X7.1 cardiomyopathic hamsters (failing hearts) and age-matched Syrian hamsters (normal hearts) were studied. After recording of heart rate, coronary flow (CF), LVDP and left ventricular systolic pressure (LVSP), hearts were exposed either to verapamil or diltiazem (1 nM-10 microM), mibefradil (1 nM-1 microM) or clentiazem (1 nM-10 microM). Mechanical increase in CF (+2 to +10 ml/min) was carried out using a roller pump. Mechanically-augmented flow led to an increase in coronary perfusion pressure (+40 to +90 mm Hg), LVSP (+5 to +40 mm Hg) and LVDP (+5 to +25 mm Hg). CCBs-induced increment of coronary flow led to a difference in their cardiac response. In normal hearts, the negative inotropic response was more important with diltiazem and verapamil. Failing hearts did not demonstrate increased inotropic sensitivity to first-generation CCBs. On the contrary, at clinically relevant concentrations, verapamil resulted in the most pronounced impairment of LVDP followed by diltiazem while mibefradil and clentiazem, at clinically relevant concentrations, preserved LVDP. Such findings provide an additional explanation for the variable efficacy of CCBs in heart failure.

  1. Less increase of CT-based calcium scores of the coronary arteries. Effect three years after breast-conserving radiotherapy using breath-hold

    Energy Technology Data Exchange (ETDEWEB)

    Mast, M.E.; Kempen-Harteveld, M.L. van; Petoukhova, A.L. [Centre West, Radiotherapy, The Hague (Netherlands); Heijenbrok, M.W. [Medical Center Haaglanden, Department of Radiology, The Hague (Netherlands); Scholten, A.N. [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Radiation Oncology, Amsterdam (Netherlands); Wolterbeek, R. [Leiden University Medical Centre, Department of Medical Statistics and Bioinformatics, Leiden (Netherlands); Schreur, J.H.M. [Medical Center Haaglanden, Department of Cardiology, The Hague (Netherlands); Struikmans, H. [Centre West, Radiotherapy, The Hague (Netherlands); Leiden University Medical Centre, Department of Clinical Oncology, Leiden (Netherlands)

    2016-10-15

    The aim of this prospective longitudinal study was to compare coronary artery calcium (CAC) scores determined before the start of whole breast irradiation with those determined 3 years afterwards. Changes in CAC scores were analysed in 99 breast cancer patients. Three groups were compared: patients receiving left- and right-sided radiotherapy, and those receiving left-sided radiotherapy with breath-hold. We analysed overall CAC scores and left anterior descending (LAD) and right coronary artery (RCA) CAC scores. Between the three groups, changes of the value of the LAD minus the RCA CAC scores of each individual patient were also compared. Three years after breath-hold-based whole breast irradiation, a less pronounced increase of CAC scores was noted. Furthermore, LAD minus RCA scores in patients treated for left-sided breast cancer without breath-hold were higher when compared to LAD minus RCA scores of patients with right-sided breast cancers and those with left-sided breast cancer treated with breath-hold. Breath-hold in breast-conserving radiotherapy leads to a less pronounced increase of CT-based CAC scores. Therefore, breath-hold probably prevents the development of radiation-induced coronary artery disease. However, the sample size of this study is limited and the follow-up period relatively short. (orig.) [German] Das Ziel dieser prospektiven Langzeitstudie war der Vergleich der Coronary-Artery-Calcium-(CAC-)Werte vor Beginn der Brustbestrahlung mit den Werten nach 3 Jahren. Aenderungen der CAC-Werte wurden bei 99 Brustkrebspatienten analysiert. Drei Gruppen wurden untersucht: Patienten nach links- und rechtsseitiger Strahlentherapie sowie mit Bestrahlung unter Atemanhalt. Wir analysierten die Gesamt-CAC-Werte sowie die CAC-Werte der vorderen linken absteigenden (''left anterior descending'', LAD) und der rechten Koronararterie (''right coronary artery'', RCA). Zwischen den drei Gruppen wurden auch die Veraenderungen

  2. X-ray dual energy spectral parameter optimization for bone Calcium/Phosphorus mass ratio estimation

    Science.gov (United States)

    Sotiropoulou, P. I.; Fountos, G. P.; Martini, N. D.; Koukou, V. N.; Michail, C. M.; Valais, I. G.; Kandarakis, I. S.; Nikiforidis, G. C.

    2015-09-01

    Calcium (Ca) and Phosphorus (P) bone mass ratio has been identified as an important, yet underutilized, risk factor in osteoporosis diagnosis. The purpose of this simulation study is to investigate the use of effective or mean mass attenuation coefficient in Ca/P mass ratio estimation with the use of a dual-energy method. The investigation was based on the minimization of the accuracy of Ca/P ratio, with respect to the Coefficient of Variation of the ratio. Different set-ups were examined, based on the K-edge filtering technique and single X-ray exposure. The modified X-ray output was attenuated by various Ca/P mass ratios resulting in nine calibration points, while keeping constant the total bone thickness. The simulated data were obtained considering a photon counting energy discriminating detector. The standard deviation of the residuals was used to compare and evaluate the accuracy between the different dual energy set-ups. The optimum mass attenuation coefficient for the Ca/P mass ratio estimation was the effective coefficient in all the examined set-ups. The variation of the residuals between the different set-ups was not significant.

  3. Subclinical coronary atherosclerosis identified by coronary computed tomographic angiography in asymptomatic morbidly obese patients

    Directory of Open Access Journals (Sweden)

    Peter A. McCullough

    2010-09-01

    Full Text Available Obesity is a common public health problem and obese individuals in particular have a disproportionate incidence of acute coronary events. This study was undertaken to identify coronary artery lesions as well as associated clinical features, risk factors and demographics in patients with a body mass index (BMI >40 kg/m2 without known coronary artery disease (CAD. Morbidly obese subjects were prospectively recruited to undergo coronary computed tomographic angiography (CCTA using a dual-source computed tomography (CT system. CAD was defined as the presence of any atherosclerotic lesion in any one coronary artery segment. The presence, location, and severity of atherosclerosis were related to patient characteristics. Forty-one patients (28 women, mean age, 50.4±10.0 years, mean BMI, 43.8±4.8 kg/m2 served as the study population. Of these, 25 patients (61% had at least one coronary stenosis. All but 2 patients within the CAD cohort had coronary artery calcium (CAC scores >0, and most plaques identified (75.4% were non-calcified. There was a predilection of calcified and non-calcified atherosclerosis involving the left anterior descending (LAD coronary artery compared with other coronary segments. Univariate predictors of CAD included older age, dyslipidemia, and diabetes. In this preliminary study of young morbidly obese patients, CCTA detected a high prevalence of calcified and non-calcified CAD, although the later predominated.

  4. Bone mass and breast milk calcium concentration are associated with vitamin D receptor gene polymorphisms in adolescent mothers.

    Science.gov (United States)

    Bezerra, Flávia F; Cabello, Giselda M K; Mendonça, Laura M C; Donangelo, Carmen M

    2008-02-01

    Lactation-associated bone loss has been reported in adolescent mothers. Polymorphisms in the vitamin D receptor (VDR) gene may contribute to differences in the physiologic skeletal response to lactation in these mothers. We evaluated the influence of VDR gene polymorphisms ApaI, BsmI, and TaqI on bone mass, bone and calcium-related hormones, and breast milk calcium of lactating adolescents with habitually low calcium intake. Total body bone mineral content (TBMC), total body bone mineral density (TBMD), lumbar spine BMD (LSBMD), serum hormones [intact parathyroid hormone (iPTH), 25-hydroxyvitamin D, insulin-like growth factor-I (IGF1), prolactin, and estradiol), and breast milk calcium were measured in 40 lactating Brazilian adolescents (15-18 y), and compared by VDR genotype subgroups after adjustment for calcium intake and postmenarcheal and lactational periods. TBMD and LSBMD Z scores were -0.55 +/- 1.01 and -1.15 +/- 1.48, respectively. LSBMD was higher (21%; P milk calcium and serum iPTH were higher (24 and 80%, respectively; P milk calcium are significantly associated with VDR genotypes in lactating Brazilian adolescents. Those with aa and tt genotypes had a better bone status and those with bb genotype had greater breast milk calcium.

  5. Body mass index and myocardium at risk in patients with acute coronary syndrome.

    Science.gov (United States)

    Arrebola-Moreno, A L; Marfil-Alvarez, R; Catena, A; García-Retamero, R; Arrebola, J P; Melgares-Moreno, R; Ramirez-Hernández, J A; Kaski, J C

    2014-04-01

    Whilst traditional studies have shown that obese individuals are at a higher risk of cardiovascular events compared to lean subjects, recent studies in patients with acute myocardial infarction (AMI) have suggested that obesity may exert protective effects (the "obesity paradox"). We sought to assess the relationship between body mass index (BMI) and the BARI score (BARIsc), a validated tool used to assess myocardium at risk, in patients with acute coronary syndrome. Participants were 116 consecutive patients (mean age, 60.6 years; 97 men) with AMI (68 ST elevated myocardial infarction, STEMI; 48 non-ST elevated myocardial infarction, NSTEMI). Demographics, BMI, risk factors, biochemistry data, left ventricular function, angiographic data and the BARIsc were assessed in every patient. Multiple linear regression analyses showed that BMI significantly correlated with BARIsc; β=.23, p<0.02. This was found only in the overweight/obese patients, β=.27, p<0.01, but not in patients with normal BMIs, β=0.08, p=0.71. An increased body weight is associated with an increased area of myocardium at risk in patients with ACS. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  6. Body Mass Index and Hospital Mortality in Patients with Acute Coronary Syndrome Receiving Care in a University Hospital

    Directory of Open Access Journals (Sweden)

    Mercedes Camprubi

    2012-01-01

    Full Text Available Although obesity is a well-established cardiovascular risk factor, some controversy has arisen with regard to its effect on hospital mortality in patients admitted for acute coronary syndrome. Methods. Clinical and anthropometric variables were analyzed in patients consecutively admitted for acute coronary syndrome to a university hospital between 2009 and 2010, and the correlation of those variables with hospital mortality was examined. Results. A total of 824 patients with a diagnosis of myocardial infarction or unstable angina were analyzed. Body mass index was an independent factor in hospital mortality (odds ratio 0.739 (IC 95%: 0.597-0.916, P=0.006. Mortality in normal weight (n=218, overweight (n=399, and obese (n=172 subjects was 6.1%, 3.1%, and 4.1%, respectively, with no statistically significant differences between the groups. Conclusions. There is something of a paradox in the relationship between body mass index and hospital mortality in patients with acute coronary syndrome in that the mortality rate decreases as body mass index increases. However, no statistically significant differences have been found in normal weight, overweight, or obese subjects.

  7. A model for quantitative correction of coronary calcium scores on multidetector, dual source, and electron beam computed tomography for influences of linear motion, calcification density, and temporal resolution : A cardiac phantom study

    NARCIS (Netherlands)

    Greuter, M. J. W.; Groen, J. M.; Nicolai, L. J.; Dijkstra, H.; Oudkerk, M.

    2009-01-01

    Purpose: The objective of this study is to quantify the influence of linear motion, calcification density, and temporal resolution on coronary calcium determination using multidetector computed tomography (MDCT), dual source CT (DSCT), and electron beam tomography (EBT) and to find a quantitative me

  8. New precision mass measurements of neutron-rich calcium and potassium isotopes and three-nucleon forces

    CERN Document Server

    Gallant, A T; Brunner, T; Chowdhury, U; Ettenauer, S; Lennarz, A; Robertson, D; Simon, V V; Chaudhuri, A; Holt, J D; Kwiatkowski, A A; Mané, E; Menéndez, J; Schultz, B E; Simon, M C; Andreoiu, C; Delheij, P; Pearson, M R; Savajols, H; Schwenk, A; Dilling, J

    2012-01-01

    We present precision Penning-trap mass measurements of neutron-rich calcium and potassium isotopes in the vicinity of neutron number N=32. Using the TITAN system the mass of $^{51}$K was measured for the first time, and the precision of the $^{51,52}$Ca mass values were improved significantly. The new mass values show a dramatic increase of the binding energy compared to those reported in the atomic mass evaluation. In particular, $^{52}$Ca is more bound by 1.74 MeV, and the behavior with neutron number deviates substantially from the tabulated values. An increased binding was predicted recently based on calculations that include three-nucleon (3N) forces. We present a comparison to improved calculations, which agree remarkably with the evolution of masses with neutron number, making neutron-rich calcium isotopes an exciting region to probe 3N forces at neutron-rich extremes.

  9. 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.

  10. Importance of bioavailable calcium drinking water for the maintenance of bone mass in post-menopausal women.

    Science.gov (United States)

    Costi, D; Calcaterra, P G; Iori, N; Vourna, S; Nappi, G; Passeri, M

    1999-12-01

    The aim of this research was to establish the importance of calcium intake through mineral water on vertebral bone density in women. To this purpose, we examined 255 women divided into two groups: those regularly drinking a high calcium content mineral water (group A; no.=175) and those using different type of water with a lower calcium content (group B; no.=80). Their dietary daily calcium intake was determined by means of a validated questionnaire (N.I.H. Consensus statement) and vertebral bone density was measured by Dual-Energy X-ray absorptiometry (Unigamma-plus ACN densitometer). Women in group A ingested a significantly higher quantity of calcium in water than women in group B (mean difference 258 mg; 95% confidence limits: 147-370 mg). The average bone density values were slightly but significantly higher in group A as compared to group B (mean+/-SD: 1.044+0,15 vs 1.002+0,14; p=0.03). In addition to age, BMI and menopausal status, calcium intake was a significant predictor of spinal BMD. These 4 variables explained about 35% of the spinal BMD variance. When the analysis was repeated separately for pre- and post-menopausal subjects, calcium remained a significant predictor in post-menopausal women (t=2.28; p=0.02), but not in premenopausal women. These results underline the importance of a lifelong daily calcium intake, resulting by the regular drinking of high bioavailable calcium water, in order to maintain bone mass after the menopause, in comparison to the use of a lower content calcium water.

  11. Heat mass transfer model of fouling process of calcium carbonate on heat transfer surface

    Institute of Scientific and Technical Information of China (English)

    QUAN ZhenHua; CHEN YongChang; MA ChongFang

    2008-01-01

    A new heat mass transfer model was developed to predict the fouling process of calcium carbonate on heat transfer surface.The model took into account not only the crystallization fouling but also the particle fouling which was formed on the heat transfer surface by the suspension particles of calcium carbonate in the su-persaturated solution.Based on experimental results of the fouling process,the deposition and removal rates of the mixing fouling were expressed.Furthermore,the coupling effect of temperature with the fouling process was considered in the physics model.As a result the fouling resistance varying with time was obtained to describe the fouling process and the prediction was compared with experimental data under same conditions.The results showed that the present model could give a good prediction of fouling process,and the deviation was less than 15% of the experimental data in most cases.The new model is credible to predict the fouling process.

  12. Comprehensive coronary risk determination in primary prevention: an imaging and clinical based definition combining computed tomographic coronary artery calcium score and national cholesterol education program risk score.

    Science.gov (United States)

    Nasir, Khurram; Vasamreddy, Chandra; Blumenthal, Roger S; Rumberger, John A

    2006-06-16

    Cardiovascular disease (CVD) is the leading cause of mortality and a major cause of morbidity. Coronary heart disease (CHD) accounts for nearly half of all CVD deaths. Currently estimation of risk in primary prevention is based on the Framingham risk equations, which inputs traditional risk factors and is helpful in predicting the development of CHD in asymptomatic individuals. However many individuals suffer events in the absence of established risk factors for atherosclerosis and broad based population risk estimations may have little precision when applied to a given individual. To meet the challenge of CHD risk assessment, several tools have been developed to identify atherosclerotic disease in its preclinical stages. This paper aims to incorporate information from coronary artery calcification (CAC) scoring from a computed tomographic "heartscan" (using Electron Beam Tomography (EBT) as the validated prototype) along with current Framingham risk profiling in order to refine risk on an absolute scale by combining imaging and clinical data to affect a more comprehensive calculation of absolute risk in a given individual. For CAC scores above the 75th percentile but or =55 years, women> or =65 years) a CAC = 0 will result in an age point score corresponding to the age-group whose median CAC score is zero i.e., 40-44 years for men and 55-59 years for women. The utilization of CAC scores allows the inclusion of sub-clinical disease definition into the context of modifiable risk factors as well as identifies high-risk individuals requiring aggressive treatment.

  13. Impact of body mass index on outcome in patients undergoing coronary artery bypass grafting and/or valve replacement surgery

    Science.gov (United States)

    Costa, Vinícius Eduardo Araújo; Ferolla, Silvia Marinho; dos Reis, Tâmara Oliveira; Rabello, Renato Rocha; Rocha, Eduardo Augusto Victor; Couto, Célia Maria Ferreira; Couto, José Carlos Ferreira; Bento, Alduir

    2015-01-01

    Objective This study aimed to analyze the impact of body mass index on outcomes of 101 patients undergoing coronary artery bypass grafting, valve replacement, or combined valve/ coronary artery bypass grafting surgery in a private hospital in Belo Horizonte, Brazil. Methods This was a prospective cross-sectional study of patients undergoing cardiac surgery from May 2009 to December 2012. All patients were followed up from the first day of admission until discharge or death. Patients were divided into three groups according to BMI: normal weight, overweight, and obese. The main outcome measure was the association between BMI and postoperative morbidities and mortality. Results Multivariate analysis identified obesity as an independent predictor of increased risk of surgical reintervention (odds ratio [OR] 13.6; 95%CI 1.1 - 162.9; P=0.046) and reduced risk of bleeding (OR 0.05; 95% CI 0.09 - 0.69; P=0.025). Univariate analysis showed that obesity was associated with increased frequency of wound dehiscence (P=0.021). There was no association between BMI and other complications or mortality in univariate analysis. There was also no association between body mass index and duration of cardiopulmonary bypass, aortic clamping, mechanical ventilation, and intensive care unit or hospital stay. Conclusion Obese individuals undergoing coronary artery bypass grafting, valve replacement, or combined surgery have a higher postoperative risk of surgical reintervention and lower chances of bleeding. PMID:26313724

  14. CALCIUM REGULATING HORMONES IN SERUM AND BONE MASS DENSITY IN PATIENTS WITH DIABETES MELLITUS

    Institute of Scientific and Technical Information of China (English)

    颜晓东; 黄忠; 胡映玉

    2003-01-01

    Objective To investigate the changes of calcium regulating hormones in serum and bone mass in patients with diabetes mellitus.Methods The levels of estradiol (E2), testosterone (T), total triiodthyronine (TT3), total thyroid hormone(TT4), parathyroid hormone (PTH-SP), calci-tonin (CT) were measured in serum of 227 patients with diabetes and 268 healthy controls by radioim-munoassay, and bone mass density (BMD) at lumbar vertebrae, hip, foream were measured by dual energy X-ray absorptiometry (DEXA). The subjects were divided into three age groups.Results T of male in three age subgroups of diabetes was significantly lower (P<0.01 or P<0.05) and PTH was significantly higher (P< 0.001 or P< 0.01) than that in controls. BMD at lumbar 3, lumbar 4 in diabetes was lower than that in controls but BMD at hip, foream was higher.Conclusion The level of T declines and PTH increases in diabetes. Bone mass loss mostly occurs at lumbar vertebrae in diabetes patients.

  15. Computed Tomography Coronary Artery Calcium Scoring Review of Evidence Base and Cost-effectiveness in Cardiovascular Risk Prediction

    NARCIS (Netherlands)

    Vliegenthart, Rozemarijn; Morris, Pamela B.

    2012-01-01

    Cardiovascular risk factor-scoring algorithms may fall short in identifying asymptomatic individuals who will subsequently suffer a coronary event. It is generally thought that evaluation of the extent of the atherosclerotic plaque and total plaque burden can improve cardiovascular risk stratificati

  16. Coronary artery calcium score and N-terminal pro-B-type natriuretic peptide as potential gatekeepers for myocardial perfusion imaging

    DEFF Research Database (Denmark)

    Haarmark, Christian; Andersen, Kim Francis; Madsen, Claus;

    2017-01-01

    Myocardial perfusion imaging (MPI) holds an important place as non-invasive risk assessment in patients with intermediate risk of coronary heart disease (CHD). However, as much as 60-70% of MPI scans are normal. This study evaluates the role of coronary artery calcium scoring (CAC score) and NT......-proBNP as potential gatekeepers for MPI. Patients with intermediate risk of CHD referred for standard MPI were included. CAC score and NT-proBNP were both assessed at the day of the stress study. Sensitivity, specificity and NPV for prediction of abnormal MPI scans were calculated for CAC, NT......-proBNP and the combination hereof. A total of 190 patients were included (mean age 61 ± 12 years, 55% female) of whom 24% had known CHD. In all 30% of the scans were abnormal. CAC score achieved the highest AUC regardless of whether patients with known CHD were included or not [AUC 0·75 95% CI (0·66-0·84) and AUC 0·79 (0...

  17. Calcium en cardioplegie

    NARCIS (Netherlands)

    Ruigrok, T.J.C.; Meijler, F.L.

    1985-01-01

    Coronary perfusion with a calcium-free solution, followed by reperfusion with a calcium containing solution, may result in acute myocardial cell death and in irreversible loss of the e1ectrical and mechanical activity of the heart. This phenomenon is known as the calcium paradox. A number of cardiop

  18. Estimation of cardiovascular risk on routine chest CT: Ordinal coronary artery calcium scoring as an accurate predictor of Agatston score ranges.

    Science.gov (United States)

    Azour, Lea; Kadoch, Michael A; Ward, Thomas J; Eber, Corey D; Jacobi, Adam H

    Coronary artery calcium (CAC) is often identified on routine chest computed tomography (CT). The purpose of our study was to evaluate whether ordinal scoring of CAC on non-gated, routine chest CT is an accurate predictor of Agatston score ranges in a community-based population, and in particular to determine the accuracy of an ordinal score of zero on routine chest CT. Two thoracic radiologists reviewed consecutive same-day ECG-gated and routine non-gated chest CT scans of 222 individuals. CAC was quantified using the Agatston scoring on the ECG-gated scans, and using an ordinal method on routine scans, with a score from 0 to 12. The pattern and distribution of CAC was assessed. The correlation between routine exam ordinal scores and Agatston scores in ECG-gated exams, as well as the accuracy of assigning a zero calcium score on routine chest CT was determined. CAC was most prevalent in the left anterior descending coronary artery in both single and multi-vessel coronary artery disease. There was a strong correlation between the non-gated ordinal and ECG-gated Agatston scores (r = 0.811, p < 0.01). Excellent inter-reader agreement (k = 0.95) was shown for the presence (total ordinal score ≥1) or absence (total ordinal score = 0) of CAC on routine chest CT. The negative predictive value for a total ordinal score of zero on routine CT was 91.6% (95% CI, 85.1-95.9). Total ordinal scores of 0, 1-3, 4-5, and ≥6 corresponded to average Agatston scores of 0.52 (0.3-0.8), 98.7 (78.2-117.1), 350.6 (264.9-436.3) and 1925.4 (1526.9-2323.9). Visual assessment of CAC on non-gated routine chest CT accurately predicts Agatston score ranges, including the zero score, in ECG-gated CT. Inclusion of this information in radiology reports may be useful to convey important information on cardiovascular risk, particularly premature atherosclerosis in younger patients. Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights

  19. 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...

  20. Body mass index-adapted prospective coronary computed tomography angiography. Determining the lowest limit for diagnostic purposes

    Energy Technology Data Exchange (ETDEWEB)

    Hosch, Waldemar, E-mail: waldemar.hosch@med.uni-heidelberg.de [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Hofmann, Nina P. [University of Heidelberg, Department of Cardiology, Heidelberg (Germany); Mueller, Dirk [Philips GmbH Healthcare Division, Hamburg (Germany); Iwan, Johannes; Gitsioudis, Gitsios [University of Heidelberg, Department of Cardiology, Heidelberg (Germany); Siebert, Stefan [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Giannitsis, Evangelos [University of Heidelberg, Department of Cardiology, Heidelberg (Germany); Kauczor, Hans U. [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Katus, Hugo A. [University of Heidelberg, Department of Cardiology, Heidelberg (Germany); Korosoglou, Grigorios, E-mail: gkorosoglou@hotmail.com [University of Heidelberg, Department of Cardiology, Heidelberg (Germany)

    2013-05-15

    Purpose: To investigate the value of 4 different protocols for prospectively triggered 256-slice coronary computed tomography angiography (coronary CTA). Methods: Two hundred and ten patients underwent prospectively triggered coronary CTA for suspected or known coronary artery disease (CAD). Patients with heart rate >75 bps before the scan despite ß-blocker administration and with arrhythmia were excluded. From January to September 2010, 60 patients underwent coronary CTA using a non-tailored protocol (120 kV; 200 mAs) and served as our ‘control’ group. From September 2010 to April 2012, based on the body mass index (BMI) of the examined patients (BMI subgroups of < 25; 25–28; 28–30, and ≥ 30 kg/m{sup 2}) current tube voltage and tube current were: (1) slightly, (2) moderately or (3) strongly reduced, resulting into the 3 following BMI-adapted acquisition groups: (1) a ‘standard’ (100/120 kV; 100–200 mAs; n = 50), 2) a ‘low dose’ (100/120 kV; 75–150 mAs; n = 50), and 3) an ‘ultra-low dose’ (100/120 kV; 50–100 mAs; n = 50) protocol. Results: Patients examined using the non-tailored protocol exhibited the highest radiation exposure (3.2 ± 0.4 mSv), followed by the standard (1.6 ± 0.7 mSv), low-dose (1.2 ± 0.6 mSv) and ultra-low dose protocol (0.7 ± 0.3 mSv) (radiation savings of 50%, 63% and 78% respectively). Overall image quality was similar with standard dose (1.9 ± 0.6) and low-dose (2.0 ± 0.5) compared to the non-tailored group (1.9 ± 0.5) (p = NS for all). In the ultra-low dose group however, image quality was significant reduced (2.7 ± 0.6), p < 0.05 versus all other groups). Conclusion: Using BMI-adapted low dose acquisitions image quality can be maintained with simultaneous radiation savings of ∼65% (dose of ∼1 mSv). This appears to be the lower limit for diagnostic coronary CTA, whereas ultra-low dose acquisitions result in significant image degradation.

  1. Relationship between Body Mass Index and Outcome of Elective Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Mohammad Alidoosti

    2015-10-01

    Full Text Available Background: Studies have shown controversial effects of obesity on major adverse cardiac events (MACE after percutaneous coronary intervention (PCI. We sought to investigate the impact of the body mass index (BMI on the mid-term outcome following successful PCI.Methods: Between March 2006 and August 2008, 3948 patients underwent successful elective PCI in Tehran Heart Center, Tehran, Iran, and were retrospectively included in this study. Patients who underwent PCI on the same day as the occurrence of myocardial infarction were excluded. The demographic, procedural, in-hospital, and follow-up information of these patients was extracted from the PCI Data Registry of our institution. The patients were divided into three groups:  normal weight (No. 1058, BMI < 25 kg/m2 age = 58 ± 10 years; overweight (No. 1867, 25 ≤ BMI < 30 kg/m2, age = 57 ± 10 years; and obese (No. 1023, BMI ≥ 30 kg/m2, age = 56 ± 10 years. MACE included death, myocardial infarction, target vessel revascularization, and target lesion revascularization.Results: Compared with the other patients, the obese individuals were significantly younger and more frequently female, had a higher ejection fraction, and more frequently presented with hypertension, diabetes, and hyperlipidemia. There was no association between the BMI and the angiographic and procedural findings in the univariate analysis. While no difference was found in the rate of in-hospital death between the groups, the number of the obese patients undergoing emergent cardiac surgery was marginally different in the univariate analysis (p value = 0.06. At 9 months' follow-up, MACE had occurred in 92 (2.3% patients and cardiac mortality was 9 (0.2%. After adjustments for confounders, no significant difference was observed in terms of MACE between the BMI groups.Conclusion: The BMI had no significant effect on the rate of MACE at 9 months' follow-up in our study population. Interventionists' recommendations for patients

  2. Childhood body-mass index and the risk of coronary heart disease in adulthood

    DEFF Research Database (Denmark)

    Baker, Jennifer Lyn; Olsen, Lina Wøhlk; Sørensen, Thorkild I A

    2007-01-01

    BACKGROUND: The worldwide epidemic of childhood obesity is progressing at an alarming rate. Risk factors for coronary heart disease (CHD) are already identifiable in overweight children. The severity of the long-term effects of excess childhood weight on CHD, however, remains unknown. METHODS: We...

  3. Expression and function of calcium-activated potassium channels following in-stent restenosis in a porcine coronary artery model

    Directory of Open Access Journals (Sweden)

    Mais F. Absi

    2012-04-01

    Functional analysis using 1-EBIO and Bradykinin produced hyperpolarization of neointimal but not medial myocytes, which indicated the expression of functional endothelial SK3 and IKCa in the former and not in the latter. The expression of IKCa and SK3 within the neointimal layer suggested that some degree of recovery of both endothelial as well as smooth muscle regeneration had occurred. Future development of selective modulators of IKCa and SK3 channels may decrease the progression of ISR and improve coronary vascular function after stent placement, and is an area for future investigation.

  4. Matrix effects of calcium on high-precision sulfur isotope measurement by multiple-collector inductively coupled plasma mass spectrometry.

    Science.gov (United States)

    Liu, Chenhui; Bian, Xiao-Peng; Yang, Tao; Lin, An-Jun; Jiang, Shao-Yong

    2016-05-01

    Multiple-collector inductively coupled plasma mass spectrometry (MC-ICP-MS) has been successfully applied in the rapid and high-precision measurement for sulfur isotope ratios in recent years. During the measurement, the presence of matrix elements would affect the instrumental mass bias for sulfur and these matrix-induced effects have aroused a lot of researchers' interest. However, these studies have placed more weight on highlighting the necessity for their proposed correction protocols (e.g., chemical purification and matrix-matching) while less attention on the key property of the matrix element gives rise to the matrix effects. In this study, four groups of sulfate solutions, which have different concentrations of sulfur (0.05-0.60mM) but a constant sequence of atomic calcium/sulfur ratios (0.1-50), are investigated under wet (solution) and dry (desolvation) plasma conditions to make a detailed evaluation on the matrix effects from calcium on sulfur isotope measurement. Based on a series of comparative analyses, we indicated that, the matrix effects of calcium on both measured sulfur isotope ratios and detected (32)S signal intensities are dependent mainly on the absolute calcium concentration rather than its relative concentration ratio to sulfur (i.e., atomic calcium/sulfur ratio). Also, for the same group of samples, the matrix effects of calcium under dry plasma condition are much more significant than that of wet plasma. This research affords the opportunity to realize direct and relatively precise sulfur isotope measurement for evaporite gypsum, and further provides some suggestions with regard to sulfur isotope analytical protocols for sedimentary pore water.

  5. 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.

  6. Age, Gender, and Race-Based Coronary Artery Calcium Score Percentiles in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Pereira, Alexandre C; Gomez, Luz M; Bittencourt, Marcio Sommer; Staniak, Henrique Lane; Sharovsky, Rodolfo; Foppa, Murilo; Blaha, Michael J; Bensenor, Isabela M; Lotufo, Paulo A

    2016-06-01

    Coronary artery calcium (CAC) has been demonstrated to independently predict the risk of cardiovascular events and all-cause mortality, especially among White populations. Although the population distribution of CAC has been determined for several White populations, the distribution in ethnically admixed groups has not been well established. The CAC distribution, stratified for age, gender and race, is similar to the previously described distribution in the MESA study. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a prospective cohort study designed to investigate subclinical cardiovascular disease in 6 different centers of Brazil. Similar to previous studies, individuals with self-reported coronary or cerebrovascular disease and those treated for diabetes mellitus were excluded from analysis. Percentiles of CAC distribution were estimated with nonparametric techniques. The analysis included 3616 individuals (54% female; mean age, 50 years). As expected, CAC prevalence and burden were steadily higher with increasing age, as well as increased in men and in White individuals. Our results revealed that for a given CAC score, the ELSA-derived CAC percentile would be lower in men compared with the Multi-Ethnic Study of Atherosclerosis (MESA) and would be higher in women compared with MESA. In our sample of the Brazilian population, we observed significant differences in CAC by sex, age, and race. Adjusted for age and sex, low-risk individuals from the Brazilian population present with significantly lower CAC prevalence and burden compared with other low-risk individuals from other worldwide populations. Using US-derived percentiles in Brazilian individuals may lead to overestimating relative CAC burden in men and underestimating relative CAC burden in women. © 2016 Wiley Periodicals, Inc.

  7. Coronary calcium score in 12-year breast cancer survivors after adjuvant radiotherapy with low to moderate heart exposure - Relationship to cardiac radiation dose and cardiovascular risk factors.

    Science.gov (United States)

    Tjessem, Kristin Holm; Bosse, Gerhard; Fosså, Kristian; Reinertsen, Kristin V; Fosså, Sophie D; Johansen, Safora; Fosså, Alexander

    2015-03-01

    We explored the relation between coronary artery calcium (CAC) and cardiac radiation doses in breast cancer survivors (BCS) treated with radiotherapy (RT). Additionally, we examined the impact of other risk factors and biomarkers of coronary artery disease (CAD). 236 BCS (median age 51years [range 30-70], median observation time 12years [9.2-15.7]), treated with 4-field RT of 50GY, were included and examined in 2004 (T1), 2007 (T2) and 2011 (T3) with clinical examination, blood tests and questionnaires. At T3, cardiac computed tomography was performed with quantification of CAC using Agatston score (AS). For 106 patients cardiac dose volume histograms were available. The cohort-based median of the mean cardiac dose was 2.5 (range 0.5-7.0) Gy. There was no correlation between measures of cardiac dose and AS. AS was correlated with high cholesterol at T1/T2 (p=0.022), high proBNP at T1/T2 (p<0.022) and T3 (p<0.022) and high HbA1c at T3 (p=0.022). In addition, a high AS was significantly associated with hypertension (p=0.022). Age (p<0.001) and cholesterol at T1/T2 (p=0.001) retained significant associations in multivariate analysis. Traditional, modifiable risk factors of CAD correlate with CAC and may be important for the long term risk of CAD after RT. With low to moderate cardiac radiation exposure, a contribution of radiation dose to CAC could not be demonstrated. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Impact of Gender on the Prognostic Value of Coronary Artery Calcium in Symptomatic Patients With Normal Single-Photon Emission Computed Tomography Myocardial Perfusion.

    Science.gov (United States)

    Engbers, Elsemiek M; Timmer, Jorik R; Ottervanger, Jan Paul; Mouden, Mohamed; Knollema, Siert; Jager, Pieter L

    2016-12-01

    The coronary artery calcium (CAC) score provides independent prognostic value on top of single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). We sought to determine whether the prognostic value of the CAC score in patients with normal SPECT MPI is gender specific. We studied 3,705 consecutive symptomatic patients without a history of coronary artery disease with normal SPECT MPI. All patients underwent concomitant CAC scoring, which was categorized as CAC score 0, 1 to 99, 100 to 399, 400 to 999, or ≥1,000. Major adverse cardiac events were defined as revascularization, nonfatal myocardial infarction, or all-cause mortality. The median CAC score was 9 in women (interquartile range 0 to 113) and 47 in men (interquartile range 1 to 307, p CAC score, annual event rates were similar (for women and men, respectively: CAC score 0, 0.6% and 0.5%, p = 0.95; CAC score 1 to 99, 0.9% and 1.2%, p = 0.45; CAC score 100 to 399, 2.7% and 3.8%, p = 0.23; CAC score 400 to 999, 3.8% and 5.3%, p = 0.34; CAC score ≥1,000, 8.4% and 8.7%, p = 0.99). The CAC score was an independent predictor of major adverse cardiac events in both genders (CAC score ≥1,000: hazard ratio for women 8.5, 95% confidence interval 4.0 to 18.1; hazard ratio for men 14.8, 95% confidence interval 5.3 to 41.1). In conclusion, risk for events is similar for both genders when stratified by CAC score, wherein a high CAC score carries a high risk for events despite normal SPECT MPI. Our findings do not reveal a gender-specific prognostic value of the CAC score.

  9. Brachial-ankle pulse wave velocity is associated with coronary calcium in young and middle-aged asymptomatic adults: The Kangbuk Samsung Health Study.

    Science.gov (United States)

    Cainzos-Achirica, Miguel; Rampal, Sanjay; Chang, Yoosoo; Ryu, Seungho; Zhang, Yiyi; Zhao, Di; Cho, Juhee; Choi, Yuni; Pastor-Barriuso, Roberto; Lim, So Yeon; Bruguera, Jordi; Elosua, Roberto; Lima, Joao A C; Shin, Hocheol; Guallar, Eliseo

    2015-08-01

    To evaluate the association between brachial-ankle pulse wave velocity (baPWV), a convenient, non-radiating, readily available measurement of arterial stiffness, and coronary artery calcium (CAC), a reliable marker of coronary atherosclerosis, in a large sample of young and middle-aged asymptomatic adults; and to assess the incremental value of baPWV for detecting prevalent CAC beyond traditional risk factors. Cross-sectional study of 15,185 asymptomatic Korean adults who voluntarily underwent a comprehensive health screening program including measurement of baPWV and CAC. BaPWV was measured using an oscillometric method with cuffs placed on both arms and ankles. CAC burden was assessed using a multi-detector CT scan and scored following Agatston's method. The prevalence of CAC > 0 and CAC > 100 increased across baPWV quintiles. The multivariable-adjusted odds ratios (95% CI) for CAC > 0 comparing baPWV quintiles 2-5 versus quintile 1 were 1.06 (0.87-1.30), 1.24 (1.02-1.50), 1.39 (1.15-1.69) and 1.60 (1.31-1.96), respectively (P trend  100 were 1.30 (0.74-2.26), 1.59 (0.93-2.71), 1.74 (1.03-2.94) and 2.59 (1.54-4.36), respectively (P trend  100, the area under the ROC curve for baPWV alone was 0.71 (0.68-0.74), and the addition of baPWV to traditional risk factors significantly improved the discrimination and calibration of models for detecting prevalent CAC > 0 and CAC > 100. BaPWV was independently associated with the presence and severity of CAC in a large sample of young and middle-aged asymptomatic adults. BaPWV may be a valuable tool for identifying apparently low-risk individuals with increased burden of coronary atherosclerosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Role of calcium mobilization in the regulation of spontaneous transient outward currents in porcine coronary artery myocytes

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The purpose of the present study was to further study the characteristics and regulation of spontaneous transient outward currents (STOCs) in freshly isolated porcine coronary artery smooth muscle cells (ASMCs). STOCs were recorded using the perforated whole-cell patch-clamp configuration. STOCs were voltage-dependent and superimposed stochastically onto whole-cell Ca2+-activated-K+ (BKCa) currents. Charybdotoxin (ChTX, 200 nmol/L), a selective blocker of BKCa channels, completely inhibited STOCs within 10 min. STOCs activity was greatly suppressed when extracellular Ca2+ concentration decreased from 1.8 mmol/L to 200 nmol/L, further removal of Ca2+ abolished STOCs activity. Ca2+ ionophore A23187 (10 μmol/L) increased STOCs activity significantly. Verapamil (20 μmol/L) and CdCl2 (200 μmol/L), two kinds of organic L-type voltage-dependent Ca2+ channels (L-VDCCs) antagonists, had little effect on STOCs. In addition, the ryanodine receptors (RyRs) agonist caffeine (5 mmol/L) significantly activated STOCs. Application of ryanodine (50 μmol/L) to block RyRs abolished STOCs, subsequent washout of ryanodine or application of caffeine failed to reproduce STOCs activity. Inhibition of inositol 1,4,5-trisphosphate receptors (IP3Rs) by 2APB (40 μmol/L) greatly suppressed the activity of STOCs, application of caffeine (5 mmol/L) in the presence of 2APB caused a burst of outward currents followed by inhibition of STOCs. These results suggest that STOCs in porcine coronary ASMCs are mediated by BKCa channels. Extracellular Ca2+ is essential for STOCs activity, while Ca2+ entry through L-VDCCs has little effect on STOCs. Intracellular Ca2+ release induced by RyRs is responsible for the regulation of STOCs, whereas IP3Rs might also be involved.

  11. Calcium isolation from large-volume human urine samples for 41Ca analysis by accelerator mass spectrometry.

    Science.gov (United States)

    Miller, James J; Hui, Susanta K; Jackson, George S; Clark, Sara P; Einstein, Jane; Weaver, Connie M; Bhattacharyya, Maryka H

    2013-08-01

    Calcium oxalate precipitation is the first step in preparation of biological samples for (41)Ca analysis by accelerator mass spectrometry. A simplified protocol for large-volume human urine samples was characterized, with statistically significant increases in ion current and decreases in interference. This large-volume assay minimizes cost and effort and maximizes time after (41)Ca administration during which human samples, collected over a lifetime, provide (41)Ca:Ca ratios that are significantly above background.

  12. Calcium Isolation from Large-Volume Human Urine Samples for 41Ca Analysis by Accelerator Mass Spectrometry

    Science.gov (United States)

    Miller, James J; Hui, Susanta K; Jackson, George S; Clark, Sara P; Einstein, Jane; Weaver, Connie M; Bhattacharyya, Maryka H

    2013-01-01

    Calcium oxalate precipitation is the first step in preparation of biological samples for 41Ca analysis by accelerator mass spectrometry. A simplified protocol for large-volume human urine samples was characterized, with statistically significant increases in ion current and decreases in interference. This large-volume assay minimizes cost and effort and maximizes time after 41Ca administration during which human samples, collected over a lifetime, provide 41Ca:Ca ratios that are significantly above background. PMID:23672965

  13. Image Quality and Radiation Exposure in Coronary CT Angiography According to Tube Voltage and Body Mass Index

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoon Kyung [Korea University Guro Hospital, Seoul (Korea, Republic of); Kim, Yoo Kyung [Ewha Womans University MokDong Hospital, Seoul (Korea, Republic of)

    2010-01-15

    To investigate the image quality and radiation dose of a coronary CT angiography (CCTA) according to tube voltage and body mass index (BMI). This study included 139 patients who underwent CCTA using a retrospective electrocardiography- gating technique. A total of 48 patients (BMI <2 5, group A) were examined with 100 kVp, 45 patients (BMI > 25, group B) with 120 kVp, and 46 patients (BMI < 25, group C) with 120 kVp. Attenuation and image noise of the aorta and coronary arteries was measured. Moreover, the image quality of 9 coronary segments was graded on a scale of 1-5, where grade 4 or 5 was considered to be diagnostic. Image quality parameters and radiation dose were compared using a t-test or Chi-squared test. Results: Vessel attenuation in group A was significantly higher than in groups B or C (group A, 592 {+-} 85 HU; group B, 437 {+-} 46 HU; group C, 469 {+-} 62 HU, p<0.001). Image noise was similar in group A and group B (23 {+-} 5 HU versus 22 {+-} 6 HU, p=0.427), but significantly higher in group A compared to group C (23 {+-} 5 HU versus 17 {+-} 4 HU, p<0.001). A significant difference was observed in the signal-to-noise ratio between the three groups (group A, 24 {+-} 6; group B, 19 {+-} 3; group C, 27 {+-} 5: p<0.05). Moreover, the contrast-to-noise ratio was significantly higher in group A than group B (group A 18 {+-} 5 versus group B 14 {+-} 3, p < 0.001) but not significantly different between group A and group C (group C 20 {+-} 4, p=0.127). The percentage of coronary segments with diagnostic image quality was 97.9% in group A, 96.0% in group B, and 99.0% in group C. The mean image quality score was 4.5 {+-} 0.5 in group A, 4.1 {+-} 0.4 in group B, and 4.2 {+-} 0,4 in group C (p<0.001). The effective radiation doses were 8.5 {+-} 0.8 mSv in group A, 14.3 {+-} 1.3 mSv in group B, and 14.9 {+-} 1.3 mSv in group C. A 42% reduction in mean effective radiation dose in group A was observed compared with groups B and C. In patients with BMI less than 25

  14. Phosphorus and Calcium Metabolism in Postmenopausal Women with Diabetes Mellitus: Effects of the Type and Duration of the Disease, Time of Menopause and Body Mass

    Directory of Open Access Journals (Sweden)

    M.L. Kyryliuk

    2016-03-01

    Full Text Available The article deals with the impact of diabetes mellitus (DM on the phosphorus and calcium metabolism in postmenopausal women, depending on the type and duration of the disease, duration of menopause, body mass and type of hypoglycemic therapy. The state of phosphorus and calcium metabolism in 86 women with type 1 DM (13 patients and type 2 DM (73 patients was studied. In all patients, the concentration of calcium and phosphorus in the blood was within normal limits. It was found that the concentration of ionized calcium, total calcium and inorganic phosphorus in the blood can not be the main criterion for the state of bone mineral density in postmenopausal women with DM. Sulfonylureas and insulin in combination with biguanides have no effect on the status of phosphorus and calcium metabolism in postmenopausal women with type 2 DM.

  15. The effect of long-term hypoxia on tension and intracellular calcium responses following stimulation of the thromboxane A(2) receptor in the left anterior descending coronary artery of fetal sheep.

    Science.gov (United States)

    Maruko, Keiko; Stiffel, Virginia M; Gilbert, Raymond D

    2009-04-01

    The purpose of this study was to investigate the mechanisms of tension and intracellular calcium regulation following stimulation with the thromboxane A(2) receptor agonist U46619 in the left anterior descending coronary artery of fetal sheep exposed to long-term hypoxia. We hypothesized that there would be a reduction in intracellular calcium responses in long-term hypoxic left anterior descending coronary artery accompanied by an increase in calcium sensitivity of the contractile mechanism. Pregnant sheep were kept at altitude (3820 m) from day 30 of gestation until day 140. Fetal hearts from long-term hypoxic and from a control, normoxic group were obtained and the left anterior descending coronary artery of the fetus was dissected, cleaned, and mounted in a bath (Jasco) in which tension and intracellular calcium [Ca(2+)](i), using Fura-2, could be measured simultaneously following stimulation of the thromboxane A(2) receptor with U46619. The role of intracellular calcium and the Rho kinase and protein kinase C pathways in the tension responses were investigated by maintaining intracellular calcium constant or by using the Rho kinase blocker, Y27632, or the protein kinase C blocker, GF109203-X. There was no difference in the tension dose-response to U46619 between the normoxic fetal and hypoxic fetal left anterior descending, although [Ca(2+)](i) was lower in the hypoxic fetal than normoxic fetal at the highest doses. When [Ca(2+)]( i) was maintained constant at baseline levels, U46619 produced the same tension dose-response in both normoxic fetal and hypoxic fetal left anterior descending as when [Ca(2+)](i) was allowed to rise. The tension response was abolished in both groups when the Rho kinase inhibitor, Y27632, was given either during or before stimulation with U46619. The protein kinase C blocker, GF109203-X, had no effect on the tension response in either group. Long-term hypoxia did not alter the tension response to thromboxane A(2) receptor stimulation

  16. Dietary calcium intake and higher body mass index in Mexican adults aged 20 to 59 years old: cross-sectional study

    Directory of Open Access Journals (Sweden)

    Mario Efraín Flores-Aldana

    2013-02-01

    Full Text Available Background. Although energy balance is the main factor that regulates body weight, recent studies suggest that calcium metabolism can modify the energy balance and help regulate body weight. Objective. To evaluate the association between the calcium intake in the diet and high body mass index in Mexican adults in the 20-59 age group. Material and methods. A cross-sectional secondary analytical study was conducted based on the 2006 Mexican National Health and Nutritional Survey (ENSANUT 2006. Food intake questionnaires applied to 16,494 adults were analyzed. After removing biologically implausible values or incomplete information, we arrived at a final sample of 15,662 adults grouped according to their body mass index. Linear regression was used to assess association between daily dietary calcium intake and body mass index. Results. There was an inverse association between dietary calcium consumption and a high body mass index. The mean calcium intake in subjects with normal body mass index was 903.9 mg/day versus 832.0 mg/day in obese subjects (p < 0.0001. Conclusion. The study corroborates existing evidence of an inverse association between the dietary calcium intake and a high body mass index.

  17. Prenatal calcium and vitamin D intake, and bone mass in later life.

    Science.gov (United States)

    Curtis, Elizabeth M; Moon, Rebecca J; Dennison, Elaine M; Harvey, Nicholas C

    2014-06-01

    The aging population will result in an increasing burden of osteoporotic fractures, necessitating the identification of novel strategies for prevention. There is increasing recognition that factors in utero may influence bone mineral accrual, and, thus, osteoporosis risk. The role of calcium and vitamin D has received much attention in recent years, and in this review, we will survey available studies relating maternal calcium and vitamin D status during pregnancy to offspring bone development. The evidence base supporting a positive influence on intrauterine skeletal growth appears somewhat stronger for maternal 25(OH)-vitamin D concentration than for calcium intake, and the available data point toward the need for high-quality randomized controlled trials in order to inform public health policy. It is only with such a rigorous approach that it will be possible to delineate the optimal strategy for vitamin D supplementation in pregnancy in relation to offspring bone health.

  18. Calcium and vitamin D requirements for optimal bone mass during adolescence

    Science.gov (United States)

    There remains very strong interest in the calcium and vitamin D requirements of adolescents related to bone health. The Institute of Medicine (IOM) released new dietary guidelines in late 2010 for these nutrients. These guidelines were primarily based on literature published in 2009 and earlier and ...

  19. Body Mass Index, Blood Lipid and Apolipoprotein levels and Coronary Heart Disease among middle aged Punjabi Khatris of Northwest India

    Directory of Open Access Journals (Sweden)

    Tripta*

    2013-10-01

    Full Text Available Background: Studies have suggested that an elevated plasma concentration of apolipoprotein (apo B coupled with obesity may be considered as an important risk factor for coronary heart disease (CHD than the traditional lipid factors. Coronary artery disease (CAD is a multifactorial disease resulting from interaction among various hereditary, cultural and environment factors. Population specific studies are rare. Aim: The aim of this study was to evaluate the association of body mass index (BMI, blood lipids and apolipoproteins with the CAD among the Khatri caste, which is an indigenous population of Northwest India. Materials and Methods: The study was carried on 150 CAD patients and 150 normal controls belonging to the Punjabi Khatri caste ranging in age from 35-45 years. Height and body weight was measured using standard techniques. Blood was drawn from each subject to analyze serum concentrations of lipids and apolipoproteins. Results: The study demonstrated that CAD patients had elevated BMI in both males and females than normal controls. Apo B levels were an important predictor of CAD. ApoA/ApoB ratio among CAD patients was 0.74 compared with 1.53 in normal subjects; controls had 105.79% higher ApoA/ApoB ratio than CAD subjects. Total cholesterol, LDL-C, triglycerides, LDL-C/HDL-C ratio of the two groups also showed significant differences. Prevalence of obesity in CAD patients was 70.7% compared with 10% in normal controls. Conclusions: Apo B levels were found to the best predictor of CAD, even though significant differences were also found between CAD and normal subjects for other lipoprotein traits. Obesity was high CAD patients than normal controls.

  20. Assessment of calcium scoring performance in cardiac computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ulzheimer, Stefan; Kalender, Willi A. [Institute of Medical Physics, University of Erlangen-Nuernberg, Krankenhausstrasse 12, 91054, Erlangen (Germany)

    2003-03-01

    Electron beam tomography (EBT) has been used for cardiac diagnosis and the quantitative assessment of coronary calcium since the late 1980s. The introduction of mechanical multi-slice spiral CT (MSCT) scanners with shorter rotation times opened new possibilities of cardiac imaging with conventional CT scanners. The purpose of this work was to qualitatively and quantitatively evaluate the performance for EBT and MSCT for the task of coronary artery calcium imaging as a function of acquisition protocol, heart rate, spiral reconstruction algorithm (where applicable) and calcium scoring method. A cardiac CT semi-anthropomorphic phantom was designed and manufactured for the investigation of all relevant image quality parameters in cardiac CT. This phantom includes various test objects, some of which can be moved within the anthropomorphic phantom in a manner that mimics realistic heart motion. These tools were used to qualitatively and quantitatively demonstrate the accuracy of coronary calcium imaging using typical protocols for an electron beam (Evolution C-150XP, Imatron, South San Francisco, Calif.) and a 0.5-s four-slice spiral CT scanner (Sensation 4, Siemens, Erlangen, Germany). A special focus was put on the method of quantifying coronary calcium, and three scoring systems were evaluated (Agatston, volume, and mass scoring). Good reproducibility in coronary calcium scoring is always the result of a combination of high temporal and spatial resolution; consequently, thin-slice protocols in combination with retrospective gating on MSCT scanners yielded the best results. The Agatston score was found to be the least reproducible scoring method. The hydroxyapatite mass, being better reproducible and comparable on different scanners and being a physical quantitative measure, appears to be the method of choice for future clinical studies. The hydroxyapatite mass is highly correlated to the Agatston score. The introduced phantoms can be used to quantitatively assess the

  1. 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.

  2. Calcium and vitamin D requirements for optimal bone mass during adolescence.

    Science.gov (United States)

    Abrams, Steven A

    2011-11-01

    There remains very strong interest in the calcium and vitamin D requirements of adolescents related to bone health. The Institute of Medicine (IOM) released new dietary guidelines in late 2010 for these nutrients. These guidelines were primarily based on literature published in 2009 and earlier and emphasized the role of vitamin D combined with calcium in optimizing bone health. A series of research studies published in 2010 and 2011, mostly not included in the IOM report, have further addressed these issues. These most recently published data are generally consistent with the IOM report and earlier data in supporting calcium intakes of 1300 mg/day and vitamin D intakes of 600 IU/day for adolescents. However, there is some suggestion that a slightly higher Recommended Dietary Allowance for vitamin D might be considered at some future time. New dietary guidelines and recent research support increased vitamin D intakes compared with previous recommendations, but not very high doses. Further studies are needed related to high-dose vitamin D intake.

  3. [Effects of body mass index on blood pressure control rate in elderly coronary heart disease outpatients with hypertension].

    Science.gov (United States)

    Liang, D L; Li, X Y; Wang, L; Xu, H; Tuo, X P; Jian, Z J

    2016-09-20

    Objective: To explore the influences of body mass index (BMI) on blood pressure control rate in elderly coronary heart disease (CHD) outpatients with hypertension. Methods: In this multicenter, non-intervention and cross-sectional survey, the elderly coronary heart disease patients with hypertension aged 60 years or over were recruited from 165 hospitals in 21 provinces or cities across China from April to July 2011, and 5 140 cases of elderly CHD patients with hypertension were finally included into the study. The cases were divided into low BMI group (n=130 cases), normal body mass index (BMI) group (n=1 390 cases), overweight (n=2 418 cases), obesity group (n=662 cases) according to the different levels of BMI. Clinical data and blood pressure control rate were compared among the groups, and relationships of different BMI levels with blood pressure control rate were analyzed by the binary classification unconditioned Logistic regression equation. Results: There was a statistically significant difference in blood pressure control rate of general population, men and women patients among low BMI group, normal BMI group, overweight and obesity group (χ(2)=66.346, 58.995, 26.044, respectively, Ppressure failure rate in obesity group (73.7%) was higher than that in overweight group (65.8%) and normal BMI group (57.5%) (Pgroup was also higher than normal BMI group (Ppressure failure rate in obesity men was higher than that in normal BMI and low BMI group (Pgroup was higher than normal BMI group (Ppressure failure rate in obesity women was higher than that in normal BMI and low BMI group (Ppressure control rate of different age groups (60-70, 71-80, >80 years old) among low BMI group, normal BMI group, overweight and obesity group (χ(2)=37.729, 20.007, 15.538, respectively, Ppressure failure rate in obesity patients with 60-70 years old was higher than that in overweight and normal BMI group (Ppressure failure rates in obesity and overweight patients with 71-80 and

  4. Comparison of serum calcium measurements with respect to five models of atomic absorption spectrometers using NBS-AACC calcium reference method and isotope-dilution mass spectrometry as the definitive method.

    Science.gov (United States)

    Copeland, B E; Grisley, D W; Casella, J; Bailey, H

    1976-10-01

    Utilizing the recently described reference method for calcium (NBS-AACC) and the recently developed definitive (referee) NBS method for serum calcium measurement by isotopedilution mass spectrometry (IDMS), an evaluation of five recent-model atomic absorption spectrometers was carried out. Under optimal conditions of instrument operation using aqueous standards, significant differences were found during the comparative analyses of three lyophilized pool samples and one liquid serum pool sample. Use of the NBS-AACC serum calcium protocol did not guarantee analytic results within +/- 2% of the IDMS value. In four of eight comparisons, differences from IDMS greater than 2% were observed. Several variables were studied to account for these differences. It was shown that a serum matrix, when present in standards used to bracket the unknown sample, reduced differences between instruments in four of four instances and improved the accuracy of the results from a range of -1.1 to +3.5% to +0.1 to +1.0%. It is concluded that a serum sample with a verified IDMS calcium value is a valuable tool that establishes an accurate and stable reference point for serum calcium measurement. The use of transfer-of-NBS-technology multipliers is suggested. Regional quality control serum pools and clinical chemistry survey sample materials that have been analyzed for calcium concentration by the NBS-IDMS definitive method are examples of these multipliers.

  5. Coronary Calcium Scoring and Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus Cuantificación del calcio coronario y riesgo cardiovascular en pacientes con diabetes mellitus tipo 2

    Directory of Open Access Journals (Sweden)

    Elodia M. Rivas Alpízar

    2011-03-01

    Full Text Available Background: Diabetes mellitus is considered as an independent cardiovascular risk factor. Coronary calcium scoring has proved to be a useful tool for stratifying cardiovascular risk. Objective: To quantify coronary calcium in patients with diabetes mellitus type 2 in order to estimate cardiovascular risk. Methods: A descriptive observational study was conducted. The sample included 33 patients with type 2 diabetes mellitus admitted in the Center for Diabetes Care and Education of Cienfuegos from April to July 2009. Variables studied: age, sex, nutritional assessment, illness duration, history of hypertension, hyperlipidemia and smoking. Coronary calcium was determined with multislice helical CT scanner. Results: females were predominant. Most patients were between 41 and 70 years old. More than half were from 2 to 11 years of evolution and had fasting glucose levels higher than 7.0 mmol / L. In 40.0% of diabetic patients three or more risk factors and average and high coronary calcium values were present. Out of the total, 21.7% (5 patients has less than three risk factors and average and high values. Conclusions: Performing coronary calcium quantification can reclassify cardiovascular risk in a high percentage of estimated cases.Fundamento: la diabetes mellitus es considerada como un factor de riesgo cardiovascular independiente. La cuantificación de calcio coronario ha demostrado ser una herramienta útil para estratificar el riesgo cardiovascular. Objetivo: cuantificar el calcio coronario en pacientes con diabetes mellitus tipo 2 para estimar el riesgo cardiovascular. Métodos: estudio descriptivo observacional que incluyó 33 pacientes con diabetes mellitus tipo 2 que ingresaron en el Centro de Atención al Diabético de Cienfuegos de abril a julio del 2009. Variables estudiadas: edad, sexo, evaluaci

  6. Impact of hybrid iterative reconstruction on Agatston coronary artery calcium scores in comparison to filtered back projection in native cardiac CT; Einfluss der hybriden iterativen Rekonstruktion bei der nativen CT des Herzens auf die Agatston-Kalziumscores der Koronararterien

    Energy Technology Data Exchange (ETDEWEB)

    Obmann, V.C.; Heverhagen, J.T. [Inselspital - University Hospital Bern (Switzerland). University Inst. for Diagnostic, Interventional and Pediatric Radiology; Klink, T. [Wuerzburg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology; Stork, A.; Begemann, P.G.C. [Roentgeninstitut Duesseldorf, Duesseldorf (Germany); Laqmani, A.; Adam, G. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Diagnostic and Interventional Radiology

    2015-05-15

    To investigate whether the effects of hybrid iterative reconstruction (HIR) on coronary artery calcium (CAC) measurements using the Agatston score lead to changes in assignment of patients to cardiovascular risk groups compared to filtered back projection (FBP). 68 patients (mean age 61.5 years; 48 male; 20 female) underwent prospectively ECG-gated, non-enhanced, cardiac 256-MSCT for coronary calcium scoring. Scanning parameters were as follows: Tube voltage, 120 kV; Mean tube current time-product 63.67 mAs (50 - 150 mAs); collimation, 2 x 128 x 0.625 mm. Images were reconstructed with FBP and with HIR at all levels (L1 to L7). Two independent readers measured Agatston scores of all reconstructions and assigned patients to cardiovascular risk groups. Scores of HIR and FBP reconstructions were correlated (Spearman). Interobserver agreement and variability was assessed with k-statistics and Bland-Altmann-Plots. Agatston scores of HIR reconstructions were closely correlated with FBP reconstructions (L1, R = 0.9996; L2, R = 0.9995; L3, R = 0.9991; L4, R = 0.986; L5, R = 0.9986; L6, R = 0.9987; and L7, R = 0.9986). In comparison to FBP, HIR led to reduced Agatston scores between 97% (L1) and 87.4% (L7) of the FBP values. Using HIR iterations L1-L3, all patients were assigned to identical risk groups as after FPB reconstruction. In 5.4% of patients the risk group after HIR with the maximum iteration level was different from the group after FBP reconstruction. There was an excellent correlation of Agatston scores after HIR and FBP with identical risk group assignment at levels 1 - 3 for all patients. Hence it appears that the application of HIR in routine calcium scoring does not entail any disadvantages. Thus, future studies are needed to demonstrate whether HIR is a reliable method for reducing radiation dose in coronary calcium scoring.

  7. Body mass index and risk for mental stress induced ischemia in coronary artery disease.

    Science.gov (United States)

    Soufer, Robert; Fernandez, Antonio B; Meadows, Judith; Collins, Dorothea; Burg, Matthew M

    2016-05-19

    Acute emotionally reactive mental stress (MS) can provoke prognostically relevant deficits in cardiac function and myocardial perfusion, and chronic inflammation increases risk for this ischemic phenomenon. We have described parasympathetic withdrawal and generation of inflammatory factors in MS. Adiposity is also associated with elevated markers of chronic inflammation. High body mass index (BMI) is frequently used as a surrogate for assessment of excess adiposity, and associated with traditional CAD risk factors, and CAD mortality. BMI is also associated with autonomic dysregulation, adipose tissue derived proinflammatory cytokines, which are also attendant to emotion provoked myocardial ischemia. Thus, we sought to determine if body mass index (BMI) contributes to risk of developing myocardial ischemia provoked by mental stress. We performed a prospective interventional study in a cohort of 161 patients with stable CAD. They completed an assessment of myocardial blood flow with single photon emission computed tomography (SPECT) simultaneously during 2 conditions: laboratory mental stress and at rest. Multivariate logistic regression determined the independent contribution of BMI to the occurrence of mental-stress induced ischemia. Mean age was 65.6±9.0 years; 87.0% had a history of hypertension, and 28.6% had diabetes. Mean BMI was 30.4±4.7. Prevalence of mental stress ischemia was 39.8%. BMI was an independent predictor of mental stress ischemia, OR=1.10, 95% CI [1.01-1.18] for one-point increase in BMI and OR=1.53, 95% CI [1.06-2.21] for a 4.7 point increase in BMI (one standard deviation beyond the cohort BMI mean), p=0.025 for all. These data suggest that BMI may serve as an independent risk marker for mental stress ischemia. The factors attendant with greater BMI, which include autonomic dysregulation and inflammation, may represent pathways by which high BMI contribute to this risk and serve as a conceptual construct to replicate these findings in larger

  8. In situ Gelation of Monodisperse Alginate Hydrogel in Microfluidic Channel Based on Mass Transfer of Calcium Ions

    Energy Technology Data Exchange (ETDEWEB)

    Song, YoungShin; Lee, Chang-Soo [Chungnam National University, Daejeon (Korea, Republic of)

    2014-10-15

    A microfluidic method for the in situ production of monodispersed alginate hydrogels using biocompatible polymer gelation by crosslinker mass transfer is described. Gelation of the hydrogel was achieved in situ by the dispersed calcium ion in the microfluidic device. The capillary number (Ca) and the flow rate of the disperse phase which are important operating parameters mainly influenced the formation of three distinctive flow regions, such as dripping, jetting, and unstable dripping. Under the formation of dripping region, monodispersed alginate hydrogels having a narrow size distribution (C.V=2.71%) were produced in the microfluidic device and the size of the hydrogels, ranging from 30 to 60 µm, could be easily controlled by varying the flow rate, viscosity, and interfacial tension. This simple microfluidic method for the production of monodisperse alginate hydrogels shows strong potential for use in delivery systems of foods, cosmetics, inks, and drugs, and spherical alginate hydrogels which have biocompatibility will be applied to cell transplantation.

  9. Assessment of left ventricular function and mass in dual-source computed tomography coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, Christoph J., E-mail: c.jensen@contilia.d [Department of Cardiology and Angiology, Elisabeth Hospital, Essen (Germany); Jochims, Markus [Department of Cardiology and Angiology, Elisabeth Hospital, Essen (Germany); Hunold, Peter; Forsting, Michael; Barkhausen, Joerg [Department of Diagnostic and Interventional Radiology and Neuroradiology, University of Essen (Germany); Sabin, Georg V.; Bruder, Oliver [Department of Cardiology and Angiology, Elisabeth Hospital, Essen (Germany); Schlosser, Thomas [Department of Diagnostic and Interventional Radiology and Neuroradiology, University of Essen (Germany)

    2010-06-15

    Purpose: To quantify left ventricular (LV) function and mass (LVM) derived from dual-source computed tomography (DSCT) and the influence of beta-blocker administration compared to cardiac magnetic resonance imaging (CMR). Methods: Thirty-two patients undergoing cardiac DSCT and CMR were included, where of fifteen received metoprolol intravenously before DSCT. LV parameters were calculated by the disc-summation method (DSM) and by a segmented region-growing algorithm (RGA). All data sets were analyzed by two blinded observers. Interobserver agreement was tested by the intraclass correlation coefficient. Results.: 1. Using DSM LV parameters were not statistically different between DSCT and CMR in all patients (DSCT vs. CMR: EF 63 {+-} 8% vs. 64 {+-} 8%, p = 0.47; EDV 136 {+-} 36 ml vs. 138 {+-} 35 ml, p = 0.66; ESV 52 {+-} 21 ml vs. 52 {+-} 22 ml, p = 0.61; SV 83 {+-} 22 ml vs. 87 {+-} 19 ml, p = 0.22; CO 5.4 {+-} 0.9 l/min vs. 5.7 {+-} 1.2 l/min, p = 0.09, LVM 132 {+-} 33 g vs. 132 {+-} 33 g, p = 0.99). 2. In a subgroup of 15 patients beta-blockade prior to DSCT resulted in a lower ejection fraction (EF), stroke volume (SV), cardiac output (CO) and increase in end systolic volume (ESV) in DSCT (EF 59 {+-} 8% vs. 62 {+-} 9%; SV 73 {+-} 17 ml vs. 81 {+-} 15 ml; CO 5.7 {+-} 1.2 l/min vs. 5.0 {+-} 0.8 l/min; ESV 52 {+-} 27 ml vs. 57 {+-} 24 ml, all p < 0.05). 3. Analyzing the RGA parameters LV volumes were not significantly different compared to DSM, whereas LVM was higher using RGA (177 {+-} 31 g vs. 132 {+-} 33 g, p < 0.05). Interobserver agreement was excellent comparing DSM values with best agreement between RGA calculations. Conclusion: Left ventricular volumes and mass can reliably be assessed by DSCT compared to CMR. However, beta-blocker administration leads to statistically significant reduced EF, SV and CO, whereas ESV significantly increases. DSCT RGA reliably analyzes LV function, whereas LVM is overestimated compared to DSM.

  10. 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.

  11. Reduced dental calcium expression and dental mass in chronic sleep deprived rats: Combined EDS, TOF-SIMS, and micro-CT analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kuo, Yi-Jie [Department of Orthopedics, Taipei Medical University Hospital, Taipei 110, Taiwan (China); Huang, Yung-Kai [School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan (China); Chou, Hsiu-Chu; Pai, Man-Hui; Lee, Ai-Wei [Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan (China); Mai, Fu-Der [Department of Biochemistry and Molecular Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan (China); Chang, Hung-Ming, E-mail: taiwanzoo@gmail.com [Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan (China)

    2015-08-01

    Highlights: • The growth of teeth is closely regulated by the circadian rhythmicity. • Sleep deprivation significantly disrupts the circadian regulation. • Sleep deprivation reduces the dental calcium level and impairs dental intensity. • This study highlights for the first time that sleep is essential for dental structure. • Establishing satisfactory sleep behavior may be a helpful strategy to prevent dental disability. - Abstract: Teeth are the hardest tissue in the body. The growth of teeth is closely regulated by circadian rhythmicity. Considering that sleep deprivation (SD) is a severe condition that disrupts normal circadian rhythmicity, this study was conducted to determine whether calcium expression (the major element participating in teeth constitution), and dental mass would be significantly impaired following SD. Adolescent rats subjected to 3 weeks of SD were processed for energy dispersive spectrum (EDS), time-of-flight secondary ion mass spectrometry (TOF-SIMS), and micro-computed tomography (micro-CT) analyses. The EDS and TOF-SIMS results indicated that high calcium intensity was detected in both the upper and lower incisors of untreated rats. Micro-CT analysis corresponded closely with spectral data in which an enhanced dental mass was calculated in intact animals. However, following SD, both calcium expression and the dental mass were remarkably decreased to nearly half those of the untreated values. Because SD plays a detrimental role in impairing dental structure, establishing satisfactory sleep behavior would therefore serve as a crucial strategy for preventing or improving prevalent dental dysfunctions.

  12. Breakfast consumption by African-American and white adolescent girls correlates positively with calcium and fiber intake and negatively with body mass index

    NARCIS (Netherlands)

    Affenito, SG; Thompson, DR; Barton, BA; Franko, DL; Daniels, [No Value; Obarzanek, E; Schreiber, GB; Striegel-Moore, RH

    2005-01-01

    Objective To describe age- and race-related differences in breakfast consumption and to examine the association of breakfast intake with dietary calcium and fiber and body mass index (BMI). Design Data from the National Heart, Lung, and Blood Institute Growth and Health Study, a 9-year, longitudinal

  13. Breakfast consumption by African-American and white adolescent girls correlates positively with calcium and fiber intake and negatively with body mass index

    NARCIS (Netherlands)

    Affenito, SG; Thompson, DR; Barton, BA; Franko, DL; Daniels, [No Value; Obarzanek, E; Schreiber, GB; Striegel-Moore, RH

    Objective To describe age- and race-related differences in breakfast consumption and to examine the association of breakfast intake with dietary calcium and fiber and body mass index (BMI). Design Data from the National Heart, Lung, and Blood Institute Growth and Health Study, a 9-year, longitudinal

  14. Optimal Body Mass Index Cut-offs for Identification of Patients with Coronary Artery Disease at High Risk of Obstructive Sleep Apnoea.

    Science.gov (United States)

    Chan, Po-Fun; Tai, Bee-Choo; Loo, Germaine; Koo, Chieh-Yang; Ong, Thun-How; Yeo, Tiong-Cheng; Lee, Chi-Hang

    2016-08-01

    We sought to evaluate the relationship between Body Mass Index (BMI) and obstructive sleep apnoea (OSA) in Chinese patients hospitalised with coronary artery disease, and to determine the optimal BMI cut-off for prediction of OSA. Consecutive Chinese patients who were hospitalised with symptomatic coronary artery disease were recruited to undergo an in-hospital sleep study. A total of 587 patients were recruited. Using cut-off for Asians, 81.2% of the cohort was overweight (BMI ≥23kg/m(2)) and 31.6% was obese (≥27kg/m(2)). A total of 59.5% was diagnosed with OSA, defined as apnoea-hypopnoea index ≥15. Body mass index, hypertension and smoking were predictors of OSA. Multiple logistic regression analysis showed that BMI remains an independent predictor of OSA (odds ratio: 1.11 [95% confidence interval: 1.06 to 1.17], poptimal BMI cut-offs to screen for OSA were 27.3kg/m(2), 23.0-23.9kg/m(2), and 20kg/m(2) for patients with neither, either, or both predictors (smoking and hypertension) respectively. The area under the curve for the adjusted and unadjusted models were similar (0.6013 vs 0.6262, p=0.118). Body mass index represents a convenient and readily available tool for bedside identification of patients at high risk of OSA. Body mass index cut-offs to predict risks of OSA in Chinese patients with symptomatic coronary artery disease are defined in this study. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  15. The Study of Thermal Decomposition of Natural Calcium Carbonate by the Temperature-programmed Mass Spectrometry Technique

    Directory of Open Access Journals (Sweden)

    S.N. Danilchenko

    2016-11-01

    Full Text Available The experiments have shown that the heating range for quantitative evolution of carbon dioxide gas (CO2 from natural calcium carbonates (e.g., chalk, corals, shells of the Anadara clams (Anadara inaequivalvis, shell of bird eggs is from 500 to 850 C with a total heating time of 30-50 minutes. The only exception is the sample of a mortar from a masonry of Saint Sophia Cathedral (the architectural monument of XI century, in which the lowest border of the heating range for carbon dioxide evolution is 400 C. The shape of the CO2 evolution curves for every sample is significantly different in width and intensity as compared to the standard sample (chemically pure synthetic CaCO3. The results, which were obtained on the thermoprogrammed mass-spectrometry (TP‑MS unit, designed and produced by the authors of the current paper, are of great importance for the development of a gas input technique for radiocarbon dating with accelerator mass-spectrometry.

  16. Upregulation of SK3 and IK1 channels contributes to the enhanced endothelial calcium signaling and the preserved coronary relaxation in obese Zucker rats.

    Directory of Open Access Journals (Sweden)

    Belén Climent

    Full Text Available BACKGROUND AND AIMS: Endothelial small- and intermediate-conductance KCa channels, SK3 and IK1, are key mediators in the endothelium-derived hyperpolarization and relaxation of vascular smooth muscle and also in the modulation of endothelial Ca2+ signaling and nitric oxide (NO release. Obesity is associated with endothelial dysfunction and impaired relaxation, although how obesity influences endothelial SK3/IK1 function is unclear. Therefore we assessed whether the role of these channels in the coronary circulation is altered in obese animals. METHODS AND RESULTS: In coronary arteries mounted in microvascular myographs, selective blockade of SK3/IK1 channels unmasked an increased contribution of these channels to the ACh- and to the exogenous NO- induced relaxations in arteries of Obese Zucker Rats (OZR compared to Lean Zucker Rats (LZR. Relaxant responses induced by the SK3/IK1 channel activator NS309 were enhanced in OZR and NO- endothelium-dependent in LZR, whereas an additional endothelium-independent relaxant component was found in OZR. Fura2-AM fluorescence revealed a larger ACh-induced intracellular Ca2+ mobilization in the endothelium of coronary arteries from OZR, which was inhibited by blockade of SK3/IK1 channels in both LZR and OZR. Western blot analysis showed an increased expression of SK3/IK1 channels in coronary arteries of OZR and immunohistochemistry suggested that it takes place predominantly in the endothelial layer. CONCLUSIONS: Obesity may induce activation of adaptive vascular mechanisms to preserve the dilator function in coronary arteries. Increased function and expression of SK3/IK1 channels by influencing endothelial Ca2+ dynamics might contribute to the unaltered endothelium-dependent coronary relaxation in the early stages of obesity.

  17. Investigation of potassium sulphate–calcium sulphate binary system by Knudsen effusion mass spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Armatys, Kamila, E-mail: k.armatys@fz-juelich.de [Institute of Non Metallic Materials, Clausthal University of Technology, Clausthal-Zellerfeld 38678 (Germany); Bencze, Laszlo [Department of Physical Chemistry, EötvösLoránd University, Budapest H-1117, PázmányPéter sétány 1/A (Hungary); Miller, Miroslaw [International Laboratory of High Magnetic Felds and Low Temperatures, Gajowicka 95, 53-421 Wrocław (Poland); Wolter, Albrecht [Institute of Non Metallic Materials, Clausthal University of Technology, Clausthal-Zellerfeld 38678 (Germany)

    2014-01-10

    Highlights: • Thermodynamic activities of the system K{sub 2}SO{sub 4}–CaSO{sub 4} determined for the first time. • New approach of ion division in Knudsen effusion mass spectrometry. • The confirmation of the vaporisation of pure sulphates with the previous literature data. - Abstract: Vaporisation studies of pure K{sub 2}SO{sub 4} and mixtures of K{sub 2}SO{sub 4} and CaSO{sub 4} in the quasi-binary K{sub 2}SO{sub 4}–CaSO{sub 4} system using Knudsen effusion mass spectrometry resulted in the determination of thermodynamic data. From the partial pressures of the gaseous species over the condensed phases it was possible to determine the sublimation enthalpyΔ{sub sub}H and the thermodynamic activities of the components. The sublimation enthalpy of K{sub 2}SO{sub 4} agrees very well with that of two literature sources. For the first time the experimental data of activities of K{sub 2}SO{sub 4} and CaSO{sub 4} in the binary system could confirm the theoretical studies.

  18. Birth weight, childhood body mass index and risk of coronary heart disease in adults: combined historical cohort studies.

    Directory of Open Access Journals (Sweden)

    Lise Geisler Andersen

    Full Text Available BACKGROUND: Low birth weight and high childhood body mass index (BMI is each associated with an increased risk of coronary heart disease (CHD in adult life. We studied individual and combined associations of birth weight and childhood BMI with the risk of CHD in adulthood. METHODS/PRINCIPAL FINDINGS: Birth weight and BMI at age seven years were available in 216,771 Danish and Finnish individuals born 1924-1976. Linkage to national registers for hospitalization and causes of death identified 8,805 CHD events during up to 33 years of follow-up (median = 24 years after age 25 years. Analyses were conducted with Cox regression based on restricted cubic splines. Using median birth weight of 3.4 kg as reference, a non-linear relation between birth weight and CHD was found. It was not significantly different between cohorts, or between men and women, nor was the association altered by childhood BMI. For birth weights below 3.4 kg, the risk of CHD increased linearly and reached 1.28 (95% confidence limits: 1.13 to 1.44 at 2 kg. Above 3.4 kg the association weakened, and from about 4 kg there was virtually no association. BMI at age seven years was strongly positively associated with the risk of CHD and the relation was not altered by birth weight. The excess risk in individuals with a birth weight of 2.5 kg and a BMI of 17.7 kg/m(2 at age seven years was 44% (95% CI: 30% to 59% compared with individuals with median values of birth weight (3.4 kg and BMI (15.3 kg/m(2. CONCLUSIONS/SIGNIFICANCE: Birth weight and BMI at age seven years appeared independently associated with the risk of CHD in adulthood. From a public health perspective we suggest that particular attention should be paid to children with a birth weight below the average in combination with excess relative weight in childhood.

  19. Impact of Body Mass Index on the Clinical Outcomes after Percutaneous Coronary Intervention in Patients ≥75 Years Old

    Institute of Scientific and Technical Information of China (English)

    Pei-Yuan He; Yue-Jin Yang; Shu-Bin Qiao; Bo Xu; Min Yao; Yong-Jian Wu; Yuan Wu

    2015-01-01

    Background:The impact of body mass index (BMI) on the clinical outcomes after percutaneous coronary intervention (PCI) in patients ≥75 years old remained unclear.Methods:A total of 1098 elderly patients undergoing PCI with stent implantation were recruited.Patients were divided into four groups by the value of BMI:Underweight (<20.0 kg/m2),normal weight (20.0-24.9 kg/m2),overweight (25.0-29.9 kg/m2) and obese (≥30.0 kg/m2).Major clinical outcomes after PCI were compared between the groups.The primary endpoint was defined as in-hospital major adverse cardiovascular events (MACEs),which included death,myocardial infarction (MI) and target vessel revascularization.The secondary endpoint was defined as 1 year death.Logistic regression analysis was performed to adjust for the potential confounders.Results:Totally,1077 elderly patients with available BMIs were included in the analysis.Patients of underweight,normal weight,overweight and obese accounted for 5.6%,45.4%,41.5% and 7.5% of the population,respectively.Underweight patients were more likely to attract ST-segment elevation MI,and get accompanied with anemia or renal dysfunction.Meanwhile,they were less likely to achieve thrombolysis in MI 3 grade flow after PCI,and receive beta-blocker,angiotensin converting enzyme inhibitor or angiotensin receptor blocker after discharge.In underweight,normal weight,overweight and obese patients,in-hospital MACE were 1.7%,2.7%,3.8%,and 3.7% respectively (P =0.68),and 1 year mortality rates were 5.0%,3.9%,5.1% and 3.7% (P =0.80),without significant difference between the groups.Multivariate regression analysis showed that the value of BMI was not associated with in-hospital MACE in patients at 75 years old.Conclusions:The BMI "obese paradox" was not found in patients ≥75 years old.It was suggested that BMI may not be a sensitive predictor of adverse cardiovascular events in elderly patients.

  20. The Effect of Calcitonin Gene-Related Peptide (CGRP on the Cytosolic Calcium Concentration and Force in Rat Intramural Coronary Arteries

    Directory of Open Access Journals (Sweden)

    M. Sheykhzade

    2001-01-01

    Full Text Available The aim of this study was to investigate the mechanism of CGRP-induced relaxation in intramural rat coronary arteries. By using FURA-2 technique, cytosolic Ca2+-concentration ([Ca2+]i was measured during contraction of the vascular smooth muscle with receptor-dependent agonist (tromboxane A2 analogue U46619 and with high concentration of extracellular potassium. At a steady state of contraction, the increase in [Ca2+]i induced by 300 nM U46619 (100״x 14 nM, n = 7 was similar to that induced by 36 mM K+ (98 ״x 9 nM, n = 7. However, the active tension induced by 300 nM U46619 was significantly (p < 0.01 higher than that induced by 36 mM K+. CGRP concentration-dependently (10 pM - 10 nM reduced both the [Ca2+]i and tension of coronary arteries precontracted with either U46619 or BAY K 8644, and also of resting coronary arteries in PSS. In 36 mM K+-depolarized arteries, CGRP reduced only the tension without affecting the [Ca2+]i. In 300 nM U46619 precontracted arteries, pretreatment with 10 μM thapsigargin significantly (p < 0.05 attenuated the CGRP-induced reduction in the tension (but not [Ca2+]i. In 300 nM U46619 precontracted arteries, pretreatment with either 100 nM charybdotoxin or 100 nM iberiotoxin or 10 nM felodipine significantly (p < 0.05 attenuated the CGRP-induced reduction in both [Ca2+]i and the tension. In contrast, 1 μM glibenclamide did not affect the CGRP-induced responses in these coronary arteries. In resting coronary arteries, only pretreatment with the combination of 1 μM glibenclamide and 100 nM charybdotoxin attenuated the CGRP-induced decrease in the [Ca2+]i and tension, suggesting a different mechanism of action for CGRP in resting coronary arteries. We conclude that CGRP relaxes precontracted rat coronary arteries via three mechanisms: (1 a decrease in [Ca2+]i by inhibiting the Ca2+ influx through membrane hyperpolarization mediated partly by activation of BKCa channels, (2 a decrease in [Ca2+]i presumably by

  1. Association of cholesteryl ester transfer protein genotypes with CETP mass and activity, lipid levels, and coronary risk

    NARCIS (Netherlands)

    Thompson, Alexander; Di Angelantonio, Emanuele; Sarwar, Nadeem; Erqou, Sebhat; Saleheen, Danish; Dullaart, Robin P. F.; Keavney, Bernard; Ye, Zheng; Danesh, John

    2008-01-01

    Context The importance of the cholesteryl ester transfer protein (CETP) pathway in coronary disease is uncertain. Study of CETP genotypes can help better understand the relevance of this pathway to lipid metabolism and disease risk. Objective To assess associations of CETP genotypes with CETP

  2. Association of cholesteryl ester transfer protein genotypes with CETP mass and activity, lipid levels, and coronary risk

    NARCIS (Netherlands)

    Thompson, Alexander; Di Angelantonio, Emanuele; Sarwar, Nadeem; Erqou, Sebhat; Saleheen, Danish; Dullaart, Robin P. F.; Keavney, Bernard; Ye, Zheng; Danesh, John

    2008-01-01

    Context The importance of the cholesteryl ester transfer protein (CETP) pathway in coronary disease is uncertain. Study of CETP genotypes can help better understand the relevance of this pathway to lipid metabolism and disease risk. Objective To assess associations of CETP genotypes with CETP phenot

  3. Emergency coronary angioplasty in refractory unstable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); M.J.B.M. van den Brand (Marcel); K. Balakumaran (Kulasekaram); A.L. Soward; P.G. Hugenholtz (Paul); A.E.R. Arnold (Alfred); B. Mochtar (Bas)

    1985-01-01

    textabstractWe performed percutaneous transluminal coronary angioplasty as an emergency procedure in 60 patients with unstable angina pectoris that was refractory to treatment with maximally tolerated doses of beta-blockers, calcium antagonists, and intravenous nitroglycerin. The initial success

  4. Reduced dental calcium expression and dental mass in chronic sleep deprived rats: Combined EDS, TOF-SIMS, and micro-CT analysis

    Science.gov (United States)

    Kuo, Yi-Jie; Huang, Yung-Kai; Chou, Hsiu-Chu; Pai, Man-Hui; Lee, Ai-Wei; Mai, Fu-Der; Chang, Hung-Ming

    2015-08-01

    Teeth are the hardest tissue in the body. The growth of teeth is closely regulated by circadian rhythmicity. Considering that sleep deprivation (SD) is a severe condition that disrupts normal circadian rhythmicity, this study was conducted to determine whether calcium expression (the major element participating in teeth constitution), and dental mass would be significantly impaired following SD. Adolescent rats subjected to 3 weeks of SD were processed for energy dispersive spectrum (EDS), time-of-flight secondary ion mass spectrometry (TOF-SIMS), and micro-computed tomography (micro-CT) analyses. The EDS and TOF-SIMS results indicated that high calcium intensity was detected in both the upper and lower incisors of untreated rats. Micro-CT analysis corresponded closely with spectral data in which an enhanced dental mass was calculated in intact animals. However, following SD, both calcium expression and the dental mass were remarkably decreased to nearly half those of the untreated values. Because SD plays a detrimental role in impairing dental structure, establishing satisfactory sleep behavior would therefore serve as a crucial strategy for preventing or improving prevalent dental dysfunctions.

  5. Correlation between coronary artery disease severity, left ventricular mass index and carotid intima media thickness, assessed by radio-frequency

    Directory of Open Access Journals (Sweden)

    Ciccone Marco M

    2011-11-01

    Full Text Available Abstract Background Intima-media thickness of the common carotid artery (CCA-IMT is a validated marker of systemic atherosclerosis process. The aim of this study was to evaluate the association between coronary artery disease (CAD, left ventricular hypertrophy (LVH and CCA-IMT, assessed by Radio Frequency-Quality Intima Media Thickness (RFQIMT method, the next generation of IMT real-time measurement, based on the direct analysis of the radiofrequency signal and endowed with high accuracy and reproducibility in early detection of arterial wall thickness. Methods 115 patients (76 men, mean age: 65.1 ± 12 years referred to our department and shown significant (≥ 70% luminal obstruction stenosis at least in one major epicardial coronary artery were studied. Coronary angiograms were divided for severity and extent of the disease: 79 patients (69% had one, 24 patients (21% two, 12 patients (10% three major epicardial coronary arteries with ≥ 70% stenosis. All patients underwent echocardiography and carotid ultrasound examination, assessed by RF. Results Dividing RFQIMT data in tertiles, dyslipidaemia (31 patients with IMT ≥ 1.20 mm vs 16 with IMT = 0.91-1.19 vs 25 with IMT ≤ 0.9, p = 0.004, LVMI (153.5 ± 20.6 g/m2 in IMT ≥ 1.20 mm vs 131.2 ± 8.4 g/m2 in IMT = 0.91-1.19 mm vs 114.3 ± 11.1 g/m2 in IMT ≤ 0.9 mm, P 2 = 0.88, RFQIMT remained significantly associated with the dyslipidemia (regression coefficient ± standard error [SE]: 0.057 ± 0.023; p = 0.017, LVMI (regression coefficient ± SE: 0.01 ± 0.001; P Conclusions RFQIMT is a sophisticated method for carotid ultrasound evaluation. Its evaluation in patients with at least one important major epicardial coronary vessel stenosis would help the accuracy in the general assessment of the number of coronary lesions in these patients.

  6. 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.

  7. Coronary microembolization.

    Science.gov (United States)

    Skyschally, Andreas; Leineweber, Kkirsten; Gres, Petra; Haude, Michael; Erbel, Raimund; Heusch, Gerd

    2006-09-01

    Atherosclerotic plaque rupture is the key event in the pathogenesis of acute coronary syndromes and it also occurs during coronary interventions. Atherosclerotic plaque rupture does not always result in complete thrombotic occlusion of the epicardial coronary artery with subsequent impending myocardial infarction, but may in milder forms result in the embolization of atherosclerotic and thrombotic debris into the coronary microcirculation. This review summarizes the present experimental pathophysiology of coronary microembolization in animal models of acute coronary syndromes and highlights the main consequences of coronary microembolization--reduced coronary reserve, microinfarction, inflammation and oxidative modification of contractile proteins, contractile dysfunction and perfusion-contraction mismatch.Furthermore, the review presents the available clinical evidence for coronary microembolization in patients and compares the clinical observations with observations in the experimental model.

  8. Evaluation of the influence of acquisition and reconstruction parameters for 16-row multidetector CT on coronary calcium scoring using a stationary and dynamic cardiac phantom

    Energy Technology Data Exchange (ETDEWEB)

    Begemann, Philipp G.C.; Koops, Andreas; Adam, Gerhard; Nolte-Ernsting, Claus [University Medical Center Hamburg-Eppendorf, Center of Diagnostic Imaging and Intervention, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Stevendaal, Udo van; Grass, Michael [Philips Research Laboratories Hamburg, Hamburg (Germany); Koester, Ralph [University Medical Center Hamburg-Eppendorf, Center of Cardiology and Cardiovascular Surgery, Department of Cardiology/Angiology, Hamburg (Germany); Mahnken, Andreas H. [University of Technology Aachen, University Hospital, Department of Diagnostic Radiology, Aachen (Germany)

    2007-08-15

    A calcium-scoring phantom with hydroxyapatite-filled cylindrical holes (0.5 to 4 mm) was used. High-resolution scans were performed for an accuracy baseline. The phantom was mounted to a moving heart phantom. Non-moving data with the implementation of an ECG-signal were acquired for different pitches (0.2/0.3), heart rates (60/80/95 bpm) and collimations (16 x 0.75/16 x 1.5 mm). Images were reconstructed with a cone-beam multi-cycle algorithm at a standard thickness/increment of 3 mm/1.5 mm and the thinnest possible thickness (0.8/0.4 and 2/1). Subsequently, ECG-gated moving calcium-scoring phantom data were acquired. The calcium volume and Agatston score were measured. The temporal resolution and reconstruction cycles were calculated. High-resolution scans determine the calcium volume with a high accuracy (mean overestimation, 0.8%). In the non-moving measurements, the volume underestimation ranged from about 6% (16 x 0.75 mm; 0.8/0.4 mm) to nearly 25% (16 x 1.5 mm; 3/1.5 mm). Moving scans showed increased measurement errors depending on the reconstructed RR interval, collimation, pitch, heart rate and gantry rotation time. Also, a correlation with the temporal resolution could be found. The reliability of calcium-scoring results can be improved with the use of a narrower collimation, a lower pitch and the reconstruction of thinner images, resulting in higher patient doses. The choice of the correct cardiac phase within the RR interval is essential to minimize measurement errors. (orig.)

  9. The Impact of Different Amounts of Calcium Intake on Bone Mass and Arterial Calcification in Ovariectomized Rats.

    Science.gov (United States)

    Agata, Umon; Park, Jong-Hoon; Hattori, Satoshi; Aikawa, Yuki; Kakutani, Yuya; Ezawa, Ikuko; Akimoto, Takayuki; Omi, Naomi

    2015-01-01

    Reduced estrogen secretion and low calcium (Ca) intake are risk factors for bone loss and arterial calcification in female rodents. To evaluate the effects of Ca intake at different amounts on bone mass changes and arterial calcification, 8-wk-old female Wistar rats were randomly placed in ovariectomized (OVX) control and OVX with vitamin D3 plus nicotine (VDN) treatment groups. The OVX with VDN rats were then divided into six groups to receive different amounts of Ca in their diets: 0.01%, 0.1%, 0.3%, 0.6%, 1.2%, or 2.4% Ca. After 8 wk of administration, low Ca intake groups with 0.01% and 0.1% Ca diets had significantly reduced bone mineral density (BMD) and bone mechanical properties as compared with those of the other groups, whereas high Ca intake groups with 1.2% and 2.4% Ca diets showed no differences as compared with the 0.6% Ca intake group. For both the 0.01% and 2.4% Ca intake groups, Ca levels in their thoracic arteries were significantly higher as compared with those of the 0.6% Ca diet group, and that was highly correlated with serum PTH levels. An increase in relative BMP-2 mRNA expression in the arterial tissues of the 0.01% and 2.4% Ca diet groups was also observed. These results suggested that extremely low Ca intake during periods of estrogen deficiency may be a possible risk for the complications of reduced BMD and arterial calcification and that extremely high Ca intake may promote arterial calcification with no changes in BMD.

  10. Impact of intravascular enhancement, heart rate, and calcium score on diagnostic accuracy in multislice Computed Tomography coronary angiography; Influenza di attenuazione vascolare, frequenza cardiaca e calcium score sull'accuratezza diagnostica in angiografia coronarica non invasiva mediante Tomografia Computerizzata multistrato

    Energy Technology Data Exchange (ETDEWEB)

    Cademartiri, Filippo; Mollet, Nico R.; Kriestin, Gabriel P. [Erasmus Medical Center, Rotterdam (Netherlands). Dipartimento di radiologia; Runza, Giuseppe; Bartolotta, Tommaso Vincenzo; Galia, Massimo; Midiri, Massimo [Palermo Univ., Palermo (Italy). DIBIMEL, Sezione di scienze radiologiche; Belgrano, Manuel; Pozzi Mucelli, Roberto [Trieste Univ., Trieste (Italy). Ospedale di Cattinara, Istituto di radiologia

    2005-07-15

    Purpose. To assess the effect of intravascular enhancement, heart rate, and calcium score on diagnostic accuracy in the detection of significant coronary artery stenosis using 16-row multislice computed tomography (MSCT). Materials and methods. One hundred patients (88 males; 59{+-}11 years) with suspected coronary artery disease who had undergone conventional coronary angiography (CA) and MSCT-CA were retrospectively enrolled for the study. Patients underwent a MSCT-CA, with the following protocol: collimation 16x0.75 mm, gantry rotation time 420 ms, feed/rotation 2.8 mm, kV 120, mAs 400-500. The protocol for contrast material administration was 100 ml of Iodixanol 320 mgI/nl at 4 ml/s and the scan delay was defined with a bolus tracking technique. In all patients vascular enhancement was measured in the aortic root, and the left and the right coronary arteries. The average enhancement was used to divide the population in two groups of 50 patients each, one with lower enhancement (Low), and one with higher enhancement (High). In the two groups diagnostic accuracy (per coronary segment) for the detection of significant stenosis ({>=}50% lumen reduction) was evaluated in vessels {>=}2mm in diameter using quantitative CA as the reference standard. The differences in diagnostic accuracy were compared with a Chi-square test and a p<0.05 was considered significant. Results. Of the total 1116 segments ({>=}2 mm lumen diameter), 173 presented significant stenosis. The sensitivity and specificity for the assessment of significant stenosis were 89.4% and 93.3% vs 94.3% and 97.4% in the presence of increasing intravascular enhancement, 92.8% and 96.7% vs 91.1% and 93.9% in the presence of increasing heart rate, and 89.7% and 97.6% vs 93.3% and 92.8% in the presence of increasing calcium score. Conclusions. Increasing intravascular enhancement significantly improves diagnostic accuracy in MSCT-CA. A higher heart rate lowers the specificity in the detection of significant

  11. Controversies about effects of low-kilovoltage MDCT acquisition on Agatston calcium scoring.

    Science.gov (United States)

    Deprez, Fabrice C; Vlassenbroek, Alain; Ghaye, Benoît; Raaijmakers, Rolf; Coche, Emmanuel

    2013-01-01

    Recent articles have advocated the possibility of obtaining Agatston coronary calcium scoring at 100 kVp by using a single adapted elevated calcium threshold. To evaluate the influence of kilovoltage potential protocols on the Agatston score, we acquired successive scans of a calcium scoring phantom at 4 levels of kilovoltage potential (80, 100, 120, and 140 kVp, 55 mAs) and measured semiautomatically the individual and the total Agatston score of 6 inserts (of 5-mm and 3-mm diameter) containing hydroxyapatite at different concentrations (800, 400, 200 mg/cm(3)). Our results showed that Agatston scores obtained at various low-kilovoltage potential protocols can be highly overestimated in some particular cases. At 80 kVp, for example, mean measured Agatston score was multiplied by a factor from 1.06 (5-mm highest density insert) to 2.67 (3-mm lowest density insert) compared with the Agatston scores performed at 120 kVp. Indeed in the one hand, reducing kilovoltage potential in multidetector CT acquisitions increase the CT density of coronary calcifications that can be measured on the reconstructed images. On the other hand, Agatston score is a multi-threshold measurement (with a step weighting function). Consequently low kilovoltage potential can lead to overweight some calcifications scores. For these reasons, Agatston score with low kilovoltage potential acquisition cannot be reliably adapted by a unique recalibration of the standard calcium attenuation threshold of 130 HU and requires a standardized CT acquisition protocol at 120 kVp. Alternatives to performing low-dose coronary artery calcium scans are either using coronary calcium scans with reduced tube current (low mAs) at 120 kVp with the iterative reconstructions or using mass/volume scoring (not influenced by kilovoltage potential variations). Finally, we emphasized that incorrect Agatston score evaluation may have important clinical, financial, and health care implications.

  12. [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.

  13. Calcium and Calcium Supplements: Achieving the Right Balance

    Science.gov (United States)

    ... bone mass, which is a risk factor for osteoporosis. Many Americans don't get enough calcium in their diets. Children and adolescent girls are at particular risk, but so are adults age 50 and older. How much calcium you ...

  14. Acute coronary hemodynamic effects of equihypotensive doses of nisoldipine and diltiazem

    NARCIS (Netherlands)

    H. Suryapranata (Harry); P.W.J.C. Serruys (Patrick); A.L. Soward; J. Planellas; G. Vanhaleweyk; P.G. Hugenholtz (Paul)

    1985-01-01

    textabstractThe hemodynamic effects of nisoldipine and diltiazem were investigated in two groups of patients undergoing investigation for suspected coronary artery disease. Emphasis was placed on the coronary hemodynamic changes. Approximately equihypotensive doses of these two calcium channel block

  15. Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1.8 million participants

    NARCIS (Netherlands)

    Kromhout, D.; Soedamah-Muthu, S.S.; Groot, de C.P.G.M.; Hollander, de E.L.; Geleijnse, J.M.; Feskens, E.J.M.

    2014-01-01

    Background - Body-mass index (BMI) and diabetes have increased worldwide, whereas global average blood pressure and cholesterol have decreased or remained unchanged in the past three decades. We quantified how much of the effects of BMI on coronary heart disease and stroke are mediated through blood

  16. Relationship between left ventricular mass and coronary artery disease in young adults: a single-center study using cardiac computed tomography.

    Science.gov (United States)

    Cho, Jae Yong; Sun, Joo Sung; Sur, Young Keun; Park, Jin Sun; Kang, Doo Kyoung

    2015-12-01

    We evaluated the relationship between coronary artery disease (CAD) and left ventricular mass (LVM) as measured by cardiac computed tomography (CT) in young adults ≤40 years of age. We retrospectively enrolled 490 consecutive individuals (383 males; mean age, 35.2 ± 4.4 years) who underwent cardiac CT. CAD was defined by the presence of any plaque detected by coronary CT angiography. Left ventricular (LV) function, including LVM, was automatically measured by a dedicated workstation. LVM and LVM index (LVMi) in patients with CT-detected CAD were compared to those of patients without CT-detected CAD. Logistic regression analysis was used to evaluate the relationship between cardiovascular risk factors and CAD. Fifty-five individuals had CT-detected CAD (11.2 %, 53 males). LVM measured by cardiac CT was 126.9 ± 30.0 g for males and 93.6 ± 20.9 g for females. LVM was higher (117.8 ± 30.8 vs. 133.6 ± 33.1 g, P Obesity, hypertension, smoking, hypercholesterolemia, LVM and LVMi were predictors of CT-detected CAD. Body mass index (r = 0.237, P < 0.001) and systolic blood pressure (r = 0.281, P < 0.001) were positively correlated with LVM. In the multivariate analysis, LVM [odds ratio (OR) = 1.016] and LVMi (OR = 1.026) remained independent predictors of CAD. LVM and LVMi in patients with CT-detected CAD were higher than that of patients without CT-detected CAD. LVM and LVMi measured by cardiac CT were independent predictors of CAD.

  17. 钙化积分扫描缩短冠脉CTA扫描范围及降低辐射量的作用%Effect of calcium scoring scan in reducing scan range and radiation dose in retrospectively ECG-gated CT coronary angiography

    Institute of Scientific and Technical Information of China (English)

    付维东; 龚建平; 宦坚; 张伟; 张博; 乔方

    2012-01-01

    Objective:To find out a way of reducing scan range in retrospectively ECG-gated CT coronary angiography in order to reduce the radiation dose. Methods: Forty consecutive patients were analyzed retrospectively. The scan range of CT coronary angiography derived respectively from the scout view and from the axial images of calcium scoring were compared. The former was assumed to be determined from 1cm under the trachea carina to 2cm under the inferior margin of the heart. The latter was performed by identifying the left anterior descending coronary artery and posterior descending coronary artery and adding lcm cranially and caudally. Effective radiation doses were calculated for CT coronary angiography using both scout view-derived and calcium scoring-derived scan range. Results: The calcium scoring-derived range was (10. 40+.0. 60)cm; while the scout view-derived range was (12. 5 ± 0. 94)cm which was significantly larger than that of using the calcium scoring-derived scan (t = 17. 31,P<0. 01). The average difference between them was (2. 09±0. 76)cm, corresponding to a radiation dose reduction of (1. 67 ±0. 72)mSv. After offsetting the dose given for the calcium scoring scan,the savings in radiation exposure when using a calcium scoring-derived instead of a scout view-derived scan range for CT coronary angiography -including the radiation dose of the calcium scoring scan and the test bolus scan- was (1. 25 + 0. 72)mSv (t=10. 92.P<0. 01) ,which accounted for a dose reduction of 9. 20%. Conclusion:Using the images from calcium scoring instead of the scout view to determine the scan range of contrast-unenhanced CT coronary angiography can effectively decrease the scan range and reduce the radiation dose significantly.%目的:探讨使用钙化积分扫描缩短增强扫描范围以降低后门控冠状动脉CTA检查辐射量的临床应用价值.方法:40例患者行冠脉钙化积分及冠脉CTA检查,其增强扫描的实际扫描范围根据钙化积分扫描图

  18. Hormonal Relationships to Bone Mass in Elderly Spanish Men as Influenced by Dietary Calcium and Vitamin D

    Directory of Open Access Journals (Sweden)

    Jose M. Moran

    2013-12-01

    Full Text Available We aim to evaluate whether calcium and vitamin D intake is associated with 25-hydroxyvitamin D (25-OH-Vitamin D3 and parathyroid hormone (PTH serum concentrations or is associated with either the phalangeal dual energy X-ray absorptiometry (pDXA or the quantitative bone ultrasound (QUS in independent elderly men. Serum PTH and 25-OH-Vitamin D3 were measured in 195 healthy elderly men (mean age: 73.31 ± 5.10 year. Food intake was quantified using a dietetic scale. Participants with 25-OH-Vitamin D3 levels ≥ 30 ng/mL (75 nmol/L and a calcium intake of 800–1200 mg/day exhibited the lowest PTH levels (41.49 ± 16.72 ng/mL. The highest PTH levels (75.60 ± 14.16 ng/mL were observed in the <30 ng/mL group 25-OH-Vitamin D3 with a calcium intake >1200 mg/day. No significant differences in the serum PTH levels based on the serum 25-OH-Vitamin D3 levels were observed among participants with a calcium intake of 800–1200 mg/day. Serum PTH was inversely correlated with serum 25-OH-Vitamin D3 in the entire patient sample (r = −0.288, p = 0.019. No differences in any of the three densitometry techniques were observed between any of the age groups in the 800–1200 mg/day and >1200 mg/day calcium intake groups. PTH levels correlate negatively with serum 25-OH-Vitamin D3 levels, and neither calcium nor vitamin D intake exert a strong influence on either of the two parameters.

  19. Prebiotic supplementation and adequate calcium intake have beneficial effects on body mass index changes during early adolescence

    Science.gov (United States)

    Prebiotics have been shown to enhance bone and gastrointestinal health. Recent data suggest a benefit to weight maintenance as well. However, few data are available in children or adolescents. The interactive effects of prebiotic intake and calcium intake on weight maintenance are unknown. Our objec...

  20. Calcium dobesilate may improve hemorheology in patients undergoing coronary artery bypass grafting Dobesilato de cálcio pode melhorar hemorreologia em pacientes submetidos à cirurgia de revascularização miocárdica

    Directory of Open Access Journals (Sweden)

    Kazim Besirli

    2012-06-01

    Full Text Available BACKGROUND: Calcium dobesilate is an angioprotective agent that has positive effects on hemorheological parameters. It is an antioxidant that increases endothelial-derived vasodilator substance secretion, there are none that analyze its effects during the postoperative period of patients undergoing myocardial revascularization. OBJECTIVE: We aimed to determine the effects of calcium dobesilate on hemorheological parameters, such as reduced glutathione and malondialdehyde in patients with ischemic heart disease undergoing myocardial revascularization in the postoperative period. METHODS: One hundred and thirty-four patients operated for coronary heart disease were included in this study. Hemorheological, oxidant and antioxidant parameters were measured two days after surgery and after a period of treatment with calcium dobesilate. Then, 500 mg of calcium dobesilate was given twice a day to one group of 68 patients for three months. The control group was composed of 66 patients who did not receive this medication. RESULTS: The increase in the erythrocyte deformability index was found to be significant compared with both the pretreatment values and with the 1st and 2nd values of the control group after calcium dobesilate administration, whereas there were no significant changes in blood viscosity, glutathione (GSH or malondialdehyde (MDA values after the calcium dobesilate administration. The same improvement in the CCS class was observed in patients regardless of they received the calcium dobesilate treatment. CONCLUSION: In the present investigation, the same improvement in the CCS class was observed in patients regardless of they received the calcium dobesilate treatment. Improvements with calcium dobesilate were statistically significant only in the increase in erythrocyte flexibility.ANTECEDENTES: O dobesilato de cálcio é um agente angioprotetor que tem efeitos positivos sobre os parâmetros hemorreológicos. É um antioxidante que aumenta a

  1. Breakfast consumption by African-American and white adolescent girls correlates positively with calcium and fiber intake and negatively with body mass index.

    Science.gov (United States)

    Affenito, Sandra G; Thompson, Douglas R; Barton, Bruce A; Franko, Debra L; Daniels, Stephen R; Obarzanek, Eva; Schreiber, George B; Striegel-Moore, Ruth H

    2005-06-01

    To describe age- and race-related differences in breakfast consumption and to examine the association of breakfast intake with dietary calcium and fiber and body mass index (BMI). Data from the National Heart, Lung, and Blood Institute Growth and Health Study, a 9-year, longitudinal biracial cohort study with annual 3-day food records. The National Heart, Lung, and Blood Institute Growth and Health Study recruited 2,379 girls (1,166 white and 1,213 African American), aged 9 or 10 years at baseline for an observational study. Retention rates were very high at visits two through four (96%, 94%, and 91%), but declined to a low of 82% at visit seven, and increased to 89% at visit 10. Frequency of breakfast consumption, dietary calcium and fiber, and BMI. Generalized estimation equations methodology was used to examine differences in the frequency of breakfast eating by age and race. Generalized estimation equations analyses were also conducted to test whether breakfast consumption was predictive of intake of dietary calcium and fiber, and BMI, adjusting for potentially confounding effects of site, age, race, parental education, physical activity, and total energy intake. Frequency of breakfast eating declined with age, white girls reported more frequent breakfast consumption than African-American girls, and the racial difference decreased with increasing age. Days eating breakfast were associated with higher calcium and fiber intake in all models, regardless of adjustment variables. Days eating breakfast were predictive of lower BMI in models that adjusted for basic demographics (ie, site, age, and race), but the independent effect of breakfast was no longer significant after parental education, energy intake, and physical activity were added to the model. Dietetics professionals need to promote the importance of consuming breakfast to all children and adolescents, especially African-American girls.

  2. The influence of birth weight and body mass in early adulthood on early coronary heart disease risk among Danish men born in 1953.

    Science.gov (United States)

    Osler, Merete; Lund, Rikke; Kriegbaum, Margit; Andersen, Anne-Marie Nybo

    2009-01-01

    This study examines the joint and separate influence of birth weight and body mass in young adulthood on subsequent coronary heart disease (CHD) risk. A cohort of 9,143 men born in Copenhagen, Denmark, in 1953, for whom information on birth weight and body weight and height around age 19 years were retrieved from birth certificates and conscript records, respectively, were followed from 1978 until 2005 (between age 25 and 52 years) for incident fatal and non-fatal CHD. Data on CHD were obtained through record linkage to the Cause of Death Registry and the National Patient Registry. During follow-up, a total of 475 men had a CHD diagnosis. Men with low birth weight, high body mass index (BMI) at age 19, a father from the working class, and low educational level at age 19 had an increased risk for CHD. Birth weight was inversely associated with CHD only in men with BMI of 25 kg/m(2) or above. Adjustment for childhood social circumstances and educational status at age 19 had minor influence on the estimates. In conclusion, BMI in young adulthood seems to be strongly associated with the risk of CHD before age 52, and birth weight seem to modify the association. The risk estimates is highest for individuals with a combination of low birth weight and overweight in young adulthood.

  3. The influence of birth weight and body mass in early adulthood on early coronary heart disease risk among Danish men born in 1953

    DEFF Research Database (Denmark)

    Osler, Merete; Lund, Rikke; Kriegbaum, Margit

    2009-01-01

    This study examines the joint and separate influence of birth weight and body mass in young adulthood on subsequent coronary heart disease (CHD) risk. A cohort of 9,143 men born in Copenhagen, Denmark, in 1953, for whom information on birth weight and body weight and height around age 19 years were......-up, a total of 475 men had a CHD diagnosis. Men with low birth weight, high body mass index (BMI) at age 19, a father from the working class, and low educational level at age 19 had an increased risk for CHD. Birth weight was inversely associated with CHD only in men with BMI of 25 kg/m(2) or above....... Adjustment for childhood social circumstances and educational status at age 19 had minor influence on the estimates. In conclusion, BMI in young adulthood seems to be strongly associated with the risk of CHD before age 52, and birth weight seem to modify the association. The risk estimates is highest...

  4. The influence of birth weight and body mass in early adulthood on early coronary heart disease risk among Danish men born in 1953

    DEFF Research Database (Denmark)

    Osler, Merete; Lund, Rikke; Kriegbaum, Margit

    2009-01-01

    This study examines the joint and separate influence of birth weight and body mass in young adulthood on subsequent coronary heart disease (CHD) risk. A cohort of 9,143 men born in Copenhagen, Denmark, in 1953, for whom information on birth weight and body weight and height around age 19 years were......-up, a total of 475 men had a CHD diagnosis. Men with low birth weight, high body mass index (BMI) at age 19, a father from the working class, and low educational level at age 19 had an increased risk for CHD. Birth weight was inversely associated with CHD only in men with BMI of 25 kg/m2 or above. Adjustment...... for childhood social circumstances and educational status at age 19 had minor influence on the estimates. In conclusion, BMI in young adulthood seems to be strongly associated with the risk of CHD before age 52, and birth weight seem to modify the association. The risk estimates is highest for individuals...

  5. Long-term safety and efficacy of percutaneous coronary intervention with stenting and coronary artery bypass surgery for multivessel coronary artery disease: A meta-analysis with 5-year patient-level data from the ARTS, ERACI-II, MASS-II, and SoS trials

    NARCIS (Netherlands)

    J. Daemen (Joost); H. Boersma (Eric); M. Flather (Marcus); J. Booth (Jean); R.H. Stables (Rodney); A. Rodriguez (Alfredo Chapin); G.A. Rodriguez-Granillo (Gaston); W.A. Hueb (Whady Armindo); P.A. Lemos Neto (Pedro); P.W.J.C. Serruys (Patrick)

    2008-01-01

    textabstractBackground - Randomized trials that studied clinical outcomes after percutaneous coronary intervention (PCI) with bare metal stenting versus coronary artery bypass grafting (CABG) are underpowered to properly assess safety end points like death, stroke, and myocardial infarction. Pooling

  6. The Study of Thermal Decomposition of Natural Calcium Carbonate by the Temperature-programmed Mass Spectrometry Technique

    OpenAIRE

    S.N. Danilchenko; V.D. Chіvanov; A.G. Ryabishev; S.V. Novіkov; A.A. Stepanenko; V.N. Kuznetsov; E.V. Mironets; A.V. Marіychuk; A.A. Yanovska; O.G. Bordunova; A.N. Bugay

    2016-01-01

    The experiments have shown that the heating range for quantitative evolution of carbon dioxide gas (CO2) from natural calcium carbonates (e.g., chalk, corals, shells of the Anadara clams (Anadara inaequivalvis), shell of bird eggs) is from 500 to 850 C with a total heating time of 30-50 minutes. The only exception is the sample of a mortar from a masonry of Saint Sophia Cathedral (the architectural monument of XI century), in which the lowest border of the heating range for carbon dioxide ev...

  7. Social relationships and longitudinal changes in body mass index and waist circumference: the coronary artery risk development in young adults study.

    Science.gov (United States)

    Kershaw, Kiarri N; Hankinson, Arlene L; Liu, Kiang; Reis, Jared P; Lewis, Cora E; Loria, Catherine M; Carnethon, Mercedes R

    2014-03-01

    Few studies have examined longitudinal associations between close social relationships and weight change. Using data from 3,074 participants in the Coronary Artery Risk Development in Young Adults Study who were examined in 2000, 2005, and 2010 (at ages 33-45 years in 2000), we estimated separate logistic regression random-effects models to assess whether patterns of exposure to supportive and negative relationships were associated with 10% or greater increases in body mass index (BMI) (weight (kg)/height (m)(2)) and waist circumference. Linear regression random-effects modeling was used to examine associations of social relationships with mean changes in BMI and waist circumference. Participants with persistently high supportive relationships were significantly less likely to increase their BMI values and waist circumference by 10% or greater compared with those with persistently low supportive relationships after adjustment for sociodemographic characteristics, baseline BMI/waist circumference, depressive symptoms, and health behaviors. Persistently high negative relationships were associated with higher likelihood of 10% or greater increases in waist circumference (odds ratio = 1.62, 95% confidence interval: 1.15, 2.29) and marginally higher BMI increases (odds ratio = 1.50, 95% confidence interval: 1.00, 2.24) compared with participants with persistently low negative relationships. Increasingly negative relationships were associated with increases in waist circumference only. These findings suggest that supportive relationships may minimize weight gain, and that adverse relationships may contribute to weight gain, particularly via central fat accumulation.

  8. Effect of calcium carbonate combined with calcitonin on hypercalcemia in hemodialysis patients.

    Science.gov (United States)

    Wei, Yong; Kong, Xiang Lei; Li, Wen Bin; Wang, Zun Song

    2014-12-01

    This short-term study assessed the efficacy and safety of calcium carbonate combined with calcitonin in the treatment of hypercalcemia in hemodialysis patients. Patients (n=64) on hemodialysis for chronic kidney disease for more than 6 months were included based on total serum calcium more than 10.5 mg/dL. All patients were randomized (1:1) to receive calcium carbonate combined with calcitonin (Group I) or lanthanum carbonate (Group II) for 12 weeks. Blood levels of calcium, phosphorus and intact parathyroid hormone (iPTH) were measured every month, bone mass density (BMD) and coronary artery calcium scores (CACS) were measured at 3 months. During the study period, serum calcium decreased from 10.72 ± 0.39 to 10.09 ± 0.28 mg/dL (P carbonate combined with calcitonin and lanthanum carbonate were equally effective in the suppression of hypercalcemia in hemodialysis patients. There were no serious treatment-related adverse events in treatment with calcium carbonate combined with calcitonin.

  9. Nearshore human interventions reverse patterns of decline in lake calcium budgets in central Ontario as demonstrated by mass-balance analyses

    Science.gov (United States)

    Yao, Huaxia; McConnell, Christopher; Somers, Keith M.; Yan, Norman D.; Watmough, Shaun; Scheider, Wolfgang

    2011-06-01

    Calcium (Ca) has declined to levels threatening aquatic biota in lakes on the eastern Canadian Shield. Predictive models for future changes in lake Ca are generally based on catchment-scale studies, but these models rarely account for unmeasured sources of Ca supply that are common in the nearshore areas of developed lakes. In this study we utilize up to 29 years of hydrological and water chemistry data for three lakes in central Ontario that differ in degree of human intervention to demonstrate that shoreline development may exert large effects on Ca mass balances. In the relative absence of shoreline development, Red Chalk Lake exhibited what we consider to be the normal response, a reduction in Ca load from the catchment over the last three decades, leading to a reduction in lake export and lake Ca concentration. Calcium load, export, and lake water Ca concentration also fell in Harp Lake, but less than in Red Chalk Lake, because Ca loads were elevated by human activities in Harp Lake's moderately developed shoreline area. By contrast, Dickie Lake experienced an exceptional change in Ca dynamics: both export and lake concentrations rose because of elevated load from the shoreline area linked to the use of dust suppressants on gravel roads. Reductions in both stream Ca concentration and flow volume have led to calcium decline in streams and lakes. Long-term soil acidification processes and climatic variability with its link to hydrology can explain the general pattern of Ca decline in lakes on the south-central Canadian Shield. However, given the widespread lakeshore development and use of dust suppressants on gravel roads, predictions of lake Ca levels need to take into account nearshore activities, especially those that augment rates of Ca supply.

  10. Relationship of APOA5, PPARγ and HL gene variants with serial changes in childhood body mass index and coronary artery disease risk factors in young adulthood

    Directory of Open Access Journals (Sweden)

    Sinha Shikha

    2011-05-01

    Full Text Available Abstract Background Triglycerides is an independent risk factor for coronary artery disease (CAD and is especially important in Indians because of high prevalence of hypertriglyceridemia in this population. Both genetic and environmental factors determine triglyceride levels. In a birth cohort from India, hypertriglyceridemia was found in 41% of men and 11% of women. Subjects who had high triglycerides had more rapid body mass index (BMI or weight gain than rest of the cohort throughout infancy, childhood and adolescence. We analysed polymorphisms in APOA5, hepatic lipase and PPARγ genes and investigated their association with birth weight and serial changes in BMI. Results Polymorphisms in APOA5 (-1131T > C, S19W, PPARγ (Pro12Ala and hepatic lipase (-514C > T were studied by polymerase chain reaction (PCR followed by restriction digestion in 1492 subjects from the New Delhi Birth Cohort (NDBC. We assessed whether these polymorphisms influence lipid and other variables and serial changes in BMI, both individually and together. The risk allele of APOA5 (-1131C resulted in 23.6 mg/dl higher triglycerides as compared to normal allele (P PPARγ Pro12Ala variation with a lower conditional weight at 6 months, (P = 0.020 and APOA5 S19W with a higher conditional BMI at 11 yrs of age (P = 0.030, none of the other associations between the gene polymorphisms and serial changes in body mass index from birth to young adulthood were significant. Conclusion The promoter polymorphism in APOA5 was associated with raised serum triglycerides and that of HL with raised HDL2 levels. None of the polymorphisms had any significant relationship with birth weight or serial changes in anthropometry from birth to adulthood in this cohort.

  11. Body mass index and the prevalence, severity, and risk of coronary artery disease: an international multicentre study of 13 874 patients

    Science.gov (United States)

    Labounty, Troy M.; Gomez, Millie J.; Achenbach, Stephan; Al-Mallah, Mouaz; Berman, Daniel S.; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk-Jae; Cheng, Victor; Chinnaiyan, Kavitha M.; Chow, Benjamin; Cury, Ricardo; Delago, Augustin; Dunning, Allison; Feuchtner, Gudrun; Hadamitzky, Martin; Hausleiter, Jorg; Kaufmann, Philipp; Kim, Yong-Jin; Leipsic, Jonathon; Lin, Fay Y.; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J.; Villines, Todd C.; Min, James K.

    2013-01-01

    Aims Obesity is associated with the presence of coronary artery disease (CAD) risk factors and cardiovascular events. We examined the relationship between body mass index (BMI) and the presence, extent, severity, and risk of CAD in patients referred for coronary computed tomographic angiography (CCTA). Methods and results We evaluated 13 874 patients from a prospective, international, multicentre registry of individuals without known CAD undergoing CCTA. We compared risk factors, CAD findings, and risk of all-cause mortality and non-fatal myocardial infarction (MI) amongst individuals with underweight (18.5–20.0 kg/m2), normal (20.1–24.9 kg/m2), overweight (25–29.9 kg/m2), and obese (≥30 kg/m2) BMI. The mean follow-up was 2.4 ± 1.2 years with 143 deaths and 193 MIs. Among underweight, normal weight, overweight, and obese individuals, there was increasing prevalence of diabetes (7 vs.10% vs. 12 vs. 19%), hypertension (37 vs. 40% vs. 46 vs. 59%), and hyperlipidaemia (48 vs. 52% vs. 56 vs. 56%; P < 0.001 for trend). After multivariable adjustment, BMI was positively associated with the prevalence of any CAD [odds ratio (OR) 1.25 per +5 kg/m2, 95% confidence interval (CI): 1.20–1.30, P < 0.001] and obstructive (≥50% stenosis) CAD (OR: 1.13 per +5 kg/m2, 95% CI: 1.08–1.19, P < 0.001); a higher BMI was also associated with an increased number of segments with plaque (+0.26 segments per +5 kg/m2, 95% CI: 0.22–0.30, P < 0.001). Larger BMI categories were associated with an increase in all-cause mortality (P = 0.004), but no difference in non-fatal MI. After multivariable adjustment, a higher BMI was independently associated with increased risk of MI (hazards ratio: 1.28 per +5 kg/m2, 95% CI: 1.12–1.45, P < 0.001). Conclusions Amongst patients with suspected CAD referred for CCTA, individuals with increased BMI have greater prevalence, extent, and severity of CAD that is not fully explained by the presence of traditional risk factors. A higher BMI is

  12. Impact of body mass index on in-hospital complications in patients undergoing percutaneous coronary intervention in a Japanese real-world multicenter registry.

    Directory of Open Access Journals (Sweden)

    Yohei Numasawa

    Full Text Available Obesity is associated with advanced cardiovascular disease. However, some studies have reported the "obesity paradox" after percutaneous coronary intervention (PCI. The relationship between body mass index (BMI and clinical outcomes after PCI has not been thoroughly investigated, especially in Asian populations.We studied 10,142 patients who underwent PCI at 15 Japanese hospitals participating in the JCD-KICS registry from September 2008 to April 2013. Patients were divided into four groups according to BMI: underweight, BMI <18.5 (n=462; normal, BMI ≥ 18.5 and <25.0 (n=5,945; overweight, BMI ≥ 25.0 and <30.0 (n=3,100; and obese, BMI ≥ 30.0 (n=635.Patients with a high BMI were significantly younger (p<0.001 and had a higher incidence of coronary risk factors such as hypertension (p<0.001, hyperlipidemia (p<0.001, diabetes mellitus (p<0.001, and current smoking (p<0.001, than those with a low BMI. Importantly, patients in the underweight group had the worst in-hospital outcomes, including overall complications (underweight, normal, overweight, and obese groups: 20.4%, 11.5%, 8.4%, and 10.2%, p<0.001, in-hospital mortality (5.8%, 2.1%, 1.2%, and 2.7%, p<0.001, cardiogenic shock (3.5%, 2.0%, 1.5%, and 1.6%, p=0.018, bleeding complications (10.0%, 4.5%, 2.6%, and 2.8%, p<0.001, and receiving blood transfusion (7.6%, 2.7%, 1.6%, and 1.7%, p<0.001. BMI was inversely associated with bleeding complications after adjustment by multivariate logistic regression analysis (odds ratio, 0.95; 95% confidence interval, 0.92-0.98; p=0.002. In subgroup multivariate analysis of patients without cardiogenic shock, BMI was inversely associated with overall complications (OR, 0.98; 95% CI, 0.95-0.99; p=0.033 and bleeding complications (OR, 0.95; 95% CI, 0.91-0.98; p=0.006. Furthermore, there was a trend that BMI was moderately associated with in-hospital mortality (OR, 0.94; 95% CI, 0.88-1.01; p=0.091.Lean patients, rather than obese patients are at greater risk

  13. Hybrid Markov-mass action law model for cell activation by rare binding events: Application to calcium induced vesicular release at neuronal synapses

    Science.gov (United States)

    Guerrier, Claire; Holcman, David

    2016-10-01

    Binding of molecules, ions or proteins to small target sites is a generic step of cell activation. This process relies on rare stochastic events where a particle located in a large bulk has to find small and often hidden targets. We present here a hybrid discrete-continuum model that takes into account a stochastic regime governed by rare events and a continuous regime in the bulk. The rare discrete binding events are modeled by a Markov chain for the encounter of small targets by few Brownian particles, for which the arrival time is Poissonian. The large ensemble of particles is described by mass action laws. We use this novel model to predict the time distribution of vesicular release at neuronal synapses. Vesicular release is triggered by the binding of few calcium ions that can originate either from the synaptic bulk or from the entry through calcium channels. We report here that the distribution of release time is bimodal although it is triggered by a single fast action potential. While the first peak follows a stimulation, the second corresponds to the random arrival over much longer time of ions located in the synaptic terminal to small binding vesicular targets. To conclude, the present multiscale stochastic modeling approach allows studying cellular events based on integrating discrete molecular events over several time scales.

  14. Increased detection rate of melamine-containing calcium urolithiasis by using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry technique in clinical practice.

    Science.gov (United States)

    Wu, Chia-Fang; Liu, Chia-Chu; Chou, Yii-Her; Shiea, Jentaie; Shen, Jung-Tsung; Wang, Shiun-Shiuan; Wu, Ming-Tsang

    2014-04-20

    Background: Studies have shown that melamine may be associated with urolithiasis. A more sensitive method is needed to analyze melamine in urinary stones to identify potential causes of urolithiasis.Methods: Here we compare the analytical methods of detecting melamine in urinary stones by Fourier transform infrared (FTIR) spectroscopy and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS) in the laboratory and clinic. First, we established the melamine detection limit in melamine cyanurate standard by the methods of FTIR spectrophotometer and MALDI-TOF MS. Subsequently, we applied these two methods to 54 adult patients with upper urinary tract calcium urolithiasis.Results: We found that the detection limit of melamine in melamine cyanurate standard by MALD-TOF MS was~10,000-fold more sensitive than FTIR.We applied both instruments to 54 stone specimens from 54 calcium urolithias is patients. In those without distinctive melamine pattern in the FTIR spectra,melamine could be detected by MALD-TOF MS in an additional 12 out of 42 subjects' stone specimens (28.6%). Compared to MALD-TOF MS negative subjects (n = 30), those positive subjects (n = 12) excreted significantly higher urinary melamine levels (P melamine in melamine-containing kidney stones

  15. Strategies for Primary Prevention of Coronary Heart Disease Based on Risk Stratification by the ACC/AHA Lipid Guidelines, ATP III Guidelines, Coronary Calcium Scoring, and C-Reactive Protein, and a Global Treat-All Strategy: A Comparative--Effectiveness Modeling Study.

    Directory of Open Access Journals (Sweden)

    Benjamin Z Galper

    Full Text Available Several approaches have been proposed for risk-stratification and primary prevention of coronary heart disease (CHD, but their comparative and cost-effectiveness is unknown.We constructed a state-transition microsimulation model to compare multiple approaches to the primary prevention of CHD in a simulated cohort of men aged 45-75 and women 55-75. Risk-stratification strategies included the 2013 American College of Cardiology/American Heart Association (ACC/AHA guidelines on the treatment of blood cholesterol, the Adult Treatment Panel (ATP III guidelines, and approaches based on coronary artery calcium (CAC scoring and C-reactive protein (CRP. Additionally we assessed a treat-all strategy in which all individuals were prescribed either moderate-dose or high-dose statins and all males received low-dose aspirin. Outcome measures included CHD events, costs, medication-related side effects, radiation-attributable cancers, and quality-adjusted-life-years (QALYs over a 30-year timeframe.Treat-all with high-dose statins dominated all other strategies for both men and women, gaining 15.7 million QALYs, preventing 7.3 million myocardial infarctions, and saving over $238 billion, compared to the status quo, far outweighing its associated adverse events including bleeding, hepatitis, myopathy, and new-onset diabetes. ACC/AHA guidelines were more cost-effective than ATP III guidelines for both men and women despite placing 8.7 million more people on statins. For women at low CHD risk, treat-all with high-dose statins was more likely to cause a statin-related adverse event than to prevent a CHD event.Despite leading to a greater proportion of the population placed on statin therapy, the ACC/AHA guidelines are more cost-effective than ATP III. Even so, at generic prices, treating all men and women with statins and all men with low-dose aspirin appears to be more cost-effective than all risk-stratification approaches for the primary prevention of CHD

  16. Strategies for Primary Prevention of Coronary Heart Disease Based on Risk Stratification by the ACC/AHA Lipid Guidelines, ATP III Guidelines, Coronary Calcium Scoring, and C-Reactive Protein, and a Global Treat-All Strategy: A Comparative--Effectiveness Modeling Study

    Science.gov (United States)

    Galper, Benjamin Z.; Wang, Y. Claire; Einstein, Andrew J.

    2015-01-01

    Background Several approaches have been proposed for risk-stratification and primary prevention of coronary heart disease (CHD), but their comparative and cost-effectiveness is unknown. Methods We constructed a state-transition microsimulation model to compare multiple approaches to the primary prevention of CHD in a simulated cohort of men aged 45–75 and women 55–75. Risk-stratification strategies included the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines on the treatment of blood cholesterol, the Adult Treatment Panel (ATP) III guidelines, and approaches based on coronary artery calcium (CAC) scoring and C-reactive protein (CRP). Additionally we assessed a treat-all strategy in which all individuals were prescribed either moderate-dose or high-dose statins and all males received low-dose aspirin. Outcome measures included CHD events, costs, medication-related side effects, radiation-attributable cancers, and quality-adjusted-life-years (QALYs) over a 30-year timeframe. Results Treat-all with high-dose statins dominated all other strategies for both men and women, gaining 15.7 million QALYs, preventing 7.3 million myocardial infarctions, and saving over $238 billion, compared to the status quo, far outweighing its associated adverse events including bleeding, hepatitis, myopathy, and new-onset diabetes. ACC/AHA guidelines were more cost-effective than ATP III guidelines for both men and women despite placing 8.7 million more people on statins. For women at low CHD risk, treat-all with high-dose statins was more likely to cause a statin-related adverse event than to prevent a CHD event. Conclusions Despite leading to a greater proportion of the population placed on statin therapy, the ACC/AHA guidelines are more cost-effective than ATP III. Even so, at generic prices, treating all men and women with statins and all men with low-dose aspirin appears to be more cost-effective than all risk-stratification approaches for the

  17. One-step Examination of Myocardial Perfusion Imaging Combined with Coronary Artery Calcium Score in Diagnosis of Coronary Artery Disease%心肌灌注显像联合冠状动脉钙化积分一站式检查对冠心病的诊断价值

    Institute of Scientific and Technical Information of China (English)

    王建锋; 袁建伟; 王跃涛; 周瑞珏; 杨玲; 邵晓梁; 陆培奇

    2016-01-01

    Purpose The one-step examination of myocardial perfusion imaging (MPI) combined with coronary artery calcium score (CACS) can obtain both coronary functional information and anatomical information simultaneously, this paper aims to evaluate the value of the one-step examination of MPI combined with CACS for detecting coronary artery disease (CAD). Materials and Methods 188 cases who underwent one-step examination of MPI combined with CACS and invasive coronary angiography (ICA) because of chest tightness, chest pain with suspected coronary artery disease were analyzed retrospectively, with the results of ICA used as"gold standard", the diagnostic efficacy of MPI, CACS and one-step examination with combination of the two techniques for CAD was investigated. Results ①Pre-test probability of CAD was intermediate in 79.8%(150/188), and high in 20.2%(38/188) cases. Seventy-three cases were confirmed as CAD and 115 of 188 patients were negative according to ICA.②The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of CAD by MPI were 65.8%, 75.7%, 71.8%, 63.1%and 77.7%, respectively. ③ The CACS of CAD group was significantly higher than the non-CAD group (494.96±99.60 vs. 38.15±16.03, P0.05) and accuracy (75.0% vs. 71.8%, P>0.05) showed no statistically significant difference; the sensitivity of MPI combined with CACS were significantly higher than CACS (80.8%vs. 60.3%, P0.05). Conclusion The one-step examination of MPI combined with CACS can reduce coronary heart disease misdiagnosis, improve the diagnostic sensitivity of CAD compared with the MPI or CACS, with high application value for the diagnosis of CAD, especially in moderate risk groups.%目的:心肌灌注显像(MPI)联合冠状动脉钙化积分(CACS)一站式检查可同时获得冠状动脉功能信息和解剖信息,本研究探讨MPI联合CACS一站式检查对冠心病(CAD)的诊断价值。资料与方法回

  18. Association between metabolic syndrome and subclinical coronary atherosclerosis in asymptomatic adults.

    Science.gov (United States)

    Kullo, Iftikhar J; Cassidy, Andrea E; Peyser, Patricia A; Turner, Stephen T; Sheedy, Patrick F; Bielak, Lawrence F

    2004-12-15

    Metabolic syndrome was associated with the presence and quantity of coronary artery calcium, a marker of subclinical coronary atherosclerosis, in 1,129 asymptomatic adults, ages 20 to 79 years, from a community-based study. The association was independent of 10-year risk of coronary heart disease based on the Framingham risk score.

  19. Efficacy analysis of ezetimibe on lipid management in elderly patients with coronary heart disease after coronary intervention

    Institute of Scientific and Technical Information of China (English)

    段明勤

    2013-01-01

    Objective To observe the clinical efficacy of ezetimibe combined with atorvastatin calcium on hyperlipidemia,and to evaluate the role of ezetimibe on lipid management in elderly patients with coronary heart disease (CHD) after coronary intervention.Methods A total of 150 elderly CHD patients with hyperlipidemia

  20. 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 ...

  1. Upregulation of 5-hydroxytryptamine receptor signaling in coronary arteries after organ culture.

    Directory of Open Access Journals (Sweden)

    Chun-Yu Deng

    Full Text Available BACKGROUND: 5-Hydroxytryptamine (5-HT is a powerful constrictor of coronary arteries and is considered to be involved in the pathophysiological mechanisms of coronary-artery spasm. However, the mechanism of enhancement of coronary-artery constriction to 5-HT during the development of coronary artery disease remains to be elucidated. Organ culture of intact blood-vessel segments has been suggested as a model for the phenotypic changes of smooth muscle cells in cardiovascular disease. METHODOLOGY/PRINCIPAL FINDINGS: We wished to characterize 5-HT receptor-induced vasoconstriction and quantify expression of 5-HT receptor signaling in cultured rat coronary arteries. Cumulative application of 5-HT produced a concentration-dependent vasoconstriction in fresh and 24 h-cultured rat coronary arteries without endothelia. 5-HT induced greater constriction in cultured coronary arteries than in fresh coronary arteries. U46619- and CaCl2-induced constriction in the two groups was comparable. 5-HT stimulates the 5-HT2A receptor and cascade of phospholipase C to induce coronary vasoconstriction. Calcium influx through L-type calcium channels and non-L-type calcium channels contributed to the coronary-artery constrictions induced by 5-HT. The contractions mediated by non-L-type calcium channels were significantly enhanced in cultured coronary arteries compared with fresh coronary arteries. The vasoconstriction induced by thapsigargin was also augmented in cultured coronary arteries. The decrease in Orai1 expression significantly inhibited 5-HT-evoked entry of Ca2+ in coronary artery cells. Expression of the 5-HT2A receptor, Orai1 and STIM1 were augmented in cultured coronary arteries compared with fresh coronary arteries. CONCLUSIONS: An increased contraction in response to 5-HT was mediated by the upregulation of 5-HT2A receptors and downstream signaling in cultured coronary arteries.

  2. Thoracic epidural analgesia in obese patients with body mass index of more than 30 kg/m 2 for off pump coronary artery bypass surgery

    Directory of Open Access Journals (Sweden)

    Sharma Munish

    2010-01-01

    Full Text Available Perioperative Thoracic epidural analgesia (TEA is an important part of a multimodal approach to improve analgesia and patient outcome after cardiac and thoracic surgery. This is particularly important for obese patients undergoing off pump coronary artery bypass surgery (OPCAB. We conducted a randomized clinical trial at tertiary care cardiac institute to compare the effect of TEA and conventional opioid based analgesia on perioperative lung functions and pain scores in obese patients undergoing OPCAB. Sixty obese patients with body mass index> 30 kg/m 2 for elective OPCAB were randomized into two groups (n=30 each. Patients in both the groups received general anesthesia but in group 1, TEA was also administered. We performed spirometry as preoperative assessment and at six hours, 24 hours, second, third, fourth and fifth day after extubation, along with arterial blood gases analysis. Visual analogue scale at rest and on coughing was recorded to assess the degree of analgesia. The other parameters observed were: time to endotracheal extubation, oxygen withdrawal time and intensive care unit length of stay. On statistical analysis there was a significant difference in Vital Capacity at six hours, 24 hours, second and third day postextubation. Forced vital capacity and forced expiratory volume in one second followed the same pattern for first four postoperative days and peak expiratory flow rate remained statistically high till second postoperative day. ABG values and PaO 2 /FiO 2 ratio were statistically higher in the study group up to five days. Visual analogue scale at rest and on coughing was significantly lower till fourth and third postoperative day respectively. Tracheal extubation time, oxygen withdrawal time and ICU stay were significantly less in group 1. The use of TEA resulted in better analgesia, early tracheal extubation and shorter ICU stay and should be considered for obese patients undergoing OPCAB.

  3. Huge aneurysm and coronary-cameral fistula from right coronary branch: First case.

    Science.gov (United States)

    Ahmad, Tanveer; Pasarad, Ashwini Kumar; Kishore, Kolkebaile Sadanand; Maheshwarappa, Nandakumar Neralakere

    2016-02-01

    Coronary-cameral fistulas are rare cardiovascular anomalies. A giant coronary artery aneurysm associated with a coronary-cameral fistula is a very rare condition, with an estimated prevalence of 0.02%. We report the case of middle-aged woman who presented with a huge extracardiac aneurysmal mass and a coronary-cameral fistula from a right coronary artery branch. It was successfully repaired by ligation and excision plus marsupialization of the aneurysm. We believe this is the first such a case reported in literature.

  4. 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.

  5. Single-centre cohort study of gender influence in coronary CT angiography in patients with a low to intermediate pretest probability of coronary heart disease

    DEFF Research Database (Denmark)

    Nørgaard, Kirsten Schou; Isaksen, Christin; Buhl, Jørgen Selmer;

    2015-01-01

    BACKGROUND: In 'real-world' patient populations undergoing coronary CT angiography (CCTA), it is unclear whether a correlation exists between gender, coronary artery calcium (CAC) score and subsequent referral for invasive coronary angiography and coronary revascularisation. We therefore investig......BACKGROUND: In 'real-world' patient populations undergoing coronary CT angiography (CCTA), it is unclear whether a correlation exists between gender, coronary artery calcium (CAC) score and subsequent referral for invasive coronary angiography and coronary revascularisation. We therefore...... investigated the relationship between gender, CAC and use of subsequent invasive coronary angiography and coronary revascularisation in a cohort of patients with chest discomfort and low to intermediate pretest probability of coronary artery disease who underwent a CCTA at our diagnostic centre. METHODS......-up was 28.5% in men versus 18.3% in women (pCAC-adjusted HR in women versus men was 0.98 (95% CI 0.85 to 1.13) for invasive coronary angiography and 0.73 (95% CI 0.57 to 0.93) for coronary...

  6. End organ protection by calcium-channel blockers.

    Science.gov (United States)

    Tzivoni, D

    2001-02-01

    In recent years, much attention has been given to end organ protection by antihypertensive, anti-heart failure, and anti-ischemic medications. This review describes the available information on end organ protection by calcium-channel blockers (CCBs). In normotensive patients and patients with hypertension treated with long-acting dihydropyridines, medial thickness was thinner than in patients treated with atenolol or in untreated hypertensive patients. Long-term treatment was associated with significant reduction in left ventricular mass. Calcium-channel blockers also improved endothelial-dependent relaxation and reversed the vasoconstrictive response to nitric oxide inhibitors. In diabetic patients, CCBs were effective in preserving kidney function and microalbuminurea. The combination of angiotensin-converting enzyme (ACE) inhibitors and CCBs was more effective than ACE inhibitors alone in preserving kidney function. In animal experiments, CCBs prevented development of coronary atheroschlerosis; however, in humans only limited data are available on their antiatherogenic effect. Some studies suggest that CCBs exert antiplatelets properties and may therefore be beneficial in patients with coronary artery disease.

  7. 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.

  8. Application of 70 kV Third-generation High-pitch Dual-source Coronary CT Angiography in Patients with Different Body Mass Index.

    Science.gov (United States)

    Yi, Yan; Cao, Jian; Lin, Lu; Kong, Lingyan; Jiang, Shu; Li, Xiao; Liu, Peijun; Wang, Ming; Wang, Man; Wang, Yun; Jin, Zhengyu; Wang, Yining

    2017-02-20

    Objective  To investigate the optimized range of body mass index (BMI) selection for patients undergoing 70 kV high-pitch dual-source coronary CT angiography (CCTA) on the third-generation dual-source CT (DSCT). Methods  Patients undergoing prospective high-pitch ultra-low contrast media (CM) CCTA on the third-generation DSCT using the automatic tube voltage selection at 70 kV were included and divided into three groups:group A,with BMI≤24 kg/m(2);group B,with 24 kg/m(2)image quality results,and effective dose (ED) were evaluated and compared. Results  No significant difference was found in age (H=2.36,P=0.78),heart rate (H=3.51,P=0.80),and ED(H=1.77,P=0.12) among three groups. The noise of the aortic root in group A was (21.66±4.00)HU,which was significantly lower than that in group C [(23.61±4.20)HU](F=2.05,P=0.03). The signal to noise ratio of aortic root in group A (18.61±5.28) was significantly better than that in group C (14.75±2.58) (F=5.31,P=0.02). No other significant difference in quantitative image quality were found among the three groups (all P >0.05). Subjective image quality in group A(Z=2.91,P=0.004) and B(Z=2.27,P=0.021) were both significantly better than that in group C. Conclusion  The ultra-low tube voltage (70 kV) combined with ultra-low CM CCTA protocol on third-generation high-pitch DSCT may be better for patients with BMI<28 kg/m2 than those with BMI ≥28 kg/m(2) in China.

  9. Coronary collaterals

    NARCIS (Netherlands)

    Koerselman, Jeroen

    2004-01-01

    Cardiovascular diseases, in particular coronary artery disease, are the leading cause of death and disease in industrialized countries. Atherosclerotic changes of the arterial vessel wall constitute one of the major causes for the occurrence of cardiovascular disease. Important risk factors for

  10. Coronary collaterals

    NARCIS (Netherlands)

    Koerselman, Jeroen

    2004-01-01

    Cardiovascular diseases, in particular coronary artery disease, are the leading cause of death and disease in industrialized countries. Atherosclerotic changes of the arterial vessel wall constitute one of the major causes for the occurrence of cardiovascular disease. Important risk factors for card

  11. Simultaneous determination of a novel diphenylpiperazine calcium channel blocker and its four metabolites in rat liver microsomes by liquid chromatography tandem mass spectrometry.

    Science.gov (United States)

    Guo, Wei; Kong, Dezhi; Du, Yingfeng; Shi, Xiaowei; Wang, Wei; Wang, Yongli

    2012-01-01

    Dipfluzine hydrochloride (Dip), a novel diphenylpiperazine calcium channel blocker, has revealed the characteristics of a promising candidate for the treatment of cerebral vascular diseases in preclinical studies. Our research identified and quantified Dip and its 4 metabolites (M1, M2, M4 and M5) in rat liver microsomes by liquid chromatography tandem mass spectrometry. The results showed that Dip was firstly metabolized to M1 and M5 by 1- and 4-dealkylation from a piperazine nitrogen, and then the latter was subsequently metabolized to M2 and M4. The concentrations of Dip, M1, M2 and M5 were 557.3 ± 26.3, 854.3 ± 46.0, 2796.7± 126.9, 2473.3 ± 82.6 and 4.0 ± 0.4, 2.4 ± 0.1, 318.2 ± 8.7 and 27.4 ± 1.5 ng/ml in male and female rats, respectively. M4 (404.2 ± 22.2 ng/ml) was detected only in males not in females, suggesting that there is gender difference in the metabolism of Dip.

  12. Effects of denosumab, alendronate, or denosumab following alendronate on bone turnover, calcium homeostasis, bone mass and bone strength in ovariectomized cynomolgus monkeys.

    Science.gov (United States)

    Kostenuik, Paul J; Smith, Susan Y; Samadfam, Rana; Jolette, Jacquelin; Zhou, Lei; Ominsky, Michael S

    2015-04-01

    Postmenopausal osteoporosis is a chronic disease wherein increased bone remodeling reduces bone mass and bone strength. Antiresorptive agents including bisphosphonates are commonly used to mitigate bone loss and fracture risk. Osteoclast inhibition via denosumab (DMAb), a RANKL inhibitor, is a newer approach for reducing fracture risk in patients at increased risk for fracture. The safety of transitioning from bisphosphonate therapy (alendronate; ALN) to DMAb was examined in mature ovariectomized (OVX) cynomolgus monkeys (cynos). One day after OVX, cynos (7-10/group) were treated with vehicle (VEH, s.c.), ALN (50 μg/kg, i.v., twice monthly) or DMAb (25 mg/kg/month, s.c.) for 12 months. Other animals received VEH or ALN for 6 months and then transitioned to 6 months of DMAb. DMAb caused significantly greater reductions in serum CTx than ALN, and transition from ALN to DMAb caused further reductions relative to continued ALN. DMAb and ALN decreased serum calcium (Ca), and transition from ALN to DMAb resulted in a lesser decline in Ca relative to DMAb or to VEH-DMAb transition. Bone histomorphometry indicated significantly reduced trabecular and cortical remodeling with DMAb or ALN. Compared with ALN, DMAb caused greater reductions in osteoclast surface, eroded surface, cortical porosity and fluorochrome labeling, and transition from ALN to DMAb reduced these parameters relative to continued ALN. Bone mineral density increased in all active treatment groups relative to VEH controls. Destructive biomechanical testing revealed significantly greater vertebral strength in all three groups receiving DMAb, including those receiving DMAb after ALN, relative to VEH controls. Bone mass and strength remained highly correlated in all groups at all tested skeletal sites, consistent with normal bone quality. These data indicate that cynos transitioned from ALN to DMAb exhibited reduced bone resorption and cortical porosity, and increased BMD and bone strength, without

  13. Analysis of the Clinical Effect of Amlodipine and Atorvastatin Calcium Tablets in the Treatment of Hypertension and Coronary Heart Disease%分析氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的临床效果

    Institute of Scientific and Technical Information of China (English)

    徐岩

    2016-01-01

    Objective To study the clinical effect of amlodipine atorvastatin calcium tablets in the treatment of hypertension and coronary heart disease. Methods June 2013 to December 2015 in our hospital 60 cases of patients with hypertension and coronary heart disease were selected as the object of study. The patients were divided into two groups, observation group with amlodipine atorvastatin calcium therapy, and the control group was treated with nifedipine sustained-release tablets. The effect of two groups was compared. Results Observation group, the total effective rate was 93.33% control group, the total effective rate was 66.67%, compared with the control group, clinical treatment in the observation group, the effective rate was higher (χ2=5.104, P<0.05). Conclusion Amlodipine atorvastatin calcium tablets in the treatment of hypertension and coronary heart disease effect is very remarkable.%目的:研究氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的临床效果。方法选取2013年6月~2015年12月我院60例高血压合并冠心病患者为研究对象,将患者分为两组,观察组采用氨氯地平阿托伐他汀钙片治疗,对照组采用硝苯地平缓释片治疗,对比疗效。结果观察组总有效率为93.33%,对照组总有效率为66.67%,相对于对照组,观察组的临床治疗有效率要高(χ2=5.104,P <0.05)。结论氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的效果十分显著。

  14. The Clinical Curative Effect of Benazepril Symphysis Atorvastatin Calcium in Treatment Hypertension Combined Coronary Heart Disease(CHD)%贝那普利联合阿托伐他汀钙片治疗高血压合并冠心病的临床疗效

    Institute of Scientific and Technical Information of China (English)

    刘燕霞

    2016-01-01

    Objective Evaluation that benazepril combined use of atorvastatin calcium treatment hypertension combined clinical curative effect in patients with coronary heart disease.Methods From October 2013 to October 2015,168 cases of hypertension with coronary heart disease patients as the research object,is divided into control group and treatment group,84 cases in each group,the control application that benazepril treatment,treatment group on the basis of the combined use of atonrastatin statin calcium treatment.ResultsIncidence of angina pectoris and myocardial infarction,the incidence of treatment group were significantly lower than the control group,the differences were statisticaly significant(P<0.05).Conclusion That split joint atorvastatin calcium tablets in the treatment of hypertension with coronary heart disease patients can achieve significant curative effect,during the treatment of patients with angina pectoris incidence and the incidence of myocardial infarction were significantly reduced.%目的:评价贝那普利联合应用阿托伐他汀钙片治疗高血压合并冠心病患者的临床疗效。方法将我院2013年10月~2015年10月收治的168例高血压合并冠心病患者作为本次的研究对象,分为对照组和治疗组,每组84例,对照组应用贝那普利进行治疗,治疗组在此基础上联合应用阿伐他汀钙片进行治疗。结果治疗组心绞痛发生率与心肌梗死发生率分均低于对照组,差异均有统计学意义(P<0.05)。结论贝那普利联合阿托伐他汀钙片治疗高血压合并冠心病患者可以取得临床疗效,患者治疗期间心绞痛发生率和心肌梗死发生率均降低。

  15. Coronary risk stratification : from PREVEND to the prevention of coronary events

    NARCIS (Netherlands)

    Geluk, Christiane Anneliese

    2008-01-01

    The aim of the thesis was to evaluate some of the unresolved issues on the pathway from risk association to risk stratification with regard to C-reactive protein, urinary albumin excretion and coronary calcium. This thesis shows that C-reactive protein is associated to angiographic evidence of

  16. Calcium dobesilate may improve hemorheology in patients undergoing coronary artery bypass grafting Dobesilato de cálcio pode melhorar hemorreologia em pacientes submetidos à cirurgia de revascularização miocárdica

    OpenAIRE

    Kazim Besirli; Birsen Aydemir; Caner Arslan; Ali Riza Kiziler; Emir Canturk; Bekir Kayhan

    2012-01-01

    BACKGROUND: Calcium dobesilate is an angioprotective agent that has positive effects on hemorheological parameters. It is an antioxidant that increases endothelial-derived vasodilator substance secretion, there are none that analyze its effects during the postoperative period of patients undergoing myocardial revascularization. OBJECTIVE: We aimed to determine the effects of calcium dobesilate on hemorheological parameters, such as reduced glutathione and malondialdehyde in patients with isch...

  17. [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.

  18. Study on relationship between body mass index and waist circumference to slow coronary flow%冠状动脉慢血流与体质指数相关性的临床研究

    Institute of Scientific and Technical Information of China (English)

    付清海; 魏敦宏; 常快乐; 史锋庆

    2014-01-01

    目的:探讨体质指数(BMI)和腰围(WC)与冠状动脉慢血流(SCF)之间的相关性。方法:入选左室射血功能正常,经冠状动脉造影证实矫正的TIMI血流帧计数(CTFC)>27的CSF患者及同期经冠脉造影显示冠脉血流正常者为研究对象,其中CSF组92例,正常血流组92例,所有入选者常规测量身高、腰围、体重,计算BMI。分析BMI、腰围与CTFC帧计数的关系。结果:两组入选者基线资料相当CSF组患者腰围为(92.9±12.1)cm,BMI为(30.9±5.8)kg/m2,正常血流组腰围为(80.3±8.7)cm,BMI为(26.2±4.3)kg/m2,CSF组WC和BMI均明显高于正常血流组,两组比较差异有显著统计学意义,(P<0.01);BMI及WC与CSF多因素logistic回归分析提示, WC>85cm组患病危险OR及95%CI为1.628(1.425~1.859, P<0.05);BMI≥28kg/m2对CSF的患病危险OR及95%CI为3.710(3.148~4.371, P<0.05)。结论:BMI及WC与CSF相关,BMI及WC增高是冠状动脉慢血流的危险因素。%In the present study , we sought to investigate whether waist circumference (WC)levels and body mass index [BMI] are related in patients with isolated CSF compared to normal subjects . Coronary slow flow (CSF) phenomenon is defined as delayed coronary opacification in the absence of obstructive coronary artery disease . Methods:The consecutive patients who underwent coronary angiography(CAG) were identified . Those with normal left ventricular ejection fraction and normal coronary arteries were included in the study (n =184). TIMI frame counts were calculated , and data on comorbidities , and waist circumference , BMI were collected . CSF was defined as corrected TIMI frame count (CTFC)>27 . Results:There were no significant differences in general date between two groups , subjects with CSF were more obese(body mass index[BMI](30 . 9 ± 5 . 8)vs . (26 . 2 ± 4.3)kg/m2, P=0.003) and had high WC levels(93.9±12.1)vs.(80.3±8.7)cm,P=0

  19. Multislice computed tomography angiography in the diagnosis of coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    Zhong-Hua Sun; Yan Cao; Hua-Feng Li

    2011-01-01

    Multislice Cr angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease.Rapid improvements in multislice CT scanners over the last decade have allowed this technique to become a potentially effective alternative to invasive coronary angiography in patients with suspected coronary artery disease.High diagnostic value has been achieved with multisfice CT angiography with use of 64-and more slice CT scanners.In addition,multislice CT angiography shows accurate detection and analysis of coronary calcium,characterization of coronary plaques,as well as prediction of the disease progression and major cardiac events.Thus,patients can benefit from multislice CT angiography that provides a rapid and accurate diagnosis while avoiding unnecessary invasive coronary angiography procedures.The aim of this article is present an overview of the clinical applications of multislice CT angiography in coronary artery disease with a focus on the diagnostic accuracy of coronary artery disease;prognostic value of coronary artery disease with regard to the prediction of major cardiac events; detection and quantification of coronary calcium and characterization of coronary plaques.Limitations of multislice Cr angiography in coronary artery disease are also briefly discussed,and future directions are highlighted.

  20. Calcium in diet

    Science.gov (United States)

    ... D is needed to help your body use calcium. Milk is fortified with vitamin D for this reason. ... of calcium dietary supplements include calcium citrate and calcium carbonate. Calcium citrate is the more expensive form of ...

  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. A novel amorphous calcium phosphate drug-eluting stent:its biocompatibility after implantation into mini-swine coronary artery%新型纳米材料无定形磷酸钙药物支架置入小型猪冠状动脉后的生物相容性

    Institute of Scientific and Technical Information of China (English)

    谭峥; 李莉; 马燚

    2016-01-01

    BACKGROUND:As previously reported, poly-L-lactic acid stents have been mostly used as coronary artery stents, but this stent has a lack of early support force and produces some acidic products that wil induce local vascular inflammatory reactions. OBJECTIVE:To explore the biocompatibility of a novel amorphous calcium phosphate drug-eluting stent, after implantation into mini-swine coronary artery. METHODS:Twenty mini-swine were randomly equivalently divided into observation group and control group. The right femoral arteries of animals were separated layer by layer and the new type of biodegradable stent and poly-L-lactic acid stent were implanted, respectively. RESULTS AND CONCLUSION:The vessel lumes in the two groups were smooth and unobstructed showed by coronary artery angiography immediately after implantation. At 4 weeks after implantation, the coronary angiography showed the patency of vessel lumens with no stent thrombosis and stenosis in both two groups. The C-reactive protein levels in the two groups had no significant differences before and 4 weeks after stent implantation. At 4 weeks after implantation, the number of lymphocytes and inflammatory score in the observation group were significantly higher than those in the control group, but the neointimal area and percentage of stenosis area had no significant difference between the two groups. These results indicate that the novel amorphous calcium phosphate drug-eluting stent after implantation into mini-swine coronary artery has good biocompatibility.%背景:以往冠状动脉植入支架大多为聚左旋乳酸,但存在早期支撑力不足的问题,且会产生一定的酸性产物,导致血管局部出现炎性反应。  目的:探讨新型纳米材料无定形磷酸钙药物支架置入小型猪冠状动脉后的生物相容性。  方法:20只小型猪随机等分为观察组和对照组,对动物右侧股动脉予以逐层分离,分别置入新型生物全降解支架和

  3. Calcium supplement: humanity's double-edged sword.

    Science.gov (United States)

    Bunyaratavej, Narong; Buranasinsup, Shutipen

    2011-10-01

    The principle aim of the present study is to investigate the dark side of calcium, pollutions in calcium preparation especially lead (Pb), mercury (Hg) and cadmium (Cd). The collected samples were the different calcium salts in the market and 18 preparations which were classified into 3 groups: Calcium carbonate salts, Chelated calcium and natural-raw calcium. All samples were analyzed for lead, cadmium and mercury by inductively Coupled Plasma Mass Spectrometry (ICP-MS) technique, in house method based on AOAC (2005) 999.10 by ICP-MS. The calcium carbonate and the natural-raw calcium in every sample contained lead at 0.023-0.407 mg/kg of calcium powder. Meanwhile, the natural-raw calcium such as oyster, coral and animal bone showed amount of lead at 0.106-0.384 mg/kg with small amounts of mercury and cadmium. The chelated calcium such as calcium gluconate, calcium lactate and calcium citrate are free of lead.

  4. Calcium supplements

    Science.gov (United States)

    ... Related Bone Diseases National Resource Center. Calcium and vitamin D: Important at every age. NIAMS.NIH.gov website. www.niams.nih.gov/Health_Info/Bone/Bone_Health/Nutrition . Updated May 2015. Accessed March ...

  5. Calcium Electroporation

    DEFF Research Database (Denmark)

    Frandsen, Stine Krog; Gibot, Laure; Madi, Moinecha;

    2015-01-01

    BACKGROUND: Calcium electroporation describes the use of high voltage electric pulses to introduce supraphysiological calcium concentrations into cells. This promising method is currently in clinical trial as an anti-cancer treatment. One very important issue is the relation between tumor cell kill...... efficacy-and normal cell sensitivity. METHODS: Using a 3D spheroid cell culture model we have tested the effect of calcium electroporation and electrochemotherapy using bleomycin on three different human cancer cell lines: a colorectal adenocarcinoma (HT29), a bladder transitional cell carcinoma (SW780......), and a breast adenocarcinoma (MDA-MB231), as well as on primary normal human dermal fibroblasts (HDF-n). RESULTS: The results showed a clear reduction in spheroid size in all three cancer cell spheroids three days after treatment with respectively calcium electroporation (p

  6. 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...

  7. Coronary heart disease risk assessment and characterization of coronary artery disease using coronary CT angiography: comparison of asymptomatic and symptomatic groups

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Y. [Department of Radiology, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of); Kim, Y., E-mail: yookkim@ewha.ac.k [Department of Radiology, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of); Chung, I.-M. [Division of Cardiology in Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of); Ryu, J.; Park, H. [Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2010-08-15

    Aim: To evaluate the prevalence of coronary artery disease (CAD) in relation to risk of coronary heart disease (CHD) and assess plaque characteristics from coronary computed tomography (CT) angiography in asymptomatic and symptomatic patients. Materials and methods: Three hundred and ninety consecutive patients [asymptomatic group, n = 138; symptomatic group (atypical or non-anginal chest pain), n = 252] were retrospectively enrolled. They were subsequently classified into three CHD risk categories, based on the National Cholesterol Education Program guidelines, and 10 year risks of coronary events were calculated using Framingham risk score. CT was evaluated for stenosis, plaque composition, and coronary calcium scores. Results: CAD was observed in 42% of the asymptomatic group and 62% of the symptomatic group. In the former, the prevalence of CAD in low-, moderate- and high-risk subgroups was 21.4, 47.4 and 65%, respectively, and was 33.3, 74.4, and 72.4% in the symptomatic group. Framingham 10-year risks of coronary events were significantly higher in patients with CAD than in normal participants, and receiver operating characteristics curves showed that discriminatory power was poor in the asymptomatic group and symptomatic men, and good in symptomatic women. Of the participants in the asymptomatic group, 12% exhibited only non-calcified plaques and of the symptomatic group, 7% exhibited only non-calcified plaques. The coronary calcium score was significantly higher for significant stenosis than for non-significant stenosis in both groups. Conclusions: The prevalence of CAD was not negligible even in subgroups with low-to-moderate CHD risk. Additionally, the Framingham risk score was effective for predicting CAD only in symptomatic women. Coronary calcium scores correlated with significant stenosis; however, a sizeable percentage of both groups had only non-calcified plaques.

  8. Pathogenetic relationship between coronary heart disease and osteopenic syndrome

    Directory of Open Access Journals (Sweden)

    N. S. Mykhailovskaya

    2015-02-01

    Full Text Available The importance of the comorbidity problem of coronary heart disease and osteoporosis is caused by the rising prevalence, lack of early detection, prevention, severe complications and significant impact on the quality of life of the patients. Aim. In order to compile and submit a current point of view on the pathogenetic relationship between the coronary heart disease and the osteopenic syndrome we reviewed specialized literature. Conclusion. We established that coronary heart disease and osteoporosis have common mechanisms of progression involving a cascade of proinflammatory cytokines, osteoprotegerin, endothelial dysfunction, estrogen, calcium deficiency, the renin-angiotensin-aldosterone and sympathetic nervous system.

  9. 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...

  10. Arginine methylation dysfunction increased risk of acute coronary syndrome in coronary artery disease population

    Science.gov (United States)

    Zhang, Shengyu; Zhang, Shuyang; Wang, Hongyun; Wu, Wei; Ye, Yicong

    2017-01-01

    Abstract The plasma levels of asymmetric dimethylarginine (ADMA) had been proved to be an independent cardiovascular risk factor. Few studies involved the entire arginine methylation dysfunction. This study was designed to investigate whether arginine methylation dysfunction is associated with acute coronary syndrome risk in coronary artery disease population. In total 298 patients undergoing coronary angiography because of chest pain with the diagnosis of stable angina pectoris or acute coronary syndrome from February 2013 to June 2014 were included. Plasma levels of free arginine, citrulline, ornithine, and the methylated form of arginine, ADMA, and symmetric dimethylarginine (SDMA) were measured with high-performance liquid chromatography coupled with tandem mass spectrometry. We examined the relationship between arginine metabolism-related amino acids or arginine methylation index (AMI, defined as ratio of [arginine + citrulline + ornithine]/[ADMA + SDMA]) and acute coronary events. We found that plasma ADMA levels were similar in the stable angina pectoris group and the acute coronary syndrome group (P = 0.88); the AMI differed significantly between 2 groups (P angina and acute coronary syndrome patients; AMI might be an independent risk factor of acute coronary events in coronary artery disease population. PMID:28207514

  11. 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.)

  12. Eight genetic loci associated with variation in lipoprotein-associated phospholipase A2 mass and activity and coronary heart disease: meta-analysis of genome-wide association studies from five community-based studies

    Science.gov (United States)

    Grallert, Harald; Dupuis, Josée; Bis, Joshua C.; Dehghan, Abbas; Barbalic, Maja; Baumert, Jens; Lu, Chen; Smith, Nicholas L.; Uitterlinden, André G.; Roberts, Robert; Khuseyinova, Natalie; Schnabel, Renate B.; Rice, Kenneth M.; Rivadeneira, Fernando; Hoogeveen, Ron C.; Fontes, João Daniel; Meisinger, Christa; Keaney, John F.; Lemaitre, Rozenn; Aulchenko, Yurii S.; Vasan, Ramachandran S.; Ellis, Stephen; Hazen, Stanley L.; van Duijn, Cornelia M.; Nelson, Jeanenne J.; März, Winfried; Schunkert, Heribert; McPherson, Ruth M.; Stirnadel-Farrant, Heide A.; Psaty, Bruce M.; Gieger, Christian; Siscovick, David; Hofman, Albert; Illig, Thomas; Cushman, Mary; Yamamoto, Jennifer F.; Rotter, Jerome I.; Larson, Martin G.; Stewart, Alexandre F.R.; Boerwinkle, Eric; Witteman, Jacqueline C.M.; Tracy, Russell P.; Koenig, Wolfgang; Benjamin, Emelia J.; Ballantyne, Christie M.

    2012-01-01

    Aims Lipoprotein-associated phospholipase A2 (Lp-PLA2) generates proinflammatory and proatherogenic compounds in the arterial vascular wall and is a potential therapeutic target in coronary heart disease (CHD). We searched for genetic loci related to Lp-PLA2 mass or activity by a genome-wide association study as part of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. Methods and results In meta-analyses of findings from five population-based studies, comprising 13 664 subjects, variants at two loci (PLA2G7, CETP) were associated with Lp-PLA2 mass. The strongest signal was at rs1805017 in PLA2G7 [P = 2.4 × 10−23, log Lp-PLA2 difference per allele (beta): 0.043]. Variants at six loci were associated with Lp-PLA2 activity (PLA2G7, APOC1, CELSR2, LDL, ZNF259, SCARB1), among which the strongest signals were at rs4420638, near the APOE–APOC1–APOC4–APOC2 cluster [P = 4.9 × 10−30; log Lp-PLA2 difference per allele (beta): −0.054]. There were no significant gene–environment interactions between these eight polymorphisms associated with Lp-PLA2 mass or activity and age, sex, body mass index, or smoking status. Four of the polymorphisms (in APOC1, CELSR2, SCARB1, ZNF259), but not PLA2G7, were significantly associated with CHD in a second study. Conclusion Levels of Lp-PLA2 mass and activity were associated with PLA2G7, the gene coding for this protein. Lipoprotein-associated phospholipase A2 activity was also strongly associated with genetic variants related to low-density lipoprotein cholesterol levels. PMID:22003152

  13. 氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的疗效观察%Effect Observation of Amlodipine Atorvastatin Calcium Tablets Treatment of Hypertension With Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    查树德

    2016-01-01

    目的:研究分析氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的临床疗效。方法选取2015年2月~2016年2月在我院住院治疗的136例高血压合并冠心病患者,通过计算机进行随机性分组,一组68例患者应用阿托伐他汀钙片进行治疗设为对照组;一组68例患者应用氨氯地平阿托伐他汀钙片进行治疗设为研究组,对比分析治疗前、后两组患者的血压、血脂水平变化情况。结果研究组患者血压水平小于对照组,差异有统计学意义,P<0.05。研究组患者LDL-C、TC、TG水平低于对照组,而HDL-C水平高于对照组,差异有统计学意义, P<0.05。结论氨氯地平阿托伐他汀钙片治疗高血压合并冠心病患者,可有效控制其血压、血脂水平,疗效理想。%Objective To study the clinical curative effect of amlodipine and atorvastatin in treatment of hypertension and coronary heart disease. Methods Hospitalized patients in our hospital during the period of the February 2015~February 2016 136 cases of hypertension combined in patients with coronary heart disease were selected. Through the computer random grouping, a set of 68 cases patients treated with atorvastatin cutting atorvastatin calcium treatment were set as control group, a group of 68 cases patients treated with amlodipine and atorvastatin cutting atorvastatin calcium treatment were set as the study group, comparative analysis before treatment, after two groups of patients with blood pressure, changes in lipid levels.Results The blood pressure level of patients in study group were signiifcantly lower than that of control group, the difference was statistically signiifcantP<0.05. Patients in the study group LDL-C, TC and TG levels were signiifcantly lower than the control group, while the level of HDL-C was signiifcantly higher than the control group, the difference was statistically signiifcant P<0.05.Conclusion Amlodipine and atorvastatin

  14. Chronic use of the calcium channel blocker nifedipine effected on bone metabolism in elder with coronary heart disease%老年冠心病患者长期应用硝苯地平对骨代谢及功能的影响

    Institute of Scientific and Technical Information of China (English)

    陈斌

    2013-01-01

    目的:硝苯地平(NIF)临床广泛用于调节心率,本文主要研究年冠心病患者长期应用NIF对骨代谢及功能的影响。探讨NIF应用1年后对碱性磷酸酶(ALP)活性、骨钙蛋白(OCN)和钙离子水平的影响,为治疗骨代谢性疾病提供理论性的依据。方法:本研究筛选160名老年冠心病患者,均参加NIF治疗临床跟踪随访1年,观测并评价NIF的疗效及对骨代谢及功能。结果:本研究所有病例用药前与用药后,男性和女性体内的钙离子水平均显著升高(P0.05)。结论:对于长期使用NIF的老年患者,应当及时监测骨骼代谢水平以及骨骼发育状况评价指标,提前预防骨质疏松。%Calcium channel blockers have been reported to have such diverse effects as reduction in protein synthesis, diminished incorporation of proline into new col agen, and decreased hormone release in vitro. The study screened 160 elderly patients with coronary heart disease, are members of nifedipine treatment of clinical fol ow-up 1 year, observation and evaluation of nifedipine and its effect on bone metabolism and function. Results: In this study, al cases before treatment and after treatment, the average male and female body calcium ion water was significantly higher (P 0.05). Conclusion: In patients with long-term use of nifedipine should be timely monitoring of bone metabolism and bone development status evaluation, prevention of osteoporosis in advance. In summary, chronic nifedipine use in males is associated with adverse effect on bone metabolism in elder with coronary heart disease.

  15. 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.

  16. The effects of dietary calcium and protein intake on bone mass in adolescents in Beijing%青春期学生膳食钙和蛋白质对骨量的影响

    Institute of Scientific and Technical Information of China (English)

    吴非同; 胡小琪; 檀倩影; 左娇蕾; 王晓君; 卢佳希; 黄振武; 张倩

    2011-01-01

    目的 探索北京郊区青春期学生的膳食钙及蛋白质摄入与全身和股骨颈骨量之间的关系.方法 多层随机整群抽样的方法,选取北京怀柔区342名12~16岁学生(男生170人,女生172人).采用3d24h膳食回顾调查问卷了解膳食摄人情况.采用双能X线骨密度测量仪(Dual-energy X-rays absorptiometry,DXA)测量全身及股骨颈骨量.结果 研究对象平均每天膳食钙和蛋白质摄人量分别为316mg和70g.多元逐步回归分析发现:无论低钙组或高钙组中,体重和身高都是全身和股骨颈骨密度(bone mineral density,BMD)、骨矿物含量(bone mineral content,BMC)的主要影响因素,其他影响因素还包括性别、年龄、能量和钙、蛋白质、脂肪、碳水化合物及铁等营养素.调整性别、年龄、身高等混杂因素时,全身BMD、BMC在高钙低蛋白组最高(分别为0.804 g/m2,2010 g),而在低钙高蛋白组最低(分别为0.708 g/m2,1660 g;P <0.05).股骨BMD在高钙低蛋白组(0.809 g/m2)最高,BMC在低钙低蛋白组(3.8g)最高,而两者均在高钙高蛋白组最低(0.752 g/m2,3.51g;P <0.05).进一步调整体重后,上述差异的显著性消失.结论 除性别和年龄等不可控因素外,对北京郊区学生全身和股骨颈骨量影响最大的是体重和身高.对于钙摄入量不足的北京郊区青春期少年,高蛋白质、低钙饮食通过影响体重的变化间接地对全身和股骨颈BMD、BMC产生不利影响.%Objective To explore the relationship between dietary calcium and protein intake and bone mass of the total body and the femur in adolescents of rural area of Beijing. Methods A total of 342 12-16-year-old students (170 boys and 172 girls) in Huairou district, Beijing, were selected using multi-layer random cluster sampling method. A consecutive 3-day-food questionnaire was used to understand the dietary intake. Dual energy X-ray absorptiometry (DXA ) was used to measure the bone mass of total body and the femur

  17. Coronary CT: clinical indications and future directions; Tomografia de coronarias: indicacoes clinicas e perspectivas futuras

    Energy Technology Data Exchange (ETDEWEB)

    Nomura, Cesar H.; Serpa, Bruna S.; Kay, Fernando U.; Szarf, Gilberto; Passos, Rodrigo B.; Neto, Roberto S.; Chate, Rodigo C.; Funar, Marcelo B., E-mail: cesarnomura@gmail.com [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil); Cury, Roberto C. [Hospital Samaritano, Sao Paulo, SP (Brazil)

    2011-01-15

    Multidetector computed tomography (MDCT) has started its implementation in cardiology with calcium quantification of coronary plaques in the study without contrast, using the calcium score, demonstrating an important independent predictor of future cardiac events. The examination with intravenous contrast, coronary angiography, appeared later as a noninvasive method for evaluation of anatomy and obstructive coronary disease, characterizing the degree of stenosis and the presence of non calcified atherosclerotic plaques, assessing not only the lumen, but also the vessel wall. With the advent of new machines with more detectors and higher temporal resolution has been a reduction in radiation dose and the possibility of new applications. (author)

  18. Obesidade e intervenção coronariana: devemos continuar valorizando o Índice de Massa Corpórea? Obesity and coronary intervention: should we continue to use Body Mass Index as a risk factor?

    Directory of Open Access Journals (Sweden)

    José Carlos Estival Tarastchuk

    2008-05-01

    Full Text Available FUNDAMENTO: Para discriminar risco coronariano elevado, indicadores de obesidade central são melhores do que o Índice de Massa Corpórea (IMC, que é ainda o índice antropométrico (IA mais utilizado para seguimento após intervenção coronariana percutânea (ICP. OBJETIVO: Reconhecer, entre os índices antropométricos (IA, os que melhor se correlacionam com ocorrência de desfechos após intervenção coronariana percutânea (ICP. MÉTODOS: Foram considerados 308 pacientes (p, idade média de 61,92±11,06 anos, 60,7% do sexo masculino, submetidos a ICP com stent. Após seis meses, pesquisaram-se os desfechos: óbito, reintervenção por ICP ou cirurgia cardíaca, exame não-invasivo alterado por isquemia ou sintomas anginosos. Os p foram divididos em: Grupo 1 (com desfechos, n=91; 29,5% e Grupo 2 (sem desfechos, n=217; 70,45%. No sexo masculino e feminino, os IA estudados e seus respectivos pontos de corte foram: circunferência abdominal (CA > 90/80 cm, relação cintura-quadril (RCQ > 0,90/0,80cm, índice de conicidade (IC >1,25/1,18 e índice de massa corpórea (IMC >30 para ambos os sexos. RESULTADOS: Os grupos diferiram quanto à maior ocorrência de histórico familiar e infarto prévio no Grupo 2. No sexo masculino, CA > 90 cm (p=0,0498 foi, em análise multivariada, preditor independente de desfechos. IMC não foi preditor de eventos. No Grupo 1, a probabilidade de ocorrência de IMC alterada é significativamente menor do que a ocorrência dos outros IA estudados (pBACKGROUND: Central anthropometric indexes are better than the body mass index to discriminate elevated coronary risk. However, the Body Mass Index (BMI is still the most frequently studied anthropometric index on outcomes of patients undergoing percutaneous coronary angioplasty (PCI. OBJECTIVE: To recognize, among several anthropometric indexes of obesity, which one best discriminates MACE (Major Adverse Cardiac Events after PCI. METHODS: Subjects were 308 patients

  19. Escore de cálcio coronariano prediz estenose e eventos na insuficiência renal crônica pré-transplante Score de calcio coronario predice estenosis y eventos en la insuficiencia renal crónica pre trasplante Coronary calcium score as predictor of stenosis and events in pretransplant renal chronic failure

    Directory of Open Access Journals (Sweden)

    Miguel Abraão Rosário

    2010-02-01

    este grupo. La evaluación del score de calcio coronario (SCC por tomografía computarizada ha estado comprobando valor pronóstico en la población sin enfermedad renal. OBJETIVO: Evaluar la exactitud del SCC para detectar EAC obstructiva y prever eventos cardiovasculares en candidatos a trasplante renal comparada a la angiografía coronaria invasiva (ACI cuantitativa. MÉTODOS: Se evaluaron a 97 pacientes con IRC y edad > 35 años. Se consideró como EAC obstructiva la presencia de estenosis > 50% o > 70% por la ACI. Datos descriptivos, concordancia, pruebas diagnósticas, Kaplan-Meier y análisis multivariado se utilizaron. RESULTADOS: El score de Agatston promedio fue de 580,6 ± 1.102,2; los valores mínimos y máximos fueron 0 y 7.994, y mediana de 176. Solamente 14 pacientes tenían score de calcio de cero. No hubo diferencias entre las etnias y la mayor presencia de calcio regional se asoció a la mayor probabilidad de estenosis coronaria en el mismo segmento. El score de calcio de Agatston presentó buena exactitud para el diagnóstico de estenosis, > 50% y > 70% con área bajo la curva ROC de 0,75 y 0,70, respectivamente. En el umbral de 400, el score de calcio identificó el subgrupo con mayor tasa de eventos cardiovasculares en tiempo promedio de seguimiento de 29,1 ± 11,0 meses. CONCLUSIÓN: El SCC en la evaluación de EAC presentó una buena performance diagnóstica y pronostica para eventos cardiovasculares en pacientes con insuficiencia renal crónica (IRC.BACKGROUND: Coronary artery disease (CAD is the major cause of death among chronic renal failure (CRF patients. Traditional, non-invasive exams to detect CAD and to predict events have shown insufficient results in this group. CT Scan evaluation of Coronary Calcium Score (CCS has proven to be of prognostic value for the population reporting no renal condition. OBJECTIVE: To investigate CCS accuracy in detecting obstructive CAD and in predicting cardiovascular events in candidates to renal transplant

  20. Coronary heart disease

    Science.gov (United States)

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... slow down or stop. A risk factor for heart disease is something that increases your chance of getting ...

  1. Calcium and bones

    Science.gov (United States)

    Bone strength and calcium ... calcium (as well as phosphorus) to make healthy bones. Bones are the main storage site of calcium in ... your body does not absorb enough calcium, your bones can get weak or will not grow properly. ...

  2. Impact of Body Mass Index on Short-Term Outcomes in Patients Undergoing Percutaneous Coronary Intervention in Newfoundland and Labrador, Canada

    Directory of Open Access Journals (Sweden)

    Anne B. Gregory

    2016-01-01

    Full Text Available Background and Aim. Obesity (BMI ≥ 30 kg/m2 is associated with advanced cardiovascular disease requiring procedures such as percutaneous coronary intervention (PCI. Studies report better outcomes in obese patients having these procedures but results are conflicting or inconsistent. Newfoundland and Labrador (NL has the highest rate of obesity in Canada. The aim of the study was to examine the relationship between BMI and vascular and nonvascular complications in patients undergoing PCI in NL. Methods. We studied 6473 patients identified in the APPROACH-NL database who underwent PCI from May 2006 to December 2013. BMI categories included normal, 18.5 ≤ BMI < 25.0 (n=1073; overweight, 25.0 ≤ BMI < 30 (n=2608; and obese, BMI ≥ 30.0 (n=2792. Results. Patients with obesity were younger and had a higher incidence of diabetes, hypertension, and family history of cardiac disease. Obese patients experienced less vascular complications (normal, overweight, and obese: 8.2%, 7.2%, and 5.3%, p=0.001. No significant differences were observed for in-lab (4.0%, 3.3%, and 3.1%, p=0.386 or postprocedural (1.0%, 0.8%, and 0.9%, p=0.725 nonvascular complications. After adjusting for covariates, BMI was not a significant factor associated with adverse outcomes. Conclusion. Overweight and obesity were not independent correlates of short-term vascular and nonvascular complications among patients undergoing PCI.

  3. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008417 Efficacy comparison with low and high dose natroparin for patients with acute coronary syndrome underwent percutancous coronary intervention. SUN Chaoyu(孙超宇), et al. Dept Cardiol, 4th Affili Hosp, Harbin Med Univ, Harbin 150001. Chin J Cardiol 2008;36(6):493-496. Objective To evaluate the safety and optimal piror percutaneous coronary intervention (PCI) natroparin dose in patients with acute coronary syndrome (ACS).

  4. Calcium Carbonate

    Science.gov (United States)

    ... doctor if you have or have ever had kidney disease or stomach conditions.tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking calcium carbonate, call your doctor.

  5. Calcium Test

    Science.gov (United States)

    ... if a person has symptoms of a parathyroid disorder , malabsorption , or an overactive thyroid. A total calcium level is often measured as part of a routine health screening. It is included in the comprehensive metabolic panel (CMP) and the basic metabolic panel (BMP) , ...

  6. Coronary atherosclerosis evaluation among Iranian patients with zero coronary calcium score in computed tomography coronary angiography

    Directory of Open Access Journals (Sweden)

    Maryam Moradi

    2016-01-01

    Conclusion: Although, CAC scoring is a noninvasive and valuable method to evaluate CAD; but zero CAC score does not absolutely exclude the CAD, especially in the presence of risk factors such as diabetes, hyperlipidemia, and smoking.

  7. Coronary CTA assessment of coronary anomalies.

    NARCIS (Netherlands)

    Pursnani, A.; Jacobs, J.E.; Saremi, F.; Levisman, J.; Makaryus, A.N.; Capunay, C.; Rogers, I.S.; Wald, C.; Azmoon, S.; Stathopoulos, I.A.; Srichai, M.B.

    2012-01-01

    Coronary anomalies occur in <1% of the general population and can range from a benign incidental finding to the cause of sudden cardiac death. The coronary anomalies are classified here according to the traditional grouping into those of origin and course, intrinsic arterial anatomy, and

  8. Coronary CTA assessment of coronary anomalies.

    NARCIS (Netherlands)

    Pursnani, A.; Jacobs, J.E.; Saremi, F.; Levisman, J.; Makaryus, A.N.; Capunay, C.; Rogers, I.S.; Wald, C.; Azmoon, S.; Stathopoulos, I.A.; Srichai, M.B.

    2012-01-01

    Coronary anomalies occur in <1% of the general population and can range from a benign incidental finding to the cause of sudden cardiac death. The coronary anomalies are classified here according to the traditional grouping into those of origin and course, intrinsic arterial anatomy, and terminat

  9. The sex-specific relationship between body mass index and coronary heart disease: A systematic review and meta-analysis of 95 cohorts with 1.2 million participants

    Science.gov (United States)

    Mongraw-Chaffin, Morgana L.; Peters, Sanne A.E.; Huxley, Rachel R.; Woodward, Mark

    2015-01-01

    Background Risk for coronary heart disease (CHD) differs by sex, and accumulating evidence suggests sex differences in the effect of coronary risk factors on vascular risk. To date, the existence of a sex difference in the relationship between body mass index (BMI) with CHD has yet to be systematically examined. As sexual dimorphisms in body composition exist, we hypothesized that the relationship between body mass index (BMI) and CHD would differ in women and men. Methods From systematic searches of PubMed and EMBASE up to February 2015, we identified 32 published studies of the longitudinal association between BMI and CHD in women and men from population-based cohorts. We also included individual participant data from four large studies. Study results were pooled using random effect models with inverse variance weighting. Findings Data from 95 cohorts, 1,219,187 participants, and 37,488 incident cases of CHD were included. Higher BMI was significantly associated with age-adjusted incident CHD: hazard ratios (95% confidence interval) in women and men were 1.04 (1.03–1.05) and 1.05 (1.04–1.07) for one unit BMI, 1.25(1.05–1.49), 1.09(0.91–1.23) for underweight, 1.20 (1.12–1.29), 1.22 (1.12–1.32) for overweight, 1.61 (1.42–1.82) and 1.60 (1.43–1.79) for obesity, respectively). Overall, there was no sex difference in these associations. The women-to-men ratio of the hazard ratios were 0.99 (0.98–1.00) for one unit BMI; 1.08 (0.89–1.31) for underweight; 1.00(0.92–1.07) for overweight; and, 1.05(0.94–1.17) for obesity. Similar results were obtained after multiple-adjustment and in a range of sensitivity analyses. Interpretation Higher BMI, measured continuously and categorically, has the same deleterious effects on risk of incident CHD in women and men across diverse populations. PMID:25960160

  10. Calcium paradox and calcium entry blockers

    NARCIS (Netherlands)

    Ruigrok, T.J.C.; Slade, A.M.; Nayler, W.G.; Meijler, F.L.

    1984-01-01

    Reperfusion of isolated hearts with calcium-containing solution after a short period of calcium-free perfusion results in irreversible cell damage (calcium paradox). This phenomenon is characterized by an excessive influx of calcium into the cells, the rapid onset of myocardial contracture, exhausti

  11. Calpains and Coronary Vascular Disease.

    Science.gov (United States)

    Potz, Brittany A; Sabe, Ashraf A; Abid, M Ruhul; Sellke, Frank W

    2016-01-01

    Despite many advances in percutaneous and surgical interventions in the treatment of coronary artery disease (CAD), up to one-third of patients are still either not candidates or receive suboptimal revascularization. Calpains are a class of calcium-activated non-lysosomal cysteine proteases that serve as a proteolytic unit for cellular homeostasis. Uncontrolled activation of calpain has been found to be involved in the pathogenesis of myocardial reperfusion injury, cardiac hypertrophy, myocardial stunning and cardiac ischemia. Inhibition of calpains has been shown to significantly attenuate myocardial stunning and reduced infarct size after ischemia-reperfusion. Calpain inhibition therefore serves as a potential medical therapy for patients suffering from a number of diseases, including CAD.

  12. Serum osteocalcin is associated with dietary vitamin D, body weight and serum magnesium in postmenopausal women with and without significant coronary artery disease.

    Science.gov (United States)

    Alissa, Eman M; Alnahdi, Wafa A; Alama, Nabeel; Ferns, Gordon A

    2014-01-01

    Osteoporosis and atherosclerosis often present atypically in postmenopausal women, making clinical recognition difficult. Prospective studies suggest independent associations between bone mass and vascular calcification through vitamin D deficiency as an established predictor of both conditions. We aimed to examine the relationship between serum osteocalcin and vitamin D status in postmenopausal women with and without angiographic evidence of coronary artery disease (CAD). One hundred and eighty postmenopausal women undergoing coronary angiography were selected sequentially from the Catheterization unit of King Abdulaziz University Hospital. Socio-demographic, anthropometric parameters and dietary habits were measured. Biochemical variables were estimated in blood samples. Half of the postmenopausal women did not have significant CAD, 24% had significant CAD in a single and/or double coronary vessels, 26% had significant CAD in three coronary vessels. Mean serum vitamin D concentrations showed that vitamin D deficiency was a common finding in the whole population. Vitamin D and calcium intakes were uniformly low in the study cohort. Serum osteocalcin was significantly correlated with dietary vitamin D in all subgroups (r=-0.172, pmagnesium, alkaline phosphatase, dietary vitamin D, and body weight were independent variables of serum osteocalcin level. In conclusion, elevated levels of serum C reactive protein and vitamin D were associated with low serum osteocalcin levels. Therefore, osteocalcin may be a potential cardiovascular risk marker. However, further studies are needed to clarify the pathophysiological processes underlying the relationship between serum osteocalcin level and atherosclerosis parameters.

  13. Anatomic Fat Depots and Coronary Plaque Among Human Immunodeficiency Virus-Infected and Uninfected Men in the Multicenter AIDS Cohort Study.

    Science.gov (United States)

    Palella, Frank J; McKibben, Rebeccah; Post, Wendy S; Li, Xiuhong; Budoff, Matthew; Kingsley, Lawrence; Witt, Mallory D; Jacobson, Lisa P; Brown, Todd T

    2016-04-01

    Methods.  In a cross-sectional substudy of the Multicenter AIDS Cohort Study, noncontrast cardiac computed tomography (CT) scanning for coronary artery calcium (CAC) scoring was performed on all men, and, for men with normal renal function, coronary CT angiography (CTA) was performed. Associations between fat depots (visceral adipose tissue [VAT], abdominal subcutaneous adipose tissue [aSAT], and thigh subcutaneous adipose tissue [tSAT]) with coronary plaque presence and extent were assessed with logistic and linear regression adjusted for age, race, cardiovascular disease (CVD) risk factors, body mass index (BMI), and human immunodeficiency virus (HIV) parameters. Results.  Among HIV-infected men (n = 597) but not HIV-uninfected men (n = 343), having greater VAT was positively associated with noncalcified plaque presence (odds ratio [OR] = 1.04, P aSAT and tSAT and greater median VAT among men with BMI aSAT and extent of total plaque among HIV-infected men, but not among HIV-uninfected men. Lower tSAT was associated with greater CAC and total plaque score extent regardless of HIV serostatus. Conclusions.  The presence of greater amounts of VAT and lower SAT may contribute to increased risk for coronary artery disease among HIV-infected persons.

  14. Calcium channel blockers in cardiovascular pharmacotherapy.

    Science.gov (United States)

    Godfraind, Theophile

    2014-11-01

    This paper summarizes the pharmacological properties of calcium channel blockers (CCBs), their established therapeutic uses for cardiovascular disorders and the current improvement of their clinical effects through drug combinations. Their identification resulted from study of small molecules including coronary dilators, which were named calcium antagonists. Further experiments showed that they reduced contraction of arteries by inhibiting calcium entry and by interacting with binding sites identified on voltage-dependent calcium channels. This led to the denomination calcium channel blockers. In short-term studies, by decreasing total peripheral resistance, CCBs lower arterial pressure. By unloading the heart and increasing coronary blood flow, CCBs improve myocardial oxygenation. In long-term treatment, the decrease in blood pressure is more pronounced in hypertensive than in normotensive patients. A controversy on the safety of CCBs ended after a large antihypertensive trial (ALLHAT) sponsored by the National Heart, Lung, and Blood Institute. There are two main types of CCBs: dihydopyridine and non-dihydropyridine; the first type is vascular selective. Dihydropyrines are indicated for hypertension, chronic, stable and vasospastic angina. Non-dihydropyridines have the same indications plus antiarrythmic effects in atrial fibrillation or flutter and paroxysmal supraventricular tachycardia. In addition, CCBs reduced newly formed coronary lesions in atherosclerosis. In order to reach recommended blood pressure goals, there is a recent therapeutic move by combination of CCBs with other antihypertensive agents particularly with inhibitors acting at the level of the renin-angiotensin system. They are also combined with statins. Prevention of dementia has been reported in hypertensive patients treated with nitrendipine, opening a way for further studies on CCBs' beneficial effect in cognitive deterioration associated with aging.

  15. The Preventive Effect of Calcium Supplementation on Weak Bones Caused by the Interaction of Exercise and Food Restriction in Young Female Rats During the Period from Acquiring Bone Mass to Maintaining Bone Mass

    OpenAIRE

    Aikawa, Yuki; Agata, Umon; Kakutani, Yuya; Kato, Shoyo; Noma, Yuichi; Hattori, Satoshi; Ogata, Hitomi; Ezawa, Ikuko; Omi, Naomi

    2016-01-01

    Increasing calcium (Ca) intake is important for female athletes with a risk of weak bone caused by inadequate food intake. The aim of the present study was to examine the preventive effect of Ca supplementation on low bone strength in young female athletes with inadequate food intake, using the rats as an experimental model. Seven-week-old female Sprague-Dawley rats were divided into four groups: the sedentary and ad libitum feeding group (SED), voluntary running exercise and ad libitum feedi...

  16. Impact of cigarette smoking on the relationship between body mass index and coronary heart disease: a pooled analysis of 3264 stroke and 2706 CHD events in 378579 individuals in the Asia Pacific region

    Directory of Open Access Journals (Sweden)

    2009-08-01

    Full Text Available Abstract Background Elevated levels of body mass index (BMI and smoking are well established lifestyle risk factors for coronary heart disease (CHD and stroke. If these two risk factors have a synergistic relationship, rigorous lifestyle modification may contribute to greater reduction in cardiovascular burden than previously expected. Methods A pooled analysis of individual participant data from 38 cohorts, involving 378,579 participants. Hazards ratios (HRs and 95% confidence intervals (CIs for BMI by cigarette smoking status were estimated using Cox proportional hazard models. Results During a mean follow-up of 3.8 years, 2706 CHD and 3264 strokes were recorded. There was a log-linear, positive relationship of BMI with CHD and stroke in both smokers and non-smokers with evidence of a synergistic effect of smoking on the association between BMI and CHD only: HRs (95% CIs associated with a 2 kg/m2 higher BMI were 1.13 (1.10 – 1.17 in current smokers and 1.09 (1.06 – 1.11 in non-smokers (p-value for interaction = 0.04. Conclusion Smoking amplifies the positive association between BMI and CHD but not stroke. If confirmed, these results suggest that effective strategies that target smoking cessation and weight loss are likely to have a greater impact than anticipated on reducing the burden of CHD.

  17. The coronary heart team.

    Science.gov (United States)

    Yanagawa, Bobby; Puskas, John D; Bhatt, Deepak L; Verma, Subodh

    2017-09-01

    The concept of a Coronary Heart Team has generated increased interest, including support from major practice guidelines. Here, we review the rationale and the published experience of Coronary Heart Teams. A Coronary Heart Team should be led by both cardiology and cardiac surgery with a shared decision-making approach. The team should incorporate data from anatomic and clinical risk prediction models to offer individualized care. Most teams focus on management of complex patients and those with indications for both coronary artery bypass graft and percutaneous coronary intervention. The potential benefits of a Coronary Heart Team include balanced decision-making, greater adherence to evidence-based practice guidelines, as well as promoting greater collegiality and exchange of knowledge between specialties. Single-center series have demonstrated consistency in decision-making by Coronary Heart Teams but prospective data demonstrating improved patient outcomes and/or cost effectiveness are necessary. The concept of a Coronary Heart Team is gaining traction for patients with complex coronary artery disease. There is a growing literature in support of Coronary Heart Teams but comparative and prospective data demonstrating improved patient outcomes are needed.

  18. Topographic association of angioscopic yellow plaques with coronary atherosclerotic plaque: assessment with quantitative colorimetry in human coronary artery autopsy specimens.

    Science.gov (United States)

    Ishibashi, Fumiyuki; Lisauskas, Jennifer B; Kawamura, Akio; Waxman, Sergio

    2008-01-01

    Yellow plaques seen during coronary angioscopy are thought to be the surrogates for superficial intimal lipids in coronary plaque. Given diffuse and heterogeneous nature of atherosclerosis, yellow plaques in coronaries may be seen as several yellow spots on diffuse coronary plaque. We examined the topographic association of yellow plaques with coronary plaque. In 40 non-severely stenotic ex-vivo coronary segments (average length: 52.2 +/- 3.1 mm), yellow plaques were examined by angioscopy with quantitative colorimetry. The segments were cut perpendicular to the long axis of the vessel at 2 mm intervals, and 1045 slides with 5 microm thick tissue for whole segments were prepared. To construct the plaque surface, each tissue slice was considered to be representative of the adjacent 2 mm. The circumference of the lumen and the lumen border of plaque were measured in each slide, and the plaque surface region was constructed. Coronary plaque was in 37 (93%) of 40 segments, and consisted of a single mass [39.9 +/- 3.9 (0-100) mm, 311.3 +/- 47.4 (0.0-1336.2) mm2]. In 30 (75%) segments, multiple (2-9) yellow plaques were detected on a mass of coronary plaque. The number of yellow plaques correlated positively with coronary plaque surface area (r = 0.77, P colorimetry, some of them are associated with lipid cores underneath thin fibrous caps, may be used to assess the extent of coronary plaque. Further research using angioscopy could be of value to study the association of high-risk coronaries with acute coronary syndromes.

  19. CORONARY ANGIOGRAPHY WITH DUAL SOURCE COMPUTED TOMOGRAPHY: INITIAL EXPERIENCE

    Institute of Scientific and Technical Information of China (English)

    Zhu-hua Zhang; Wen-min Zhao; Wen-bin Mou; Li-ren Zhang; Wen-ling Zhu; Qi Miao; Qi Fang; Zheng-yu Jin; Shu-yang Zhang; Song-bai Lin; Dong-jing Li; Ling-yan Kong; Yi-ning Wang; Lan Song; Yun Wang

    2007-01-01

    To explore the scan technique and image quality of coronary angiography with dual source computed tomography (CT) without oral metoprolol preparation.Methods Plain and enhanced dual source CT coronary angiography without oral metoprolol preparation was prospectively performed in 600 patients. Calcium scoring with plain scan images as well as multi-planar reconstruction( MPR ), maximum intensity projection (MIP), and volume rendering technique (VRT) reconstruction with enhanced scan images were performed in all cases. The scan technique and post-reconstruction experience was summarized. The image quality was classified as 1 to 4 points, and coronary segments classified according to the American Heart Association standards were evaluated.Results The average calcium score of the 600 cases was 213.6 ± 298.7 (0-3 216. 5). The average heart rate of the enhanced scan was 82.1 ± 16.2 (47-139) bpm. The post-reconstruction methods with which coronary segments could be shown as best as possible consisted of single phase reconstruction method, two or more phases supplemented method, and electrocardiogram editing method. Altogether 8 457 coronary segments were evaluated, among which 97.2% were evaluated as point 1, 1.7% point 2, 0.5% point 3, and0.6% point 4. The coronary segments in 261 cases were completely normal, while 360 segments were diagnosed with < 50% stenosis and 625 segments with ≥50%stenosis.Conclusions Excellent coronary artery image can be obtained with dual source CT in patients with any heart rate without oral metoprolol preparation. Heart rate is not a major source of the artifact, coronary segments can be well shown with single or multiple-phase reconstruction method.

  20. Addition of 1, 2 and 3% in mass of sodium alginate in calcium phosphate cement; Adicao de alginato de sodio a cimento de fosfato de calcio

    Energy Technology Data Exchange (ETDEWEB)

    Coelho, W.T.; Fernandes, J.M.; Vieira, R.S.; Thurmer, M.B.; Santos, L.A., E-mail: trajano@ufrgs.br [Universidade Federal do Rio Grande do Sul (LABIOMAT/UFRS), RS (Brazil)

    2011-07-01

    The calcium phosphate cement (CFC) are bone substitutes with great potential for use in orthopedics, traumatology and dentistry because of their biocompatibility, bioactivity, osteoconductivity and osteotransdutivity, and a paste that can be easily molded and placed into the surgical site. However, CFCs have low mechanical strength, which equals the maximum mechanical strength of trabecular bone. Aiming to evaluate the strength and time to handle a CFC phase composed mainly of alpha were added to sodium alginate (1%, 2% and 3% wt) and an accelerator handle in an aqueous medium. The cement powder was mixed with liquid takes 2 minutes and resigned in specimens and assessed for apparent density and porosity by the Archimedes method, X-ray diffraction and mechanical strength. We noticed a significant increase in mechanical properties of cement added sodium alginate. (author)

  1. 64-slice coronary computed tomography angiography using low tube voltage of 80 kV in subjects with normal body mass indices: comparative study using 120 kV

    Energy Technology Data Exchange (ETDEWEB)

    Jun, Bo Ram; Yong, Hwan Seok; Kang, Eun-Young; Woo, Ok Hee; Choi, Eun Jung [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)], E-mail: yhwanseok@naver.com

    2012-12-15

    Background. The radiation dose of coronary computed tomography (CT) angiography (CCTA) is generally higher than that of CT scans of other parts of the body, and there is concern that the high radiation dose may result in increased cancer risk. Although various techniques have recently been introduced to lower the radiation dose of CCTA, there has been no direct comparison between protocols with 80 and 120 kV. Purpose. To assess the image quality and radiation dose of 80-kV electrocardiography (ECG)-gated CCTA in subjects with a normal body mass index (BMI), compared to 120-kV ECG-gated CCTA. Material and Methods. This retrospective study was approved by our local ethics board, and the requirement of written informed consent was waived. We analyzed the CCTA images of 100 subjects with BMIs <25 kg/m2. Fifty subjects underwent 120-kV CCTA, and the other 50 subjects underwent 80-kV CCTA. Two blinded observers independently evaluated the subjective image quality of the coronary arteries. The objective image quality (signal-to-noise ratio [SNR] and contrast-to-noise ratio [CNR]) and radiation dose were also measured in each group. Results. Although the objective image quality of the 80-kV protocol images was significantly poorer than that of 120-kV protocol images (mean SNR, 14.9 {+-} 4.7 vs. 19.8 {+-} 4.4, P < 0.0001; mean CNR, 15.2 {+-} 4.8 vs. 21.6 {+-} 4.7, P < 0.0001), there was no significant difference in the subjective image quality between the two groups (mean image score, 4.7 {+-} 1.1 vs. 4.5 {+-} 0.7 for radiologist 1, P 0.273; 5.0 {+-} 1.0 vs. 4.8 {+-} 1.0 for radiologist 2, P = 0.197). The radiation dose was reduced by 70% with the 80-kV protocol and by 88% with the 80-kV and ECG-based tube current modulation than with the 120-kV protocol (3.42 {+-} 1.16 and 2.9 {+-} 0.8 vs. 11.49 {+-} 3.62 mSv, P < 0.0001). Conclusion. The low tube voltage CCTA protocol using 80 kV allows significant reduction of the radiation dose without impairing the subjective image

  2. 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...

  3. Living with Coronary Heart Disease

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With Coronary Heart Disease Coronary heart disease (CHD) can cause serious complications. However, if you ... changes and medicines, go to "How Is Coronary Heart Disease Treated?" Work closely with your doctor to control ...

  4. Synthesis and Calcium Channel Blocking Activity of 1, 4-Dihydropyridine Derivatives Containing Ester Substitute and Phenyl Carbamoyl Group

    Directory of Open Access Journals (Sweden)

    Bassem Sadek

    2011-01-01

    Full Text Available Problem statement: Several studies on the synthesis of new nifedipine analogs have been carried out, but the literature reveled that no study on the synthesis and calcium channel blocking activity of the substituted ester with an amide (5-phenylcarbamoyl moiety has been reported. Approach: Six new derivatives of m-nifedipine have been successfully synthesized by substituting an ester moiety with an amide (5-phenylcarbamoyl moiety, using a modified Hantzsch reactions and tested for their pharmacological activities. The nifedipine analogs 1-6 were characterized and confirmed using elemental analysis, Infrared spectroscopy (IR, Nuclear Magnetic Resonance (1H NMR and Mass spectroscopy. The purity of the compounds was ascertained by melting point and TLC. The in vitro calcium channel blocking activities were evaluated using the high K+ concentration of Porcine Coronary Artery Smooth Muscles (PCASM assay. Results: The compounds (1-2 failed to exhibit any blocking activity (IC50 = 10−7 to 10−5 M range, while the compounds 3-6 relaxed precontracted porcine coronary artery smooth muscles with pEC50 values ranging between 4.37±0.10 (compound 3 and 6.46±0.07 (compound 5, indicating that compounds 3-6 exhibit comparable potencies in blocking calcium channels to reference drug varapamil (6.97±0.15 and m-nifedipine (6.48±0.05. Conclusion: The results of this study showed that some of the developed new compounds possess maximal calcium channel blocking effects comparable to m-nifedipine. The developed compounds in the present study will predicatively show an increased metabolic stability and consequently longer duration of actions compared to m-nifedipine and could be, therefore, suitable candidates for further optimization to be evaluated as a new class of antihypertensive drugs.

  5. The remodeling transient and the calcium economy.

    Science.gov (United States)

    Aloia, J F; Arunabh-Talwar, S; Pollack, S; Yeh, J K

    2008-07-01

    The remodeling transient describes a change in bone mass that lasts one remodeling cycle following an intervention that disturbs the calcium economy. We demonstrated the transient in a study of the response of bone density to calcium/vitamin D3 supplementation and show the hazards of misinterpretation if the transient is not considered. The remodeling transient describes a change in bone mass that lasts for one remodeling cycle following an intervention that disturbs the calcium economy. We report an intervention with calcium and vitamin D supplementation in 208 postmenopausal African-American women where the remodeling transient was considered a priori in the study design. Both groups (calcium alone vs. calcium + 20 microg (800 IU) vitamin D3) were ensured a calcium intake in excess of 1200 mg/day. There were no differences between the two groups in changes in BMD over time. These BMD changes were therefore interpreted to reflect increased calcium intake in both groups but not any influence of vitamin D. A transient increase in bone mineral density was observed during the first year of study, followed by a decline. The remodeling period was estimated at about 9 months, which is similar to histomorphometric estimates. It is problematic to draw conclusions concerning interventions that influence the calcium economy without considering the remodeling transient in study design. Studies of agents that effect bone remodeling must be carried out for at least two remodeling cycles and appropriate techniques must be used in data analysis.

  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. Selective Coronary Arteriography

    Science.gov (United States)

    Parker, John O.; Challis, Thomas W.; West, Roxroy O.

    1966-01-01

    The technique of selective coronary arteriography, as described originally by Sones, was employed in 255 patients. Successful catheterization of both coronary arteries was carried out in 88% of these patients, and in the last 100 examinations both coronary arteries were entered in 95 patients. Selective coronary arteriography is a useful diagnostic tool but is a potentially hazardous form of examination as we encountered four episodes of ventricular fibrillation in the present series. ImagesFig. 1Fig. 2Figs. 3A-DFig. 3EFig. 3FFig. 4Fig. 5Fig. 6Fig. 7Fig. 8Fig. 9 PMID:5902704

  8. Calcium channel as a potential anticancer agent.

    Science.gov (United States)

    Kriazhev, L

    2009-11-01

    Anticancer treatment in modern clinical practices includes chemotherapy and radiation therapy with or without surgical interventions. Efficiency of both methods varies greatly depending on cancer types and stages. Besides, chemo- and radiotherapy are toxic and damaging that causes serious side effects. This fact prompts the search for alternative methods of antitumor therapy. It is well known that prolonged or high increase of intracellular calcium concentration inevitably leads to the cell death via apoptosis or necrosis. However, stimulation of cell calcium level by chemical agents is hardly achievable because cells have very sophisticated machinery for maintaining intracellular calcium in physiological ranges. This obstacle can be overridden, nevertheless. It was found that calcium channels in so called calcium cells in land snails are directly regulated by extracellular calcium concentration. The higher the concentration the higher the calcium intake is through the channels. Bearing in mind that extracellular/intracellular calcium concentration ratio in human beings is 10,000-12,000 fold the insertion of the channel into cancer cells would lead to fast and uncontrollable by the cells calcium intake and cell death. Proteins composing the channel may be extracted from plasma membrane of calcium cells and sequenced by mass-spectrometry or N-terminal sequencing. Either proteins or corresponding genes could be used for targeted delivery into cancer cells.

  9. The Role of Calcium in Osteoporosis

    Science.gov (United States)

    Arnaud, C. D.; Sanchez, S. D.

    1991-01-01

    Calcium requirements may vary throughout the lifespan. During the growth years and up to age 25 to 30, it is important to maximize dietary intake of calcium to maintain positive calcium balance and achieve peak bone mass, thereby possibly decreasing the risk of fracture when bone is subsequently lost. Calcium intake need not be greater than 800 mg/day during the relatively short period of time between the end of bone building and the onset of bone loss (30 to 40 years). Starting at age 40 to 50, both men and women lose bone slowly, but women lose bone more rapidly around the menopause and for about 10 years after. Intestinal calcium absorption and the ability to adapt to low calcium diets are impaired in many postmenopausal women and elderly persons owing to a suspected functional or absolute decrease in the ability of the kidney to produce 1,25(OH)2D2. The bones then become more and more a source of calcium to maintain critical extracellular fluid calcium levels. Excessive dietary intake of protein and fiber may induce significant negative calcium balance and thus increase dietary calcium requirements. Generally, the strongest risk factors for osteoporosis are uncontrollable (e.g., sex, age, and race) or less controllable (e.g., disease and medications). However, several factors such as diet, physical activity, cigarette smoking, and alcohol use are lifestyle related and can be modified to help reduce the risk of osteoporosis.

  10. Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow

    DEFF Research Database (Denmark)

    Sen, Nihat; Ozlü, Mehmet F; Basar, Nurcan;

    2009-01-01

    OBJECTIVES: We evaluated the relationship between coronary blood flow and serum gamma-glutamyltransferase (GGT) activity in patients with slow coronary flow (SCF). STUDY DESIGN: The study included 90 patients (47 men, 43 women; mean age 50.8+/-9.4 years) with SCF and 88 patients (45 men, 43 women......; mean age 51.4+/-8.8 years) with coronary artery disease (CAD), whose diagnoses were made by coronary angiography. Patients with CAD had normal coronary flow. Coronary flow was quantified using the corrected TIMI frame count (TFC) method and serum levels of gamma-glutamyltransferase were measured....... The results were compared with those of a control group consisting of 86 age- and sex-matched patients who had normal coronary arteries and normal coronary flow. RESULTS: The three groups were similar with respect to body mass index, presence of hypertension and diabetes mellitus, lipid profiles, and fasting...

  11. Low calcium-phosphate intakes modulate the low-protein diet-related effect on peak bone mass acquisition: a hormonal and bone strength determinants study in female growing rats.

    Science.gov (United States)

    Fournier, C; Rizzoli, R; Ammann, P

    2014-11-01

    Peak bone mass acquisition is influenced by environmental factors including dietary intake. A low-protein diet delays body and skeletal growth in association with a reduction in serum IGF-1 whereas serum FGF21 is increased by selective amino acid deprivation. Calcium (Ca) and phosphorous (P) are also key nutrients for skeletal health, and inadequate intakes reduce bone mass accrual in association with calciotropic hormone modulation. Besides, the effect of calcium supplementation on bone mass in prepubertal children appears to be influenced by protein intake. To further explore the interaction of dietary protein and Ca-P intake on bone growth, 1-month-old female rats were fed with an isocaloric 10%, 7.5%, or 5% casein diet containing normal or low Ca-P for an 8-week period (6 groups). Changes in tibia geometry, mineral content, microarchitecture, strength, and intrinsic bone quality were analyzed. At the hormonal level, serum IGF-1, fibroblast growth factor 21 (FGF21), PTH, 1,25-dihydroxyvitamin D3 (calcitriol), and FGF23 were investigated as well as the Ghr hepatic gene expression. In normal dietary Ca-P conditions, bone mineral content, trabecular and cortical bone volume, and bone strength were lower in the 5% casein group in association with a decrease in serum IGF-1 and an increase in FGF21 levels. Unexpectedly, the low-Ca-P diet attenuated the 5% casein diet-related reduction of serum IGF-1 and Ghr hepatic gene expression, as well as the low-protein diet-induced decrease in bone mass and strength. However, this was associated with lower cortical bone material level properties. The low-Ca-P diet increased serum calcitriol but decreased FGF23 levels. Calcitriol levels positively correlated with Ghr hepatic mRNA levels. These results suggest that hormonal modulation in response to a low-Ca-P diet may modify the low-protein diet-induced effect on Ghr hepatic mRNA levels and consequently the impact of low protein intakes on IGF-1 circulating levels and skeletal

  12. 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。

  13. Calcium D-saccharate

    DEFF Research Database (Denmark)

    Garcia, André Castilho; Hedegaard, Martina Vavrusova; Skibsted, Leif Horsfelt

    2016-01-01

    K-1. Equilibria in supersaturated solutions of calcium d-saccharate seem only to adjust slowly, as seen from calcium activity measurements in calcium d-saccharate solutions made supersaturated by cooling. Solutions formed by isothermal dissolution of calcium d-gluconate in aqueous potassium d......-saccharate becomes spontaneously supersaturated with both d-gluconate and d-saccharate calcium salts, from which only calcium d-saccharate slowly precipitates. Calcium d-saccharate is suggested to act as a stabilizer of supersaturated solutions of other calcium hydroxycarboxylates with endothermic complex formation...

  14. Diagnostic Performance of Coronary Computed Tomography Angiography and Myocardial Perfusion Imaging in Kidney Transplantation Candidates

    DEFF Research Database (Denmark)

    Winther, Simon; Svensson, My; Jørgensen, Hanne Mari Skou;

    2014-01-01

    Objectives To compare the diagnostic accuracy of coronary artery calcium score (CACS), coronary computed tomography angiography (CCTA), single-photon emission computed tomography (SPECT), and a combination of these in the diagnosis of obstructive coronary artery disease (CAD) in patients with chr......Objectives To compare the diagnostic accuracy of coronary artery calcium score (CACS), coronary computed tomography angiography (CCTA), single-photon emission computed tomography (SPECT), and a combination of these in the diagnosis of obstructive coronary artery disease (CAD) in patients...... stress tests, while the diagnostic performance of CCTA remains unknown. Methods We prospectively studied 138 patients referred for pre-transplant cardiac evaluation (mean age 54 [22-72] years, 68% males, 43% treated with dialysis). All patients underwent CACS, CCTA, SPECT, and invasive coronary...... angiography. The results of the noninvasive tests were merged into integrated Hybrid (CACS/SPECT) and Hybrid (CCTA/SPECT). Results The overall prevalence of obstructive CAD (≥50% reduction in luminal diameter) according to quantitative invasive coronary angiography was 22%. Two-thirds of the patients...

  15. Significance of microalbuminuria in relation to subclinical coronary atherosclerosis in asymptomatic nonhypertensive, nondiabetic subjects.

    Science.gov (United States)

    Park, Hyo Eun; Heo, Nam Ju; Kim, Minkyung; Choi, Su-Yeon

    2013-03-01

    We aimed to investigate the significance of microalbuminuria and its relationship with subclinical atherosclerosis in nonhypertensive and nondiabetic patients, by using coronary artery computed tomography (CT). A total of 1,318 nonhypertensive and nondiabetic subjects who had taken coronary artery CT and measured spot urine albumin to creatinine ratio (UACR) were evaluated. The atherosclerotic changes of coronary arteries were greater in subjects with microalbuminuria, reflected by coronary artery calcium score (CACS) and significant coronary artery stenosis (CACS ≥ 100 in 15.3% vs 7.6% and stenosis ≥ 50% in 11.5% vs 4.9% of patients with vs without microalbuminuria, P = 0.008 and P = 0.011, respectively). Among various parameters that are known as a risk factor or possible biomarkers of coronary artery disease, presence of microalbuminuria, age and Framingham risk score were significantly related to coronary artery stenosis. Among them the presence of microalbuminuria showed stronger correlation than others to the coronary artery stenosis detected by CT, even after adjusting confounding factors (OR 3.397, 95% confidence interval 1.138 to 10.140, P = 0.028). The presence of microalbuminuria by UACR was significantly associated with presence of coronary artery stenosis ≥ 50% in asymptomatic, nonhypertensive and nondiabetic general population. Our study suggests that the presence of microalbuminuria may imply subclinical coronary artery disease, even in asymptomatic population.

  16. 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 ...

  17. 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.

  18. Mass concentration and ion composition of coarse and fine particles in an urban area in Beirut: effect of calcium carbonate on the absorption of nitric and sulfuric acids and the depletion of chloride

    Directory of Open Access Journals (Sweden)

    H. Kouyoumdjian

    2006-01-01

    Full Text Available Levels of coarse (PM10-2.5 and fine (PM2.5 particles were determined between February 2004 and January 2005 in the city of Beirut, Lebanon. While low PM mass concentrations were measured in the rainy season, elevated levels were detected during sand storms originating from Arabian desert and/or Africa. Using ATR-FTIR and IC, it was shown that nitrate, sulfate, carbonate and chloride were the main anionic constituents of the coarse particles, whereas sulfate was mostly predominant in the fine particles in the form of (NH42SO4. Ammonium nitrate was not expected to be important because the medium was defined as ammonium poor. In parallel, the cations Ca2+ and Na+ dominated in the coarse, and NH4+, Ca2+ and Na+ in the fine particles. Coarse nitrate and sulfate ions resulted from the respective reactions of nitric and sulfuric acid with a relatively high amount of calcium carbonate. Both CaCO3 and Ca(NO32 crystals identified by ATR-FTIR in the coarse particles were found to be resistant to soaking in water for 24 h but became water soluble when they were formed in the fine particles suggesting, thereby, different growth and adsorption phenomena. The seasonal variational study showed that nitrate and sulfate ion concentrations increased in the summer due to the enhancement of photochemical reactions which facilitated the conversion of NO2 and SO2 gases into NO3- and SO42-, respectively. While nitrate was mainly due to local heavy traffic, sulfates were due to local and long-range transport phenomena. Using the air mass trajectory HYSPLIT model, it was found that the increase in the sulfate concentration correlated with wind vectors coming from Eastern and Central Europe. Chloride levels, on the other hand, were high when wind originated from the sea and low during sand storms. In addition to sea salt, elevated levels of chloride were also attributed to waste mass burning in proximity to the site. In comparison to other neighboring Mediterranean

  19. Development of a method based on inductively coupled plasma-dynamic reaction cell-mass spectrometry for the simultaneous determination of phosphorus, calcium and strontium in bone and dental tissue

    Energy Technology Data Exchange (ETDEWEB)

    De Muynck, David [Ghent University, Department of Analytical Chemistry, Krijgslaan 281-S12, BE-9000 Ghent (Belgium)], E-mail: David.DeMuynck@UGent.be; Vanhaecke, Frank [Ghent University, Department of Analytical Chemistry, Krijgslaan 281-S12, BE-9000 Ghent (Belgium)], E-mail: Frank.Vanhaecke@UGent.be

    2009-05-15

    A method, based on the use of a quadrupole-based inductively coupled plasma-mass spectrometry instrument equipped with a quadrupole-based collision/reaction cell (dynamic reaction cell, DRC), was developed for the simultaneous determination of phosphorus, calcium and strontium in bone and dental (enamel and dentine) tissue. The use of NH{sub 3}, introduced at a gas flow rate of 0.8 mL min{sup -1} in the dynamic reaction cell, combined with a rejection parameter q (RPq) setting of 0.65, allows interference-free determination of calcium via its low-abundant isotopes {sup 42}Ca, {sup 43}Ca and {sup 44}Ca, and of strontium via its isotopes {sup 86}Sr and {sup 88}Sr that are freed from overlap due to the occurrence of ArCa{sup +} and/or Ca{sub 2}{sup +} ions. Also the determination of phosphorus ({sup 31}P, mono-isotopic) was shown to be achievable using the same dynamic reaction cell operating conditions. The bone certified reference materials NIST SRM 1400 Bone Ash and NIST SRM 1486 Bone Meal were used for validation of the measurement protocol that was shown capable of providing accurate and reproducible results. Detection limits of P, Ca and Sr in dental tissue digests were established as 3 {mu}g L{sup -1} for P, 2 {mu}g L{sup -1} for Ca and 0.2 {mu}g L{sup -1} for Sr. This method can be used to simultaneously (i) evaluate the impact of diagenesis on the elemental and isotopic composition of buried skeletal tissue via its Ca/P ratio and (ii) determine its Sr concentration. The measurement protocol was demonstrated as fit-for-purpose by the analysis of a set of teeth of archaeological interest for their Ca/P ratio and Sr concentration.

  20. Calcium sensing in exocytosis

    DEFF Research Database (Denmark)

    Gustavsson, Natalia; Wu, Bingbing; Han, Weiping

    2012-01-01

    an increase in intracellular calcium levels. Besides the triggering role, calcium signaling modulates the precise amount and kinetics of vesicle release. Thus, it is a central question to understand the molecular machineries responsible for calcium sensing in exocytosis. Here we provide an overview of our...... current understanding of calcium sensing in neurotransmitter release and hormone secretion....

  1. Effects of retrograde coronary sinus perfusion with vascular endothelial growth factor on L-type calcium ion current in rabbit myocardial infarction model%冠状静脉窦逆行灌注血管内皮生长因子对兔心肌梗死心室肌细胞L型钙电流的影响

    Institute of Scientific and Technical Information of China (English)

    李安杰; 周永刚; 罗罕; 韦方

    2011-01-01

    目的 研究经冠状静脉窦逆行灌注血管内皮生长因子(vascular endothelial growth factor,VEGF)对兔心肌梗死模型心室肌细胞L型钙离子电流(L-type calcium ion current,Lca-L)的影响,探讨VEGF抗心律失常的细胞学离子机制。方法 45只新西兰大耳大白兔按电脑随机数字法分为3组(每组15只),胸骨正中切开,暴露心脏,Ⅰ组(假手术对照组)冠状静脉窦插管备取静脉血;Ⅱ组(0.9%氯化钠溶液对照组)结扎左心室支建立心肌梗死模型,冠状静脉窦插管逆灌0.9%氯化钠溶液;Ⅲ组(VEGF逆灌治疗组)冠状静脉窦插管逆行灌注VEGF蛋白。全程监测心电,记录恶性心律失常发生情况,酶解法分离缺血部位单个心室肌细胞,采用全细胞膜片钳技术记录Lca-L,于术前及术后120min取冠状静脉窦血检测VEGF、一氧化氮(nitric oxide,NO)、肌钙蛋白T(cardiotroponin T,TnT)浓度。结果 术前3组动物VEGF、NO、TnT浓度比较,差异无统计学意义(P>0.05)。Ⅱ组心律失常发生率及电流密度峰值(mV)明显高于Ⅰ组及Ⅲ组,差异有统计学意义(P<0.05)。术后120min,Ⅱ、Ⅲ组TnT浓度均显著高于Ⅰ组[(4.93±0.57)μg/L vs.(0.72±0.21)μg/L,P<0.05;(2.26±0.49)μg/Lvs.(0.72±0.21)μg/L,P<0.05];但Ⅲ组低于Ⅱ组,差异有统计学意义[(2.26±0.49)μg/L vs(4.93±0.57)μg/L,P<0.05]。Ⅲ组NO[(108.14±14.57)μmol/L vs.(62.98±10.29)μmol/L,P<0.05;(108.14±14.57)μmol/L vs.(67.28±13.45)μmol/L,P<0.05]、VEGF[(834.65±49.23)ng/L vs.(112.34±30.18)ng/L,P<0.05;(834.65±49.23)ng/L vs.(123.45±27.98)ng/L,P<0.05]浓度明显高于Ⅰ、Ⅱ组,差异有统计学意义。结论 经冠状静脉窦逆行灌注vEGF能使缺血区心室肌细胞明显增加的Lca-L得到逆转,减少恶性心律失常发生率,其机制可能与增加NO水平有关。%Objectives To investigate effects of retrograde coronary sinus perfusion with vascular

  2. 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

  3. 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.

  4. Imaging calcium in neurons.

    Science.gov (United States)

    Grienberger, Christine; Konnerth, Arthur

    2012-03-08

    Calcium ions generate versatile intracellular signals that control key functions in all types of neurons. Imaging calcium in neurons is particularly important because calcium signals exert their highly specific functions in well-defined cellular subcompartments. In this Primer, we briefly review the general mechanisms of neuronal calcium signaling. We then introduce the calcium imaging devices, including confocal and two-photon microscopy as well as miniaturized devices that are used in freely moving animals. We provide an overview of the classical chemical fluorescent calcium indicators and of the protein-based genetically encoded calcium indicators. Using application examples, we introduce new developments in the field, such as calcium imaging in awake, behaving animals and the use of calcium imaging for mapping single spine sensory inputs in cortical neurons in vivo. We conclude by providing an outlook on the prospects of calcium imaging for the analysis of neuronal signaling and plasticity in various animal models.

  5. 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...

  6. 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 • ...

  7. Prevalence of asymptomatic coronary disease in fibrosing idiopathic interstitial pneumonias

    Energy Technology Data Exchange (ETDEWEB)

    Cassagnes, Lucie; Gaillard, Vianney [Department of Thoracic Imaging (EA 2694), Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Monge, Emmanuel [Department of Pulmonology, Center of Competence for Rare Pulmonary Diseases, Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Faivre, Jean-Baptiste [Department of Thoracic Imaging (EA 2694), Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Delhaye, Cédric [Department of Cardiology, Cardiology Hospital, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Molinari, Francesco [Department of Thoracic Imaging (EA 2694), Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Petyt, Grégory; Hossein-Foucher, Claude [Department of Nuclear Medicine, Hospital Salengro, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Wallaert, Benoit [Department of Pulmonology, Center of Competence for Rare Pulmonary Diseases, Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Duhamel, Alain [Department of Medical Statistics (EA 2694), Univ Lille Nord de France, F-59000 Lille (France); Remy, Jacques [Department of Thoracic Imaging (EA 2694), Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Remy-Jardin, Martine, E-mail: martine.remy@chru-lille.fr [Department of Thoracic Imaging (EA 2694), Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France)

    2015-01-15

    Background: Because of growing body of interest on the association between fibrosing idiopathic interstitial pneumonias (f-IIP) and ischaemic heart disease, we initiated this prospective study to evaluate the prevalence of asymptomatic coronary artery disease (CAD) in patients with f-IIP. Methods: Forty-two patients with f-IIP underwent noninvasive screening for CAD that included (a) a chest CT examination enabling calculation of the coronary artery calcium (CAC) score, then depiction of coronary artery stenosis; and (b) stress myocardial perfusion scintigraphy (MPS). Patients with significant coronary abnormalities, defined by a CAC score >400 or coronary artery stenosis >50% at CT and/or perfusion defect >5% at MPS, were referred to the cardiologist. Coronary angiography was indicated in presence of a perfusion defect >10% at MPS or significant left main or proximal left anterior descending stenosis whatever MPS findings. Results: Combining CT and MPS, significant abnormalities were detected in 32/42 patients (76%). The cardiologist: (a) did not consider further investigation in 21 patients (CT abnormalities but no ischaemia at MPS: 12/21; false-positive findings at MPS: 3/21; poor respiratory condition: 6/21); (b) proceeded to coronary angiography in 11 patients which confirmed significant stenoses in 5 patients (5/42; 12%). In the worst-case-scenario (i.e., inclusion of 6 patients with significant coronary artery abnormalities who were not investigated due to poor respiratory condition), the prevalence of CAD reached 26% (11/42). Conclusion: In the studied population of patients with f-IIP, asymptomatic CAD ranged between 12% and 26%.

  8. Treatment of Angina Pectoris Associated with Coronary Microvascular Dysfunction.

    Science.gov (United States)

    Ong, Peter; Athanasiadis, Anastasios; Sechtem, Udo

    2016-08-01

    Treatment of angina pectoris associated with coronary microvascular dysfunction is challenging as the underlying mechanisms are often diverse and overlapping. Patients with type 1 coronary microvascular dysfunction (i.e. absence of epicardial coronary artery disease and myocardial disease) should receive strict control of their cardiovascular risk factors and thus receive statins and ACE-inhibitors in most cases. Antianginal medication consists of ß-blockers and/or calcium channel blockers. Second line drugs are ranolazine and nicorandil with limited evidence. Despite individually titrated combinations of these drugs up to 30 % of patients have refractory angina. Rho-kinase inhibitors and endothelin-receptor antagonists represent potential drugs that may prove useful in these patients in the future.

  9. Tibolone and its metabolites acutely relax rabbit coronary arteries in vitro

    DEFF Research Database (Denmark)

    Lund, Claus Otto; Nilas, Lisbeth; Pedersen, Susan Helene

    2004-01-01

    OBJECTIVES: To compare the acute effects of estradiol, tibolone and its metabolites on coronary arteries in vitro and to investigate possible vascular mechanisms. METHODS: Coronary artery ring segments from female rabbits were mounted in myographs for isometric tension recordings. Concentration.......05, ANOVA). CONCLUSIONS: Our data indicate that the acute relaxation induced by tibolone and its metabolites in coronary arteries in vitro are probably mediated by endothelium independent inhibition of calcium channels but may also involve an endothelium-dependent mechanism via nitric oxide. The effect...

  10. Immunosuppressive therapy induced coronary vasospasm and acute myocardial infarction in a patient undergoing new renal transplantation

    Science.gov (United States)

    Akturk, Ibrahim Faruk; Yalcin, Ahmet Arif; Celik, Omer; Oner, Ender

    2015-01-01

    Immunosuppressant agents such as calcineurin inhibitors (CNI) used after solid organ transplantation may cause endothelial dysfunction, and coronary and renal arterial vasospasm. We report a patient presenting acute ST segment elevation myocardial infarction (STEMI) at the second week of renal transplantation. In the case of STEMI in patients with solid organ transplants under immunosuppressive therapy with CNI, coronary vasospasm associated with these drugs should be kept in mind before starting any interventional procedure. High dose nitroglycerine may immediately resolve tacrolimus or cyclosporine A induced coronary vasospasm. Calcium channel blockers should immediately be added to treatment because of the short half-life of nitroglycerine. PMID:26161107

  11. Correlation study on waist circumference-triglyceride (WT) index and coronary artery scores in patients with coronary heart disease.

    Science.gov (United States)

    Yang, R-F; Liu, X-Y; Lin, Z; Zhang, G

    2015-01-01

    Coronary disease is analyzed through common lipid profiles, but these analyses fail to account for residual risk due to abdominal weight and elevated TG levels. We aimed to investigate the relationship between the waist circumference × triglyceride index (WT index) and the Coronary Artery Score (CAS) in patients with coronary heart disease. 346 patients in our Cardiology Department were recruited from September 2007 to August 2011 and divided into two groups according to whether the patients presented with metabolic syndrome. We performed coronary angiography using the standard Judkins method. The severity of coronary artery stenosis and the CAS were calculated and analyzed with a computerized quantitative analysis system. The signs index, which includes the body mass index (BMI), waist circumference, hip circumference, waist-hip-ratio, and waist-height-ratio, the blood glucose and blood lipid index of all the patients were collected and used to calculate the WT index (waist circumference x triglyceride index. We performed a correlative analysis with age, gender, body mass index, blood glucose and blood lipid, blood pressure and other risk indicators of all patients as the dependent variables and the CAS as the independent variable. We show that the CAS is positively correlated to the WT index. Several lipid profiles and waist circumference were significantly associated with the CAS. The WT index is correlated to the CAS and is a good predictor for the development of coronary artery disease; it can be applied in the clinic for early intervention in populations at risk for coronary heart disease.

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

    Science.gov (United States)

    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.

  13. Study Of Calcium And Potassium Different Nature Strength Gel Kappa-Carrageenan

    Directory of Open Access Journals (Sweden)

    Петро Васильович Гурський

    2015-07-01

    Full Text Available The influence of certain organic and mineral salts of potassium and calcium for strength gel kappa-carrageenan. The influence of the mass concentration of individual calcium for strength gels with different content kappa-carrageenan. Grounded mass concentration of some calcium salts for use in the composition of the jelly for sweet and savory dishes based on kappa-carrageenan

  14. 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 ...

  15. Auxetic coronary stent endoprosthesis

    DEFF Research Database (Denmark)

    Amin, Faisal; Ali, Murtaza Najabat; Ansari, Umar;

    2014-01-01

    BACKGROUND: Cardiovascular heart disease is one of the leading health issues in the present era and requires considerable health care resources to prevent it. The present study was focused on the development of a new coronary stent based on novel auxetic geometry which enables the stent to exhibit...... a negative Poisson's ratio. Commercially available coronary stents have isotropic properties, whereas the vascular system of the body shows anisotropic characteristics. This results in a mismatch between anisotropic-isotropic properties of the stent and arterial wall, and this in turn is not favorable...... for mechanical adhesion of the commercially available coronary stents with the arterial wall. It is believed that an auxetic coronary stent with inherent anisotropic mechanical properties and negative Poisson's ratio will have good mechanical adhesion with the arterial wall. METHODS: The auxetic design...

  16. 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 ...

  17. Efficacy and safety of calcium channel blockers in hypertensive patients with concomitant left ventricular dysfunction.

    Science.gov (United States)

    Parmley, W W

    1992-04-01

    The use of calcium channel blockers (CCBs) in the treatment of hypertension and concomitant left ventricular dysfunction is reviewed. Some CCBs, particularly second-generation dihydropyridine agents such as felodipine, isradipine, nicardipine, nimodipine, and nitrendipine, have properties that enhance their usefulness in these patients. All CCBs have a similar mechanism of action. Differences in their selective action at various tissue sites determine which are most appropriate for patients with concomitant hypertension and left ventricular dysfunction. Most CCBs do not produce reflex stimulation of the heart or induce intravascular expansion. While all CCBs produce arteriolar dilation, all local beds and regional circulations in target organs are not affected equally. Most CCBs can decrease cardiac mass, and second-generation CCBs tend to have little or no negative inotropic effects at therapeutic dosages. In addition, they increase blood flow and reduce myocardial oxygen requirements. Because of differences in functional and electrophysiologic effects, specific CCBs may not be appropriate for all patients. Since second-generation dihydropyridine CCBs lack clinically relevant negative inotropic effects, and have been shown to improve exercise tolerance and coronary artery perfusion, they are appropriate for hypertensive patients with left ventricular dysfunction, angina, and coronary heart disease. Second-generation CCBs tend to lack cardiodepressant side effects and are less likely to react with digoxin than are first-generation CCBs.

  18. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008042 Analysis of coronary artery lesion characteristics and its clinical implications in patients with acute non-ST-segment elevation myocardial infarction. BAI Taizhu(柏太柱), et al. Cardiovasc Dept, Hengyang Centr Hosp & Hengyang Cardiovasc Intervention Center, Hengyang 421001. Chin J Arterioscler 2007;15(10):780-782. Objective To investigate the coronary artery lesion characteristics and its clinical implications in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI).

  19. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008277 Relationship between pulse wave velocity and the NYHA classification of coronary insufficiency.SUN Weiping(孙卫平),et al.Dept Cardiol,Tongji Hosp Tongji Univ,Shanghai 200065.Chin J Intern Med 2008;47(5):382-384.Objective To investigate the relationship between brachial-ankle pulse wave velocity(baPWV)and different stage of cardiac dysfunction.Methods 253 consecutive patients with coronary atherosclerotic heart disease

  20. Large coronary intramural hematomas

    DEFF Research Database (Denmark)

    Antonsen, Lisbeth; Thayssen, Per; Jensen, Lisette Okkels

    2015-01-01

    coronary vessel wall pathology, with poorly understood underlying pathogenic mechanisms. Affected individuals may present with a broad spectrum of symptoms ranging from acute coronary syndromes (ACS) to cardiogenic shock or even sudden cardiac death. The disease entity causes challenges in terms of both......, no randomized, controlled trials exist to guide treatment, and no consensus regarding management is available. Currently, treatment strategies are based on a case-by-case clinical assessment, and experiences described in previous, limited retrospective studies and case reports....

  1. Coronary Fistulas: A Case Series

    Directory of Open Access Journals (Sweden)

    Nada Fennich

    2014-01-01

    Full Text Available Coronary artery fistula is an uncommon finding during angiographic exams. We report a case series of five patients with congenital coronary fistulas. The first patient was 56 years old and had a coronary fistula associated with a partial atrio ventricular defect, the second patient was 54 years old and had two fistulas originating from the right coronary artery with a severe atherosclerotic coronary disease, the third patient was 57 years old with a fistula originating from the circumflex artery associated with a rheumatic mitral stenosis, the fourth patient was 50 years old and had a fistulous communication between the right coronary artery and the right bronchial artery, and the last patient was 12 years old who had bilateral coronary fistulas draining into the right ventricle with an aneurismal dilatation of the coronary arteries. Angiographic aspects of coronary fistulas are various; management is controversial and depends on the presence of symptoms.

  2. Discovery and Development of Calcium Channel Blockers

    Directory of Open Access Journals (Sweden)

    Théophile Godfraind

    2017-05-01

    Full Text Available In the mid 1960s, experimental work on molecules under screening as coronary dilators allowed the discovery of the mechanism of calcium entry blockade by drugs later named calcium channel blockers. This paper summarizes scientific research on these small molecules interacting directly with L-type voltage-operated calcium channels. It also reports on experimental approaches translated into understanding of their therapeutic actions. The importance of calcium in muscle contraction was discovered by Sidney Ringer who reported this fact in 1883. Interest in the intracellular role of calcium arose 60 years later out of Kamada (Japan and Heibrunn (USA experiments in the early 1940s. Studies on pharmacology of calcium function were initiated in the mid 1960s and their therapeutic applications globally occurred in the the 1980s. The first part of this report deals with basic pharmacology in the cardiovascular system particularly in isolated arteries. In the section entitled from calcium antagonists to calcium channel blockers, it is recalled that drugs of a series of diphenylpiperazines screened in vivo on coronary bed precontracted by angiotensin were initially named calcium antagonists on the basis of their effect in depolarized arteries contracted by calcium. Studies on arteries contracted by catecholamines showed that the vasorelaxation resulted from blockade of calcium entry. Radiochemical and electrophysiological studies performed with dihydropyridines allowed their cellular targets to be identified with L-type voltage-operated calcium channels. The modulated receptor theory helped the understanding of their variation in affinity dependent on arterial cell membrane potential and promoted the terminology calcium channel blocker (CCB of which the various chemical families are introduced in the paper. In the section entitled tissue selectivity of CCBs, it is shown that characteristics of the drug, properties of the tissue, and of the stimuli are

  3. Affinity-tagged phosphorylation assay by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (ATPA-MALDI): application to calcium/calmodulin-dependent protein kinase.

    Science.gov (United States)

    Kinumi, Tomoya; Niki, Etsuo; Shigeri, Yasushi; Matsumoto, Hiroyuki

    2005-12-01

    A matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)-based kinase assay using a peptide substrate tagged with a biotinyl group has been developed. The peptide moiety was designed to serve as an efficient substrate for calcium/calmodulin-dependent protein kinase II, based on the in vivo phosphorylation site of phosrestin I, a Drosophila homolog of arrestin. In the assay, the quantitative relationship was determined from the ratio of the peak areas between the two peaks respectively representing the unphosphorylated and the phosphorylated substrate. Attempts to assay phosphorylated peptides directly from the reaction mixture, gave inaccurate results because of the high noise level caused by the presence of salts and detergents. In contrast, after purifying the substrate peptides with the biotin affinity tag using streptavidin-coated magnetic beads, peak areas accurately represented the ratio between the unphosphorylated and phosphorylated peptide. By changing the substrate peptide to a peptide sequence that serves as a kinase substrate, it is expected that an efficient non-radioactive protein kinase assay using MALDI-TOF MS can be developed for any type of protein kinase. We call this technique "Affinity-Tagged Phosphorylation Assay by MALDI-TOF MS (ATPA-MALDI)." ATPA-MALDI should serve as a quick and efficient non-radioactive protein kinase assay by MALDI-TOF MS.

  4. Diagnostic performance of computed tomography coronary angiography to detect and exclude left main and/or three-vessel coronary artery disease

    DEFF Research Database (Denmark)

    Dharampal, Anoeshka S; Papadopoulou, Stella L; Rossi, Alexia

    2013-01-01

    To determine the diagnostic performance of CT coronary angiography (CTCA) in detecting and excluding left main (LM) and/or three-vessel CAD ("high-risk" CAD) in symptomatic patients and to compare its discriminatory value with the Duke risk score and calcium score....

  5. Biocompatibility of Coronary Stents

    Directory of Open Access Journals (Sweden)

    Thamarasee M. Jeewandara

    2014-01-01

    Full Text Available Cardiovascular disease is the dominant cause of mortality in developed countries, with coronary artery disease (CAD a predominant contributor. The development of stents to treat CAD was a significant innovation, facilitating effective percutaneous coronary revascularization. Coronary stents have evolved from bare metal compositions, to incorporate advances in pharmacological therapy in what are now known as drug eluting stents (DES. Deployment of a stent overcomes some limitations of balloon angioplasty alone, but provides an acute stimulus for thrombus formation and promotes neointimal hyperplasia. First generation DES effectively reduced in-stent restenosis, but profoundly delay healing and are susceptible to late stent thrombosis, leading to significant clinical complications in the long term. This review characterizes the development of coronary stents, detailing the incremental improvements, which aim to attenuate the major clinical complications of thrombosis and restenosis. Despite these enhancements, coronary stents remain fundamentally incompatible with the vasculature, an issue which has largely gone unaddressed. We highlight the latest modifications and research directions that promise to more holistically design coronary implants that are truly biocompatible.

  6. Effect of Two Isocaloric Diets, Low Fat- High Calcium and Low Fat- High Fiber on Weight Reduction, Lipid Profile, and Blood Pressure

    Directory of Open Access Journals (Sweden)

    MH Eftekhari

    2009-12-01

    Full Text Available Background: Coronary Heart Disease is commonly associated with obesity, raised serum lipid levels and changes in blood pressure. The present study was designed to assess the effect of low fat- high calcium, and low fat- high fiber diets on weight reduction, lipid profile and blood pressure.Methods: The study sample consisted of 136 referred patients adult, obese men aged 53-64 years. Samples randomly were subdivided in two groups. Group 1 was advised 1600 calories, 20% fat, 1600 mg calcium rich diet and group 2 followed similar diet as for group 1 except a total daily intake of 55g fiber and 900 mg calcium per day for 12 weeks. Blood samples were collected and assayed for total cholesterol, LDL-cholesterol, HDLcholesterol and TG. Anthropometric assessments included measurement of weight, height, and waist circumferences followed by calculating Body mass index. Systolic and diastolic blood pressures were measured by using sphygmomanometer. Statistical analysis was performed with parametric and non-parametric methods as appropriate.Results: Data analysis revealed a significant decrease in total cholesterol, LDL-cholesterol, and TG in two groups, without any significant changes in HDL-cholesterol. Weight and blood pressure decreased in two groups, but the rate of reduction in blood pressure, weight and waist circumference were more significant in group 1 compared to group 2.Conclusion: An increase in dietary calcium intake, together with a Low calorie, low-fat diet can increase lipolysis in fat tissues, make greater weigh loss, ameliorate blood pressure, improve lipid levels, and reduce the risk of coronary vascular diseases.

  7. 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.

  8. Do calcium-dependent ionic currents mediate ischemic ventricular fibrillation?

    Science.gov (United States)

    Clusin, W T; Bristow, M R; Karagueuzian, H S; Katzung, B G; Schroeder, J S

    1982-02-18

    Calcium ions mediate the adverse effects of myocardial ischemia and have been implicated in the genesis of arrhythmias. Calcium influx blocking drugs protect against early ventricular arrhythmias during experimental coronary occlusion, and recent studies suggest that this effect is at least partly due to inhibition of myocardial cell calcium influx. Most of the pharmacologic maneuvers used to simulate acute ischemic arrhythmias in vivo also produce intracellular calcium overload. Production of calcium overload in small myocardial cell clusters causes fibrillatory electrical and mechanical activity similar to that recorded from fibrillating hearts. Fibrillation in these cell clusters is mediated not by reentrant conduction, but by the same subcellular processes that give rise to depolarizing afterpotentials and abnormal automaticity. Agents favoring calcium influx, such as beta adrenergic agonists, accentuate these processes, while agents that depress calcium influx inhibit them. Although the relation of these experimental models to clinical ischemic arrhythmias has not been fully delineated, calcium influx blocking drugs may prove useful in reducing the incidence of sudden cardiac death.

  9. Evaluation of pH and calcium ion diffusion from calcium hydroxide pastes and MTA.

    Science.gov (United States)

    Sáez, María Del M; López, Gabriela L; Atlas, Diana; de la Casa, María L

    2017-04-01

    The aim of this ex vivo study was to evaluate changes in pH and calcium ion diffusion through root dentin from calcium hydroxide (Ca (OH) 2) and mineral trioxide aggregate (MTA) pastes at 7, 30 and 60 days; and the relationship between pH and ion diffusion. Thirty-two human premolars were used. Crowns were sectioned and root canals instrumented and filled in with the following preparations: 1) Ca(OH) 2 + distilled water (n=7); 2) Ca(OH) 2 + 0.1% chlorhexidine gluconate (n=7); 3) MTA + distilled water (n=7); 4) MTA + 0.1% chlorhexidine gluconate (CHX) (n=7); 5) distilled water (n=2) (control); 6) 0.1% chlorhexidine gluconate (n=2) (control). The apex and coronary opening were sealed with IRM. Roots were placed in Eppendorf tubes with 1 ml distilled water at 37°C and 100% humidity. At baseline, 7, 30 and 60 days, pH was measured with pH meter, and calcium ion content in the solution was analyzed by atomic absorption spectrophotometry. The data were statistically analyzed using ANOVA, simple linear regression analysis and Pearson's correlation test. The highest pH values were achieved with calcium hydroxide pastes at 60 days (p ≤ 0.05). Calcium ions were released in all groups. The calcium hydroxide paste with distilled water at 60 days had the highest calcium ion value (p ≤ 0.01). There was a positive correlation between calcium and pH values. Sociedad Argentina de Investigación Odontológica.

  10. 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

  11. Distal coronary hemoperfusion during percutaneous transluminal coronary angioplasty

    NARCIS (Netherlands)

    deMuinck, ED; denHeijer, P; vanDijk, RB; Crijns, HJGM; Hillige, HL; Lie, KI

    1996-01-01

    Distal coronary hemoperfusion during percutaneous transluminal coronary angioplasty (PTCA)-with an autoperfusion balloon or active system-facilitates prolonged balloon inflation. Prolonged inflations may tack up intimal dissections and improve the primary angioplasty result in complex lesions. Addit

  12. Integumentary loss of calcium.

    Science.gov (United States)

    Chu, J Y; Margen, S; Calloway, D H; Costa, F M

    1979-08-01

    Integumentary calcium loss was studied in 16 healthy young men. The daily loss by the 16 ambulatory but relatively sedentary young men in 52 determinations of 6-day periods each was 8.7 +/- 1.9 mg/m2 per day (average 15.8 mg/man per day). The amount lost was not influenced by calcium intake (0.1 to 2.3 g/day). In contrast to urinary calcium excretion, which is directly related to protein intake, there was no significant change in integumentary calcium loss with varying protein intakes (1 to 96 g nitrogen per day). No compensatory relationship between urinary and integumentary calcium excretion was noted. During strenuous exercise calcium loss increased to an average of 25 mg in 40 min. There was no compensatory decrease in urinary excretion on the day of strenuous exercise. It was also noted that integumentary calcium loss was not affected by general calcium balance.

  13. Calcium and Mitosis

    Science.gov (United States)

    Hepler, P.

    1983-01-01

    Although the mechanism of calcium regulation is not understood, there is evidence that calcium plays a role in mitosis. Experiments conducted show that: (1) the spindle apparatus contains a highly developed membrane system that has many characteristics of sarcoplasmic reticulum of muscle; (2) this membrane system contains calcium; and (3) there are ionic fluxes occurring during mitosis which can be seen by a variety of fluorescence probes. Whether the process of mitosis can be modulated by experimentally modulating calcium is discussed.

  14. Calcium and Mitosis

    Science.gov (United States)

    Hepler, P.

    1983-01-01

    Although the mechanism of calcium regulation is not understood, there is evidence that calcium plays a role in mitosis. Experiments conducted show that: (1) the spindle apparatus contains a highly developed membrane system that has many characteristics of sarcoplasmic reticulum of muscle; (2) this membrane system contains calcium; and (3) there are ionic fluxes occurring during mitosis which can be seen by a variety of fluorescence probes. Whether the process of mitosis can be modulated by experimentally modulating calcium is discussed.

  15. 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.

  16. Distal coronary hemoperfusion during percutaneous transluminal coronary angioplasty

    NARCIS (Netherlands)

    Muinck, Ebo Derk de

    1994-01-01

    In this thesis several aspects of passive and active coronary perfusion during coronary angioplasty are investigated. The autoperfusion balloon catheters that were evaluated are the Stack® and the RX-60® catheters (Advanced Cardiovascular Systems, inc., Santa Clara, California, U.S.A). The coronary

  17. Distal coronary hemoperfusion during percutaneous transluminal coronary angioplasty

    NARCIS (Netherlands)

    Muinck, Ebo Derk de

    1994-01-01

    In this thesis several aspects of passive and active coronary perfusion during coronary angioplasty are investigated. The autoperfusion balloon catheters that were evaluated are the Stack® and the RX-60® catheters (Advanced Cardiovascular Systems, inc., Santa Clara, California, U.S.A). The coronary

  18. Calcium - Function and effects

    NARCIS (Netherlands)

    Liang, Jianfen; He, Yifan; Gao, Qian; Wang, Xuan; Nout, M.J.R.

    2016-01-01

    Rice is the primary food source for more than half of the world population. Levels of calcium contents and inhibitor - phytic acid are summarized in this chapter. Phytic acid has a very strong chelating ability and it is the main inhibit factor for calcium in rice products. Calcium contents in br

  19. Calcium absorption from fortified ice cream formulations compared with calcium absorption from milk.

    Science.gov (United States)

    van der Hee, Regine M; Miret, Silvia; Slettenaar, Marieke; Duchateau, Guus S M J E; Rietveld, Anton G; Wilkinson, Joy E; Quail, Patricia J; Berry, Mark J; Dainty, Jack R; Teucher, Birgit; Fairweather-Tait, Susan J

    2009-05-01

    Optimal bone mass in early adulthood is achieved through appropriate diet and lifestyle, thereby protecting against osteoporosis and risk of bone fracture in later life. Calcium and vitamin D are essential to build adequate bones, but calcium intakes of many population groups do not meet dietary reference values. In addition, changes in dietary patterns are exacerbating the problem, thereby emphasizing the important role of calcium-rich food products. We have designed a calcium-fortified ice cream formulation that is lower in fat than regular ice cream and could provide a useful source of additional dietary calcium. Calcium absorption from two different ice cream formulations was determined in young adults and compared with milk. Sixteen healthy volunteers (25 to 45 years of age), recruited from the general public of The Netherlands, participated in a randomized, reference-controlled, double-blind cross-over study in which two test products and milk were consumed with a light standard breakfast on three separate occasions: a standard portion of ice cream (60 g) fortified with milk minerals and containing a low level (3%) of butter fat, ice cream (60 g) fortified with milk minerals and containing a typical level (9%) of coconut oil, and reduced-fat milk (1.7% milk fat) (200 mL). Calcium absorption was measured by the dual-label stable isotope technique. Effects on calcium absorption were evaluated by analysis of variance. Fractional absorption of calcium from the 3% butterfat ice cream, 9% coconut oil ice cream, and milk was 26%+/-8%, 28%+/-5%, and 31%+/-9%, respectively, and did not differ significantly (P=0.159). Results indicate that calcium bioavailability in the two calcium-fortified ice cream formulations used in this study is as high as milk, indicating that ice cream may be a good vehicle for delivery of calcium.

  20. Growth hormone and insulin-like growth factor-1 in prognosis coronary artery disease in patients with obesity

    Directory of Open Access Journals (Sweden)

    Olga Viktorovna Shpagina

    2014-10-01

    Full Text Available Introduction. In patients with obesity coronary atherosclerosis and chronic heart failure (CHF progress rapidly and have a worse long-term prognosis than those with normal weight.Objective: To investigate the prognostic significance of GH and IGF-1 in the evaluation of cardiovascular risk in patients with obesity.Materials and Methods. The study included 75 men (mean age 55.31±6.32 years, which are overweight or have mild obesity (body mass index (BMI 28.69±3.6 kg/m2. Group 1 included 45 patients (age 56.4±6.29 years, BMI 28.69±3.69 kg/m2, blood pressure 124±10.18/80±4.59 mm Hg who underwent coronary angiography. Group 2 included 30 patients (mean age 53.6 ± 6.1 years, BMI 28.68±3.52 kg/m2, blood pressure 128±9/83±6.81 mm Hg, CAD who are excluded by treadmill test. The coronary artery calcium score was assessed in group 2. All participants were evaluated impaired glucose tolerance (IGT, triglycerides (TG, IGF-1 and GH, LPHD, LPLD, geometry of the heart chambers was assessed by echocardiography.Results. Patients in both groups did not differ in age, BMI, blood pressure. IGF-1 levels were not significantly different among the study groups. High circulating IGF-1 levels were frequently observed in group 1 (р=0.018. A statistically significant association of high IGF-1 observed with obesity (p=0.033, smoking (p=0.049, hypertension (p=0.002, end-diastolic dimension (p=0.045. GH was lower in group 1 compared with group 2 (p=0.046. Serum levels of GH are positively associated with EF (p=0.023 and E/A (p=0.043 and negatively associated with left atrial wall thickness (p=0.025 and coronary artery calcium score (p=0.005.Conclusion: 1. IGF-1 may be a useful indicator to assess the prognosis of CAD and CHF in patients with obesity. 2. Relative GH deficiency was more often associated with severe CAD in patients with obesity.

  1. Current Indications for Coronary Arteriography

    OpenAIRE

    Dodek, Arthur

    1981-01-01

    Coronary arteriography is not necessary in all patients with angina pectoris. Angiography is indicated to define coronary anatomy in patients who have persistent angina despite full medication. It is also indicated in patients with a markedly positive stress test, unstable angina pectoris, positive stress test following myocardial infarction, variants of angina, ventricular aneurysm complications, and in the young coronary patient. Coronary arteriography may clarify the diagnosis in patients ...

  2. PROLONGED MULTIPLE SPASMS OF SMOOTH CORONARY ARTERIES PRESENTING AS ACUTE MIOCARDIAL INFARCTION, COMPLETE AV BLOCK AND SYNCOPE

    Directory of Open Access Journals (Sweden)

    Franci Cesar

    2004-11-01

    Full Text Available Background. A variant form of angina pectoris (VAP is caused by coronary vessel spasm and occures in patients with and without varying degrees of obstructive coronary artery disease. Although the prognosis of VAP without significant organic stenosis is generally good, multivessel spasm is associated with a high risk of life-threatening abnormalities of rhythm and conduction.Patient and methods. We describe a patient who presented with prolonged chest pain, associated with hypotension, lost of consciousness, complete AV block and widespread ST segment elevations consistent with inferoanterior acute myocardial infarction. Urgent selective coronary angiography revealed spasms in right coronary artery and in left circumflex artery that were relieved by intracoronary injection of nitroglycerin. All coronary arteries were otherwise patient, without signs of atherosclerosis. The patient was treated with diltiazem and nitrates. She made a complete recovery and resumed her normal activities.Conclusions. Simultaneous multiple spasms of native coronary arteries represent a rare syndrome characterized by significantly higher incidence of potentially life-threatening arrhythmia. Less commonly, prolonged coronary spasm may mimic acute myocardial infarction. Modern management of acute coronary syndromes, including urgent coronarography, enables a prompt differentiation between prolonged coronary spasm and atherosclerotic coronary disease, warranting different treatment strategies. Medical treatment with nitrates and calcium channel blockers in most cases prevents recurrence of vasospasms and arrhythmias.

  3. Association between epicardial fat volume and coronary plaques diagnosed by multislice computed tomography

    Directory of Open Access Journals (Sweden)

    José A. Morán Quijada

    2016-01-01

    Full Text Available Introduction: Coronary atherosclerotic disease is a major cause of death in Cuba and elsewhere. The volume of epicardial fat is considered a new cardiovascular risk factor because of its association with coronary atherogenesis.Objective: To determine, by multislice computed tomography, the association between epicardial fat volume and the presence of coronary atherosclerotic plaques.Method: A descriptive study was conducted with a universe of 130 patients with chest pain suggestive of ischemic heart disease, of which 117 were selected by opinion sampling. These patients underwent a calcium score study, a coronary angiography and a measurement of the epicardial fat volume.Results: Male patients predominated (54.7% and those aged 60-69 years (32.5%. A high volume of epicardial fat was found in 51.3% of patients, affecting 52.8% of women; 78.9% of patients with a calcium score between 100 and 399 UH had a high volume of epicardial fat, just as 71.2% of those with plaques and 100% of those with 4 or 5 plaques; 41% of patients had various types of plaque, which were mainly located in the anterior descending artery (88.1%.Conclusions: The measurement of the volume of epicardial fat is a useful tool to estimate the presence of coronary disease. When it was high, it was associated with older age, female gender and the presence of a higher calcium score, more plaques, more injuries and a greater involvement of the anterior descending artery.

  4. What Is Coronary Heart Disease?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is Coronary Heart Disease? Español Coronary heart disease (CHD) is a disease in which a waxy ... medical procedures can help prevent or treat coronary heart disease. These treatments may reduce the risk of related ...

  5. Nuclear cardiology and coronary surgery

    DEFF Research Database (Denmark)

    Eckardt, R.; Andersen, L.I.; Hesse, B.

    2008-01-01

    Rising age, repeated percutaneous coronary revascularizations, and co-morbidity such as overweight, diabetes, and hypertension, characterize a change over the last 20-30 years in coronary patients referred to coronary artery bypass grafting (CABG). This patient group represents a great part of to...

  6. Bioequivalence studies of fosfomycin calcium in healthy volunteers by liquid chromatography tandem mass spectrometry assay%液-质联用法研究磷霉素钙在健康人体的生物等效性

    Institute of Scientific and Technical Information of China (English)

    孙严彤; 王利君; 褚扬; 韩江彬; 魏岩

    2011-01-01

    目的:建立液-质联用法测定人血浆中磷霉素钙的浓度,研究磷霉素钙的人体药动学及生物等效性.方法:血浆样品中加入内标阿德福韦,经乙腈蛋白沉淀,SB-Aq C18色谱柱进行分离,流动相流速为1.0 mL·min-1,梯度洗脱方式,采用多反应监测(MRM)的负离子方式检测.结果:在100~25 000 μg·L-1范围内呈良好的线性关系,日内及日间精密度(RSD)小于8%.受试制剂和参比制荆的tmax分别为(1.8±0.2)h和(2.4±0.5)h,Cmax分别为(6034.0±1540.9)μg·L-1和(6182.5±1221.4)μg·L-1,AUC0-t分别为(43755.6±7198.0)μg·h·L-1和(43720.1±9134.2)μg·h·L-1.结论:本法准确,灵敏无杂质干扰.两种制剂生物等效.%OBJECTIVE A simple, sensitive and rapid liquid chromatography tandem mass spectrometry assay was developed and validated for the quantification of fosfomycin calcium in human plasma.The assay was applied in a bioequivalence study of two suspension formulations of fosfomycin calcium METHODS Adefovir was used as internal standard (I.S.).After protein precipitation by acetonitrile, the analyte and I.S.were separated on a Zorbax SB-Aq C18 column using gradient elution at a flow rate of 1.0 mL·min-1.Detection was by electrospray negative ionization mass spectrometry in the multiple-reaction monitoring mode.RESULTS The method was linear over the range of 100 - 25 000 μg· L-1 with inter- and intra-day precisions (as relative standard deviation)<8%.The pharmacokinetics parameters of test and reference formulations were as follows: tmax were (1.8 ± 0.2) h and (2.4 ± 0.5) h, respectively; Cmax were (6 034.0 ± 1 540.9) μg· L- 1 and (6 182.5 ± 1 221.4) μg·L- 1 respectively, AUC0-t were (43 755.6 ± 7 198.0) μg· h· L-1 and (43 720.1 ± 9 134.2) μg· h· L-1 respectively.CONCLUSION The method is accurate and sensitive with no endogenous interference The two formulations are bioequivalent.

  7. Diagnostic Accuracy of 64-Slice MDCT Coronary Angiography for the Assessment of Coronary Artery Disease in Korean Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Jun Sung Moon

    2013-02-01

    Full Text Available BackgroundA 64-slice multidetector computed tomography (MDCT is well known to be a useful noninvasive form of angiography for the general population, but not for certain patients with diabetes. The aim of this study was to investigate the diagnostic accuracy and usefulness of 64-slice MDCT coronary angiography for detecting coronary artery disease in Korean patients with type 2 diabetes mellitus (T2DM.MethodsA total of 240 patients were included, 74 of whom had type 2 diabetes (M:F=40:33; 41.8±9.5 years. We compared significant coronary stenosis (>50% luminal narrowing in MDCT with invasive coronary angiography (ICA by segment, artery, and patient. We also evaluated the influence of obesity and coronary calcium score on MDCT accuracy.ResultsOf the 4,064 coronary segments studied, 4,062 segments (T2DM=1,109 were assessed quantitatively by both MDCT and ICA, and 706 segments (T2DM=226 were detected as a significant lesion by ICA in all patients. Sensitivity, specificity, as well as positive and negative predictive values for the presence of significant stenosis in T2DM were: by segment, 89.4%, 96.4%, 85.8%, and 97.4%, respectively; by artery (n=222, 95.1%, 92.9%, 94.4%, and 93.8%, respectively; by patients (n=74, 98.4%, 100.0%, 98.4%, and 90.0%, respectively. Regardless of presence of diabetes, there was no significant difference in diagnostic accuracy. Obesity (≥25 kg/m2 and coronary calcium score did not also affect the diagnostic accuracy of MDCT.ConclusionThe 64-slice MDCT coronary angiography was found to have similar diagnostic accuracy with ICA, regardless of diabetes. These results suggest MDCT may be helpful to reduce unnecessary invasive studies for patients with diabetes.

  8. Mass attenuation coefficient (μ/ρ), effective atomic number (Z{sub eff}) and measurement of x-ray energy spectra using based calcium phosphate biomaterials: a comparative study

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes Z, M. A.; Da Silva, T. A.; Nogueira, M. S. [Centro de Desenvolvimento da Tecnologia Nuclear / CNEN, Pte. Antonio Carlos 6627, Belo Horizonte 31270-901, Minas Gerais (Brazil); Goncalves Z, E., E-mail: madelon@cdtn.br [Pontifice Catholic University of Minas Gerais, Av. Dom Jose Gaspar 500, Belo Horizonte 30535-901, Minas Gerais (Brazil)

    2015-10-15

    In dentistry, alveolar bone regeneration procedures using based calcium phosphate biomaterials have been shown effective. However,there are not reports in the literature of studies the interaction of low energy radiation in these biomaterials used as attenuator and not being then allowed a comparison between the theoretical values and experimental.The objective of this study was to determine the interaction of radiation parameters of four dental biomaterials - BioOss, Cerasorb M Dental, Straumann Boneceramic and Osteogen for diagnostic radiology qualities. As a material and methods, the composition of the biomaterials was determined by the analytical techniques. The samples with 0.181 cm to 0,297 cm thickness were experimentally used as attenuators for the measurement of the transmitted X-rays spectra in X-ray equipment with 50 to 90 kV range by spectrometric system comprising the Cd Te detector. After this procedure, the mass attenuation coefficient, the effective atomic number were determined and compared between all the specimens analyzed, using the program WinXCOM in the range of 10 to 200 keV. In all strains examined observed that the energy spectrum of x-rays transmitted through the BioOss has the mean energy slightly smaller than the others biomaterials for close thickness. The μ/ρ and Z{sub eff} of the biomaterials showed its dependence on photon energy and atomic number of the elements of the material analyzed. It is concluded according to the methodology employed in this study that the measurements of x-ray spectrum, μ/ρ and Z{sub eff} using biomaterials as attenuators confirmed that the thickness, density, composition of the samples, the incident photon energy are factors that determine the characteristics of radiation in a tissue or equivalent material. (Author)

  9. The haemodynamic effects of nifedipine, verapamil and diltiazem in patients with coronary artery disease. A review

    NARCIS (Netherlands)

    A.L. Soward; G.L.J. Vanhaleweyk; P.W.J.C. Serruys (Patrick)

    1986-01-01

    textabstractOf the 3 most widely used calcium antagonists--nifedipine, verapamil and diltiazem--nifedipine is the most potent arterial vasodilator. Increases in cardiac output and coronary blood flow following nifedipine administration result in part from the afterload reduction. Reflex adrenergic s

  10. Calcium handling in Sparus auratus: effects of water and dietary calcium levels on mineral composition, cortisol and PTHrP levels.

    NARCIS (Netherlands)

    Abbink, W.; Bevelander, G.S.; Rotllant, J.; Canario, A.V.; Flik, G.

    2004-01-01

    Juvenile gilthead sea bream (Sparus auratus L.; 10-40 g body mass) were acclimatized in the laboratory to full strength (34 per thousand) or dilute (2.5 per thousand) seawater and fed normal, calcium-sufficient or calcium-deficient diet for nine weeks. Mean growth rate, whole-body calcium and

  11. Calcium signaling and epilepsy.

    Science.gov (United States)

    Steinlein, Ortrud K

    2014-08-01

    Calcium signaling is involved in a multitude of physiological and pathophysiological mechanisms. Over the last decade, it has been increasingly recognized as an important factor in epileptogenesis, and it is becoming obvious that the excess synchronization of neurons that is characteristic for seizures can be linked to various calcium signaling pathways. These include immediate effects on membrane excitability by calcium influx through ion channels as well as delayed mechanisms that act through G-protein coupled pathways. Calcium signaling is able to cause hyperexcitability either by direct modulation of neuronal activity or indirectly through calcium-dependent gliotransmission. Furthermore, feedback mechanisms between mitochondrial calcium signaling and reactive oxygen species are able to cause neuronal cell death and seizures. Unravelling the complexity of calcium signaling in epileptogenesis is a daunting task, but it includes the promise to uncover formerly unknown targets for the development of new antiepileptic drugs.

  12. Vitamin D, calcium homeostasis and aging

    Science.gov (United States)

    Veldurthy, Vaishali; Wei, Ran; Oz, Leyla; Dhawan, Puneet; Jeon, Yong Heui; Christakos, Sylvia

    2016-01-01

    Osteoporosis is characterized by low bone mass and microarchitecture deterioration of bone tissue, leading to enhanced bone fragility and consequent increase in fracture risk. Evidence is accumulating for an important role of calcium deficiency as the process of aging is associated with disturbed calcium balance. Vitamin D is the principal factor that maintains calcium homeostasis. Increasing evidence indicates that the reason for disturbed calcium balance with age is inadequate vitamin D levels in the elderly. In this article, an overview of our current understanding of vitamin D, its metabolism, and mechanisms involved in vitamin D-mediated maintenance of calcium homeostasis is presented. In addition, mechanisms involved in age-related dysregulation of 1,25(OH)2D3 action, recommended daily doses of vitamin D and calcium, and the use of vitamin D analogs for the treatment of osteoporosis (which remains controversial) are reviewed. Elucidation of the molecular pathways of vitamin D action and modifications that occur with aging will be an active area of future research that has the potential to reveal new therapeutic strategies to maintain calcium balance. PMID:27790378

  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. Fate of Patients With Coronary Perforation Complicating Percutaneous Coronary Intervention (from the Euro Heart Survey Percutaneous Coronary Intervention Registry).

    Science.gov (United States)

    Bauer, Timm; Boeder, Niklas; Nef, Holger M; Möllmann, Helge; Hochadel, Matthias; Marco, Jean; Weidinger, Franz; Zeymer, Uwe; Gitt, Anselm K; Hamm, Christian W

    2015-11-01

    Coronary perforation (CP) is a life-threatening complication that can occur during percutaneous coronary intervention (PCI). Little is known, however, about the incidence and clinical outcome of CP. We sought to investigate the occurrence of CP and its determinants and risk profile in a large-scale, prospective registry. From 2005 to 2008, unselected patients (n = 42,068) from 175 centers in 33 countries who underwent a PCI procedure were prospectively enrolled in the PCI registry of the Euro Heart Survey program. For the present analysis, patients experiencing CP during PCI (n = 124, 0.3%) were compared with those who underwent PCI without CP. Patients with CP were older, more often women, had more severe coronary disease, and underwent more complex types of coronary intervention. Independent factors associated with CP were the use of rotablation, intravascular ultrasound-guided PCI, bypass PCI, a totally occluded vessel, a type C lesion, peripheral arterial disease, and body mass index <25. More than 10% of the patients developed cardiac tamponade. In a small minority (3.3%), emergency bypass surgery had to be performed. The inhospital death rate was markedly elevated in patients with CP (7.3% vs 1.5%, p <0.001). After adjustment for the EuroHeart score, CP remained a strong predictor of hospital mortality (odds ratio 5.21, 95% confidence interval 2.34 to 11.60). In conclusion, in this real world, all-comers registry, the incidence of CP was low, occurred more often in patients who underwent more complex coronary interventions, and was associated with a fivefold higher hospital mortality.

  15. 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.

  16. 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.

  17. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950286 Percutaneous transluminal coronary angio-plasty for unstable angina.LIU Meilin(刘梅林),et.al.1st Teach Hosp,Beijing Med Univ,Beijing,100034.Chin J Intern Med 1995;34(3):169-172.Percutaneous transluminal coronary angioplasty(PTCA) was performed in 190 patients with 250 dis-eased vessels and 278 lesions from Dec.1987 to Feb.1994.All the patients had unstable angina (UA).There were 52(18.7%) type A lesions,175(62.9%)type B lesions and 51(18.3%) type C lesions.Of the

  18. 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.

  19. Photodissociation studies of calcium-coronene and calcium-pyrene cation clusters

    Science.gov (United States)

    Scott, A. C.; Buchanan, J. W.; Flynn, N. D.; Duncan, M. A.

    2008-01-01

    Gas-phase cluster cations combining calcium atoms and the polycyclic aromatic hydrocarbons (PAHs) coronene (C24H12) and pyrene (C16H10) are produced in a molecular beam using laser vaporization in a pulsed nozzle cluster source. Time-of-flight mass spectrometry reveals the formation of clusters of the form Cax(coronene)y+ for up to x = 4 and y = 3 and Cax(pyrene)y+ for up to x = 2 and y = 3. Mass-selected photodissociation studies show that the calcium cation is the most prominent fragment for each system. Photoinduced calcium carbide formation is prominent when two or more calcium atoms are present. Additionally, there is evidence that these clusters can form sandwich structures.

  20. 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

  1. 新疆维吾尔族健康及冠心病人群中体质指数、腰围与动脉僵硬程度相关性研究%Correlation between the body mass index, the waist circumference and the arterial stiffness in ;healthy and coronary artery disease Uygur population of the Xinjiang

    Institute of Scientific and Technical Information of China (English)

    刘军; 潘硕; 马依彤; 陈铀; 陶静

    2014-01-01

    Objective To study the correlation between the body mass index, the waist circumference and the arterial stiffness in healthy and coronary artery disease Uygur population in Xinjiang. Methods The study included 113 coronary artery disease patients and 92 healthy people in the Xinjiang. Their body mass index, waist circumference, and brachial-ankle pulse wave index and biochemical value were measured. In the healthy people and the coronary artery disease patients, the linear correlation analysis is performed with the body mass index, the waist circumference and brachial-ankle pulse wave index. The confounding factors of the brachial-ankle pulse wave index were adjusted. Results In healthy people, the pulse wave index (PWV) was not correlated with body mass index (BMI)(r=0.076, P>0.05). The PWV was positively correlated with waist circumference(r=0.218, P<0.05). In coronary artery disease patients, the PWV was positively correlated with BMI(r=0.232, P<0.01).The PWV was positively correlated with waist circumference(r=0.256, P<0.01). After adjusting for age, gender, and other cardiovascular risk factors, each additional 1 kg/m2 in BMI may be accompanied with an increase of 0.053 m/s in the PWV, each 1 cm increase in waist circumference may be accompanied with an increase of 0.027 m/s in the PWV. Conclusion Whether in the healthy or coronary artery disease Uygur population, the measure of abdominal obesity (waist circumference) and general obesity (BMI) were positively associated with arterial stiffness presented by the PWV.%目的:研究新疆地区维吾尔族健康及冠心病人群中体质指数(BMI)、腰围与动脉僵硬程度相关性。方法本研究纳入新疆地区冠心病患者113例,健康人92人。测量其体质指数、腰围、臂踝脉搏波传导速度(PWV)及各项生化指标。分别在健康人群与冠心病人群中,用体质指数、腰围与PWV做线性相关性分析,并对PWV的影响因素进行校正。结果在健

  2. Calcium and calcium isotope changes during carbon cycle perturbations at the end-Permian

    Science.gov (United States)

    Komar, Nemanja; Zeebe, Richard

    2016-04-01

    Negative carbon and calcium isotope excursions, as well as climate shifts, took place during the most severe mass extinction event in Earth's history, the end-Permian (˜252 Ma). Investigating the connection between carbon and calcium cycles during transient carbon cycle perturbation events, such as the end-Permian, may help resolve the intricacies between the coupled calcium-carbon cycles, as well as provide a tool for constraining the causes of mass extinction. Here, we identify the deficiencies of a simplified calcium model employed in several previous studies and we demonstrate the importance of a fully coupled carbon-cycle model when investigating the dynamics of carbon and calcium cycling. Simulations with a modified version of the LOSCAR model, which includes a fully coupled carbon-calcium cycle, indicate that increased weathering rates and ocean acidification (potentially caused by Siberian Trap volcanism) are not capable of producing trends observed in the record, as previously claimed. Our model results suggest that combined effects of carbon input via Siberian Trap volcanism (12,000 Pg C), the cessation of biological carbon export, and variable calcium isotope fractionation (due to a change in the seawater carbonate ion concentration) represents a more plausible scenario. This scenario successfully reconciles δ13C and δ44Ca trends observed in the sediment record, as well as the proposed warming of >6oC.

  3. 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.)

  4. [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.

  5. Documenting the use of calcium supplements with oral bisphosphonates.

    Science.gov (United States)

    Nye, Ann Marie; Hamrick, Irene; Rauch, Allison; Pound, Melanie W; Shelton, Penny S

    2013-01-01

    Patients receiving an oral bisphosphonate for treatment of osteopenia or osteoporosis without adequate calcium intake are not optimally treated. Physicians prescribing bisphosphonates may not consistently document calcium supplementation recommendations. This is a retrospective chart review of osteoporotic or osteopenic outpatients with an active prescription for an oral bisphosphonate. This cross-sectional study was designed to determine the point prevalence of calcium supplementation recommendations by physicians. Academic family medicine outpatient clinics. Of the 1,229 patients with osteoporosis or osteopenia, 425 patients had an active prescription for an oral bisphosphonate and were included in the study. The active/inactive medication list and physician clinic notes in the electronic medical record were reviewed for documentation regarding calcium. The primary endpoint was the percentage of patients on bisphosphonates also receiving calcium. The secondary endpoint was the identification of demographic characteristics associated with lower use of calcium. The patient sample was 94% female, 69% white, with a mean body mass index of 27, and mean age of 72 years. Of the 425 patients, 387 (91.1%) were taking calcium or had a documented recommendation for calcium supplementation. Of the demographic characteristics evaluated, only age was statistically significantly different, with an average age of 76 years in the calcium group and 66 years of age in the noncalcium group. In this study, 91% of outpatients who were prescribed a bisphosphonate also were taking calcium or had it recommended to them. The only statistically significant difference between groups was greater age for those who received calcium.

  6. 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

  7. Lead removal in rats using calcium alginate.

    Science.gov (United States)

    Savchenko, Olga V; Sgrebneva, Marina N; Kiselev, Vladimir I; Khotimchenko, Yuri S

    2015-01-01

    Lead (Pb) exposure, even at low levels, causes a variety of health problems. The aims of this study were to investigate the tissue distribution of lead in the bodies of rats, to evaluate lead removal from the internal organs and bones using calcium alginate in doses of 500, 200 and 100 mg/kg per day for 28 days and to assess the impact of calcium alginate on the level of essential elements. Lead (Pb), calcium (Ca), manganese (Mn), iron (Fe), copper (Cu) and zinc (Zn) levels in the blood, hearts, kidneys, livers and femurs of the experimental animals were measured using mass spectrometry with inductively coupled plasma. The results revealed that lead acetate exposure increased the levels of Pb in the blood and organs of the animals and significantly reduced contents of Ca, Mn, Fe, Cu and Zn. Treatment with calcium alginate in dose 500 mg/kg contributed to significant decreases in the amount of lead in the kidney, heart and bones of animals and a slight increase in the content of essential elements in the liver, kidneys and heart, although these changes were not significant. Decreasing of lead was not significant in the internal organs, bones and blood of animals treated with calcium alginate 200 and 100 mg/kg. Consequently, calcium alginate dose of 500 mg/kg more efficiently removes lead accumulated in the body. Calcium alginate does not have negative effect on level of essential elements quite the contrary; reducing the levels of lead, calcium alginate helps normalize imbalances of Ca, Mn, Fe, Cu and Zn. The results of this study suggest that calcium alginate may potentially be useful for the treatment and prevention of heavy metal intoxications.

  8. 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)

  9. [Acute coronary syndrome -- 2012].

    Science.gov (United States)

    Becker, Dávid; Merkely, Béla

    2012-12-23

    The acute coronary syndrome is the most severe form of coronary artery disease. It is an immediate threat of life and the mortality rate can be high without proper therapy and patient management. Based on the first ECG, two different forms can be distinguished: acute coronary syndrome with and without ST elevation. Besides adequate medication, management of these patients is an essential part of treatment. In case of ST elevation, coronarography and percutaneous coronary intervention is needed in general, within 24 hours from the onset of symptoms. When ST elevation is not detected on the ECG, individual ischemic risk factors and predictable mortality of the patient may define the necessity and the date of the invasive examination. The Hungarian hemodynamic laboratory network covers almost the whole country and, therefore, practically each patient may receive a state-of-the-art therapy. Although indicators of cardiovascular diseases are still prominent, the mortality rate of myocardial Infarction is decreasing in Hungary due to the well-organized invasive care.

  10. 糖调节受损对中青年高血压患者冠状动脉钙化积分的影响%The Impact of Coronary Artery Calcium Score in Youth and Middle Aged Essential Hypertension Patients with Impaired Glucose Regulation

    Institute of Scientific and Technical Information of China (English)

    唐彬; 吴沃栋; 黄唤亮; 梁国华; 江魁明

    2011-01-01

    目的:探讨糖调节受损对中青年高血压患者冠状动脉钙化积分(Coronary artery calcium score,CACS)的影响.方法:入选的高血压患者分为正常糖调节组(NGR-H)38例; 糖调节受损组(IGR-H)共36例,糖尿病组(DM-H)共42例.比较各组不同CACS积分和FRFC%分层患者分布的比例和各组CACS总积分与HOMA-IR指数的相关性.结果:CACS高危患者比例,IGR-H组或DM-H组均较高于NGR-H组(P<0.01).CACS极高危患者比例IGR-H组或DM-H组均高于NGR-H组(P<0.01).在各CACS危险分层,IGR-H组与DM-H组比较差异无统计学意义.IGR-H组患者CACS总积分与HOMA-IR指数呈正相关,r=0.726,(P<0.01).结论:糖调节受损中青年高血压患者冠状动脉钙化积分(CACS)高于正常糖调节的中青年高血压患者,与糖尿病患者CACS积分相近.CACS总积分与HOMA-IR指数呈正相关.%Objective: To explore the changes of CACS in youth and middle aged essential hypertension (EH) patients with impaired glucose regulation ( IGR ) by CTA. Method: EH patients were classified by OGTT, 36 EH patients with IGR (IGR-H) as study group, 42 EH patients with diabetes mellitus (DM-H)and 38 EH patients with normal glucose regulation ( NGR-H) as control groups. The CACS difference or relationship between total CACS and RI in each study and control groups had been compared. Result: The patients rate in high risk CACS, IGR-H group or DM-H group was higher than that in NGR-H group, ( all P <0.01 ). In very high risk CACS, IGR-H group or DM-H group was higher than that in NGR-H group,(all P<0.01). In each CACS risk stratify, there was no significant differences between IGR-H group and DM-H group. The total CACS was positive related to the increased IR in IGR-H or DM-H patients (r=0.726, P<0.01 ). Conclusion: The CACS is significantly higher in IGR EH patients than that in NGR EH patients. The CACS was no significantly differences compared with IGR -H patients and DM -H patients. The total CACS is positive related

  11. [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.

  12. Impact of coronary tortuosity on coronary pressure: numerical simulation study.

    Directory of Open Access Journals (Sweden)

    Yang Li

    Full Text Available BACKGROUND: Coronary tortuosity (CT is a common coronary angiographic finding. Whether CT leads to an apparent reduction in coronary pressure distal to the tortuous segment of the coronary artery is still unknown. The purpose of this study is to determine the impact of CT on coronary pressure distribution by numerical simulation. METHODS: 21 idealized models were created to investigate the influence of coronary tortuosity angle (CTA and coronary tortuosity number (CTN on coronary pressure distribution. A 2D incompressible Newtonian flow was assumed and the computational simulation was performed using finite volume method. CTA of 30°, 60°, 90°, 120° and CTN of 0, 1, 2, 3, 4, 5 were discussed under both steady and pulsatile conditions, and the changes of outlet pressure and inlet velocity during the cardiac cycle were considered. RESULTS: Coronary pressure distribution was affected both by CTA and CTN. We found that the pressure drop between the start and the end of the CT segment decreased with CTA, and the length of the CT segment also declined with CTA. An increase in CTN resulted in an increase in the pressure drop. CONCLUSIONS: Compared to no-CT, CT can results in more decrease of coronary blood pressure in dependence on the severity of tortuosity and severe CT may cause myocardial ischemia.

  13. Calcium channel blocker poisoning

    Directory of Open Access Journals (Sweden)

    Miran Brvar

    2005-04-01

    Full Text Available Background: Calcium channel blockers act at L-type calcium channels in cardiac and vascular smooth muscles by preventing calcium influx into cells with resultant decrease in vascular tone and cardiac inotropy, chronotropy and dromotropy. Poisoning with calcium channel blockers results in reduced cardiac output, bradycardia, atrioventricular block, hypotension and shock. The findings of hypotension and bradycardia should suggest poisoning with calcium channel blockers.Conclusions: Treatment includes immediate gastric lavage and whole-bowel irrigation in case of ingestion of sustainedrelease products. All patients should receive an activated charcoal orally. Specific treatment includes calcium, glucagone and insulin, which proved especially useful in shocked patients. Supportive care including the use of catecholamines is not always effective. In the setting of failure of pharmacological therapy transvenous pacing, balloon pump and cardiopulmonary by-pass may be necessary.

  14. CT coronary angiography vs. invasive coronary angiography in CHD

    Directory of Open Access Journals (Sweden)

    Anja Hagen

    2012-04-01

    Full Text Available Scientific background: Various diagnostic tests including conventional invasive coronary angiography and non-invasive computed tomography (CT coronary angiography are used in the diagnosis of coronary heart disease (CHD. Research questions: The present report aims to evaluate the clinical efficacy, diagnostic accuracy, prognostic value cost-effectiveness as well as the ethical, social and legal implications of CT coronary angiography versus invasive coronary angiography in the diagnosis of CHD. Methods: A systematic literature search was conducted in electronic data bases (MEDLINE, EMBASE etc. in October 2010 and was completed with a manual search. The literature search was restricted to articles published from 2006 in German or English. Two independent reviewers were involved in the selection of the relevant publications. The medical evaluation was based on systematic reviews of diagnostic studies with invasive coronary angiography as the reference standard and on diagnostic studies with intracoronary pressure measurement as the reference standard. Study results were combined in a meta-analysis with 95 % confidence intervals (CI. Additionally, data on radiation doses from current non-systematic reviews were taken into account. A health economic evaluation was performed by modelling from the social perspective with clinical assumptions derived from the meta-analysis and economic assumptions derived from contemporary German sources. Data on special indications (bypass or in-stent-restenosis were not included in the evaluation. Only data obtained using CT scanners with at least 64 slices were considered. Results: No studies were found regarding the clinical efficacy or prognostic value of CT coronary angiography versus conventional invasive coronary angiography in the diagnosis of CHD. Overall, 15 systematic reviews with data from 44 diagnostic studies using invasive coronary angiography as the reference standard (identification of obstructive

  15. Angiography and coronary function, a clinical approach

    NARCIS (Netherlands)

    Stoel, Martin Gerrit

    2013-01-01

    Coronary angiography has the potential to determine coronary function in addition to merely showing coronary anatomy. In this thesis, we describe several facets of angiographic evaluation of coronary flow velocity and function. Measurement of the length of the coronary vessels by means of a guide

  16. Calcium is important forus.

    Institute of Scientific and Technical Information of China (English)

    高利平

    2005-01-01

    Calcium is important for our health.We must have it in our diet to stay well.A good place to get it is from dairy products like milk, cheese and ice cream.One pound of cheese has fifty times the calcium we should have every day.Other foods have less.For example,a pound of beans also has calcium.But it has only three times the amount we ought to have daily.

  17. Effect of dietary calcium intake on its retention by caged broiler breeder hens

    Directory of Open Access Journals (Sweden)

    John Cassius Moreki,

    2011-04-01

    Full Text Available Calcium is an important mineral in bone development and egg shell formation of broiler breeder hens. A study was undertaken to further examine the effect of dietary calcium intake on calcium retention of broiler breeder hens and to investigate the relationship between calcium retention and egg characteristics. Ninety broiler breeder hens were obtained from a previous study and allocated to three dietary treatments, 1.5, 2.5 and 3.5% calcium level. Feeds were isocaloric and isonitrogenous but differed only in calcium and phosphorus contents. Birds were fed and caged individually with metal trays placed below cages for excreta collection. Excreta samples (30 birds per treatment were collected for calcium and phosphorus determinations during a 7-day period at 3-weekly intervals, i.e., 27, 33, 36 and 42 weeks of age. Other parameters measured included calcium intake of hens, hen day production, egg mass, egg weight, shell weight, shell percentage, shell thickness, egg surface area, shell weight per unit surface area, total calcium retention, shell calcium excretion, shell calcium as a percentage of calcium intake and faecal calcium as percentage of calcium intake. These results showed that dietary calcium level had significant (P<.0001 effect on calcium intake and retention. Dietary calcium level had significant effect on all parameters except egg weight and shell calcium excretion as a percentage of calcium intake. Calcium retention of hens was correlated with age, calcium intake and eggshell characteristics. Age was significantly correlated with all traits except daily calcium intake, calcium retention and shell percentage. The net effect of calcium intake and total calcium excretion was that the 2.5% calcium level (3.8 g calcium /hen/day exhibit a significant (P<.05 higher calcium retention compared to 1.5% calcium level. This suggests that the calcium level of 2.5% and intake of 3.8 g/hen/day is adequate to support egg production, good shell

  18. Current role of MDCT in the diagnosis of coronary artery disease (2011). A clinical guideline of the Austrian Societies of Cardiology and Radiology; Aktueller Stellenwert der MSCTA in der Koronargefaessdiagnostik (2011). Klinischer Leitfaden der Oesterreichischen Gesellschaften fuer Kardiologie und Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Hergan, K. [Salzburger Landeskliniken, Paracelsus Medizinische Privatuniv. (Austria). Universitaetsinst. fuer Radiologie; Globits, S. [Landesklinikum St. Poelten (Austria). 3. Medizinische Abt./Kardiologie; Loewe, C. [Medizinische Univ. Wien (AT). Universitaetsklinik fuer Radiodiagnostik] (and others)

    2011-10-15

    The clinical guideline of the Austrian Societies for Cardiology and Radiology on the actual role of MDCT in the diagnosis of coronary artery diseases includes the following issues: CT calcium scoring; CT angiography (CTA) of the coronaries; actually recommended application of MDCR; generally inappropriate use of the technique for specific patients; radiation exposure; structural and organizational framework.

  19. Low Bone Mass in Thalassemia

    Science.gov (United States)

    4 Low Bone Mass in Thalassemia • In addition to a diet rich in calcium and vitamin D, your doctor may recommend taking calcium and/or vitamin D ... Zoledronic acid may be beneficial to patients with thalassemia and osteoporosis; other trials are investigating whether increasing ...

  20. Feasibility and accuracy of coronary imaging in elderly patients using the 64-row multi-detector computed tomography: a correlation study with conventional coronary angiography

    Institute of Scientific and Technical Information of China (English)

    Wei Ling CHAN; Kui Hian SIM; Chee Khoon LIEW; Sze Piaw CHIN; Tiong Kiam ONG; Seyfarth Tobias; Yean Yip FONG; Choon Kiat ANG; Houng Bang LIEW; Rapaee ANNUAR

    2006-01-01

    Background Elderly patients generally have higher occurrence of coronary calcification, increased heart rate and difficulty with prolonged breath-holding. The aim of our study was to investigate the feasibility and accuracy of using 64-row multi-detector computed tomography (MDCT) in the assessment of coronary artery stenoses in elderly patients. Methods One hundred and fifty two patients with suspected or known coronary artery disease were divided into 4 groups according to their age (Group A: 40-49 years,n=34; Group B: 50-59 years, n=57; Group C: 60-69 years, n=48; Group D: 70 years and above; n=13). Coronary CT angiography (CTA) using a 64-row MDCT was performed and the findings were compared with that of conventional coronary angiography (CCA).Using axial images, multi-planar reconstructions (MPR) and maximum intensity projections (MIP), coronary segments of lumen diameter = 1.5mm were analyzed for the presence of significant stenosis (= 50% ). Results Percentages of poor image quality from coronary CTA preventing reliable correlations with CCA were 21%, 14%, 19% and 62% in Groups A to D respectively. Patients in Group D had significantly higher calcium scores compared with the other groups (P<0.001). In patients where CTA images were of acceptable quality, percentages of accurate correlations with CCA were 89.8%, 93.4%, 86.6% and 78.0% for Groups A to D respectively.There were no significant difference in serum creatinine, heart rate and contrast volume between the 4 groups. Conclusions The 64-row MDCT coronary angiography was less accurate and feasible for patients aged 70 years or above due to heavy coronary calcification and inability to perform a satisfactory breath-hold. However, a high diagnostic accuracy with the MDCT is possible in patients aged less than 70 years.

  1. Variant angina and coronary artery spasm: the clinical spectrum, pathophysiology, and management.

    Science.gov (United States)

    Kusama, Yoshiki; Kodani, Eitaro; Nakagomi, Akihiro; Otsuka, Toshiaki; Atarashi, Hirotsugu; Kishida, Hiroshi; Mizuno, Kyoichi

    2011-01-01

    Variant angina is a form of angina pectoris that shows transient ST-segment elevation on electrocardiogram during an attack of chest pain. Ischemic episodes of variant angina show circadian variation and often occur at rest from midnight to early morning. Ischemic episodes also occur during mild exercise in the early morning. However, they are not usually induced by strenuous exercise in the afternoon. Other important clinical features of variant angina include the high frequency of asymptomatic ischemic episodes and the syncope that sometimes occur during the ischemic episodes. Syncope is due to severe arrhythmias, including ventricular tachycardia, ventricular fibrillation, and high-degree atrioventricular block. Coronary artery spasm is the mechanism of ischemic episodes in variant angina. The incidence of coronary artery spasm shows a racial difference and is higher in Japanese than in Caucasians. Coronary arteriograms are normal or near-normal in most Japanese patients with variant angina. Deficient basal release of nitric oxide (NO) due to endothelial dysfunction, and enhanced vascular smooth muscle contractility with the involvement of the Rho/Rho-kinase pathway are reported to play important roles in the pathogenesis of coronary artery spasm. Other precipitating factors of coronary artery spasm include imbalance in autonomic nervous activity, increased oxidative stress, chronic low-grade inflammation, magnesium deficiency, and genetic susceptibility. The genetic risk factors associated with coronary artery spasm include gene polymorphisms of endothelial NO synthase (NOS), paraoxonase, and other genes. Calcium channel blockers are extremely effective in preventing coronary spasm. The long-acting nitrate, nicorandil, and Rho-kinase inhibitor are also useful for inhibiting coronary artery spasm. Because variant angina can lead to acute myocardial infarction, fatal arrhythmias, and sudden death, early treatment is important. The prognosis of patients with

  2. Leptin augments coronary vasoconstriction and smooth muscle proliferation via a Rho-kinase-dependent pathway.

    Science.gov (United States)

    Noblet, Jillian N; Goodwill, Adam G; Sassoon, Daniel J; Kiel, Alexander M; Tune, Johnathan D

    2016-05-01

    Leptin has been implicated as a key upstream mediator of pathways associated with coronary vascular dysfunction and disease. The purpose of this investigation was to test the hypothesis that leptin modifies the coronary artery proteome and promotes increases in coronary smooth muscle contraction and proliferation via influences on Rho kinase signaling. Global proteomic assessment of coronary arteries from lean swine cultured with obese concentrations of leptin (30 ng/mL) for 3 days revealed significant alterations in the coronary artery proteome (68 proteins) and identified an association between leptin treatment and calcium signaling/contraction (four proteins) and cellular growth and proliferation (35 proteins). Isometric tension studies demonstrated that both acute (30 min) and chronic (3 days, serum-free media) exposure to obese concentrations of leptin potentiated depolarization-induced contraction of coronary arteries. Inhibition of Rho kinase significantly reduced leptin-mediated increases in coronary artery contractions. The effects of leptin on the functional expression of Rho kinase were time-dependent, as acute treatment increased Rho kinase activity while chronic (3 day) exposure was associated with increases in Rho kinase protein abundance. Proliferation assays following chronic leptin administration (8 day, serum-containing media) demonstrated that leptin augmented coronary vascular smooth muscle proliferation and increased Rho kinase activity. Inhibition of Rho kinase significantly reduced these effects of leptin. Taken together, these findings demonstrate that leptin promotes increases in coronary vasoconstriction and smooth muscle proliferation and indicate that these phenotypic effects are associated with alterations in the coronary artery proteome and dynamic effects on the Rho kinase pathway.

  3. Serum Calcium Increase Correlates With Worsening of Lipid Profile

    Science.gov (United States)

    Gallo, Luigia; Faniello, Maria C.; Canino, Giovanni; Tripolino, Cesare; Gnasso, Agostino; Cuda, Giovanni; Costanzo, Francesco S.; Irace, Concetta

    2016-01-01

    Abstract Despite the well-documented role of calcium in cell metabolism, its role in the development of cardiovascular disease is still under heavy debate. Several studies suggest that calcium supplementation might be associated with an increased risk of coronary heart disease, whereas others underline a significant effect on lowering high blood pressure and hyperlipidemia. The purpose of this study was to investigate, in a large nonselected cohort from South Italy, if serum calcium levels correlate with lipid values and can therefore be linked to higher individual cardiovascular risk. Eight-thousand-six-hundred-ten outpatients addressed to the Laboratory of Clinical Biochemistry, University of Magna Græcia, Catanzaro, Italy from January 2012 to December 2013 for routine blood tests, were enrolled in the study. Total HDL-, LDL- and non-HDL colesterol, triglycerides, and calcium were determined with standard methods. We observed a significant association between total cholesterol, LDL-cholesterol, HDL-cholesterol, non-HDL cholesterol, triglycerides, and serum calcium in men and postmenopause women. Interestingly, in premenopause women, we only found a direct correlation between serum calcium, total cholesterol, and HDL-cholesterol. Calcium significantly increased while increasing total cholesterol and triglycerides in men and postmenopause women. Our results confirm that progressive increase of serum calcium level correlates with worsening of lipid profile in our study population. Therefore, we suggest that a greater caution should be used in calcium supplement prescription particularly in men and women undergoing menopause, in which an increase of serum lipids is already known to be associated with a higher cardiovascular risk. PMID:26937904

  4. 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

  5. Calcium sulphate in ammonium sulphate solution

    Science.gov (United States)

    Sullivan, E.C.

    1905-01-01

    Calcium sulphate, at 25?? C., is two-thirds as soluble in dilute (o.i mol per liter) and twice as soluble in concentrated (3 mois per liter) ammonium sulphate solution as in water. The specific electric conductivity of concentrated ammonium sulphate solutions is lessened by saturating with calcium sulphate. Assuming that dissociation of ammonium sulphate takes place into 2NH4?? and SO4" and of calcium sulphate into Ca and SO4" only, and that the conductivity is a measure of such dissociation, the solubility of calcium sulphate in dilute ammonium sulphate solutions is greater than required by the mass-law. The conductivity of the dilute mixtures may be accurately calculated by means of Arrhenius' principle of isohydric solutions. In the data obtained in these calculations, the concentration of non-dissociated calcium sulphate decreases with increasing ammonium sulphate. The work as a whole is additional evidence of the fact that we are not yet in possession of all the factors necessary for reconciling the mass-law to the behavior of electrolytes. The measurements above described were made in the chemical laboratory of the University of Michigan.

  6. Three-dimensional modeling of oxidized-LDL accumulation and HDL mass transport in a coronary artery: a proof-of-concept study for predicting the region of atherosclerotic plaque development.

    Science.gov (United States)

    Sakellarios, Antonis I; Siogkas, Panagiotis K; Athanasiou, Lambros S; Exarchos, Themis P; Papafaklis, Michail I; Bourantas, Christos V; Naka, Katerina K; Michalis, Lampros K; Filipovic, Nenad; Parodi, Oberdan; Fotiadis, Dimitrios I

    2013-01-01

    Low density lipoprotein (LDL) has a significant role on the atherosclerotic plaque development, while the concentration of high density lipoproteins (HDL) is considered to play an atheroprotective role according to several biochemical mechanisms. In this work, it is the first time that both LDL and HDL concentrations are taken into account in order to predict the regions prone for plaque development. Our modeling approach is based on the use of a realistic three-dimensional reconstructed pig coronary artery in two time points. Biochemical data measured in the pig were also included in order to develop a more customized model. We modeled coronary blood flow by solving the Navier-Stokes equations in the arterial lumen and plasma filtration in the arterial wall using Darcy's Law. HDL transport was modeled only in the arterial lumen using the convection-diffusion equation, while LDL transport was modeled both in the lumen and the arterial wall. An additional novelty of this work is that we model the oxidation of LDL taking into account the atheroprotective role of HDL. The results of our model were in good agreement with histological findings demonstrating that increased oxidized LDL is found near regions of advanced plaques, while non-oxidized LDL is found in regions of early plaque types.

  7. Calcium Absorption in Infants and Small Children: Methods of Determination and Recent Findings

    Directory of Open Access Journals (Sweden)

    Steven A. Abrams

    2010-04-01

    Full Text Available Determining calcium bioavailability is important in establishing dietary calcium requirements. In infants and small children, previously conducted mass balance studies have largely been replaced by stable isotope-based studies. The ability to assess calcium absorption using a relatively short 24-hour urine collection without the need for multiple blood samples or fecal collections is a major advantage to this technique. The results of these studies have demonstrated relatively small differences in calcium absorption efficiency between human milk and currently available cow milk-based infant formulas. In older children with a calcium intake typical of Western diets, calcium absorption is adequate to meet bone mineral accretion requirements.

  8. Leiomyosarcoma with coronary fistulae and ventricular septal perforation:A case study

    Institute of Scientific and Technical Information of China (English)

    Dang-Sheng HUANG; Yu-Mei WANG; Yu CHEN

    2014-01-01

    Coronary fistulae and ventricular septal perforation are very rare clinically, and even less caused by cardiac leiomyosarcoma. A case is reported that a 67-year-old female had cardiac leiomyosarcoma with progressive heart failure and coronary fistulae and ventricular septal perforation. This case was special since all ante-mortem examinations and cardiac surgery failed to detect the presence of any abnormal car-diac mass. Therefore, the malignant cardiac tumors could appear in an invasive form without mass and be one of the causes of the coronary fistulae and ventricular septal perforation.

  9. 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.

  10. Acidosis and Urinary Calcium Excretion

    DEFF Research Database (Denmark)

    Alexander, R Todd; Cordat, Emmanuelle; Chambrey, Régine

    2016-01-01

    Metabolic acidosis is associated with increased urinary calcium excretion and related sequelae, including nephrocalcinosis and nephrolithiasis. The increased urinary calcium excretion induced by metabolic acidosis predominantly results from increased mobilization of calcium out of bone and inhibi...

  11. Depression and Coronary Heart Disease

    OpenAIRE

    2012-01-01

    There are exciting findings in the field of depression and coronary heart disease. Whether diagnosed or simply self-reported, depression continues to mark very high risk for a recurrent acute coronary syndrome or for death in patients with coronary heart disease. Many intriguing mechanisms have been posited to be implicated in the association between depression and heart disease, and randomized controlled trials of depression treatment are beginning to delineate the types of depression manage...

  12. Calcium signaling in neurodegeneration

    Directory of Open Access Journals (Sweden)

    Dreses-Werringloer Ute

    2009-05-01

    Full Text Available Abstract Calcium is a key signaling ion involved in many different intracellular and extracellular processes ranging from synaptic activity to cell-cell communication and adhesion. The exact definition at the molecular level of the versatility of this ion has made overwhelming progress in the past several years and has been extensively reviewed. In the brain, calcium is fundamental in the control of synaptic activity and memory formation, a process that leads to the activation of specific calcium-dependent signal transduction pathways and implicates key protein effectors, such as CaMKs, MAPK/ERKs, and CREB. Properly controlled homeostasis of calcium signaling not only supports normal brain physiology but also maintains neuronal integrity and long-term cell survival. Emerging knowledge indicates that calcium homeostasis is not only critical for cell physiology and health, but also, when deregulated, can lead to neurodegeneration via complex and diverse mechanisms involved in selective neuronal impairments and death. The identification of several modulators of calcium homeostasis, such as presenilins and CALHM1, as potential factors involved in the pathogenesis of Alzheimer's disease, provides strong support for a role of calcium in neurodegeneration. These observations represent an important step towards understanding the molecular mechanisms of calcium signaling disturbances observed in different brain diseases such as Alzheimer's, Parkinson's, and Huntington's diseases.

  13. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920658 Assessment of plasma catechola-mine and β-endorphin contents in patientswith silent myocardial ischemia and anginapectoris. WU Lin(吴林), et al. 1st Hosp, BeijingMed Univ, Beijing, 100034. Cbin J Cardiol1992; 20(2): 90-91. Thirteen Patients with totally silent myocar-dial ischemia(group 1)and 15 patients with ef-fort angina(group 2)were studied. The coronary

  14. Associations between Tobacco, Alcohol, and Drug Use with Coronary Artery Plaque among HIV-Infected and Uninfected Men in the Multicenter AIDS Cohort Study.

    Directory of Open Access Journals (Sweden)

    Sean G Kelly

    Full Text Available We characterized associations between smoking, alcohol, and recreational drug use and coronary plaque by HIV serostatus within the Multicenter AIDS Cohort Study (MACS.MACS participants (N = 1005, 621 HIV+ and 384 HIV- underwent non-contrast CT scanning to measure coronary artery calcium; 764 underwent coronary CT angiograms to evaluate plaque type and extent. Self-reported use of alcohol, tobacco, smoked/inhaled cocaine, methamphetamine, ecstasy, marijuana, inhaled nitrites, and erectile dysfunction drugs was obtained at semi-annual visits beginning 10 years prior to CT scanning. Multivariable logistic and linear regression models were performed, stratified by HIV serostatus.Among HIV+ men, current smoking, former smoking, and cumulative pack years of smoking were positively associated with multiple coronary plaque measures (coronary artery calcium presence and extent, total plaque presence and extent, calcified plaque presence, and stenosis >50%. Smoking was significantly associated with fewer plaque measures of comparable effect size among HIV- men; current smoking and calcified plaque extent was the only such association. Heavy alcohol use (>14 drinks/week was associated with stenosis >50% among HIV+ men. Among HIV- men, low/moderate (1-14 drinks/week and heavy alcohol use were inversely associated with coronary artery calcium and calcified plaque extent. Few significant associations between other recreational drug use and plaque measures were observed.Smoking is strongly associated with coronary plaque among HIV+ men, underscoring the value of smoking cessation for HIV+ persons. Alcohol use may protect against coronary artery calcium and calcified plaque progression in HIV- (but not HIV+ men. Few positive associations were observed between recreational drug use and coronary plaque measures.

  15. 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.

  16. Dietary calcium but not elemental calcium from supplements is associated with body composition and obesity in Chinese women.

    Directory of Open Access Journals (Sweden)

    Lina Huang

    Full Text Available OBJECTIVE: We assessed whether dietary calcium intake or calcium supplements associated with body composition and obesity in a Chinese population. METHODS: A cross-sectional survey was performed in a population of 8940, aged 20 to 74 y. 8127 participants responded (90.9%. Height, weight, fat mass (FM, waist circumference (WC and hip circumference were measured. Obesity definition: body mass index (BMI ≥28 kg/m(2 (overall obesity; WC ≥85 cm for men or ≥80 cm for women (abdominal obesity І and waist hip ratio (WHR ≥0.90 for men or ≥0.85 for women (abdominal obesity П. The data on dietary calcium and calcium supplements were collected using food-frequency questionnaire and self-report questionnaire. Multivariate linear and multivariable logistic regressions were used to examine the associations between dietary calcium intake or calcium supplements and body composition and obesity. PRINCIPAL FINDINGS: The average dietary calcium intake of all subjects was 430 mg/d. After adjusting for potential confounding factors, among women only, negative associations were observed between habitual dietary calcium intake and four measures of body composition (β, -0.086, P0.05. Similarly, among both men and women, we did not observe significant associations between calcium supplements and any measures of body composition or abdominal obesity (P>0.05. CONCLUSIONS: Dietary calcium from food rather than elemental calcium from calcium supplements has beneficial effects on the maintenance of body composition and preventing abdominal obesity in Chinese women.

  17. Calcium and weight control-Publications summaries

    Directory of Open Access Journals (Sweden)

    Feride Çelebi

    2011-08-01

    Full Text Available Obesity is a public health problem. And it is known that both energy balance and nutritional factors are effective on it. The effects of dietary calcium on bone health are known however with recent studies, it has become a food item that focused on the effect on body weight control. Most epidemiyolojik studies claim that there is a relationship between long-term consumption of diary milk and milk products and the decrease of body weight and fat mass. In this article, there are different studies that support or do not support this idea. However the effect mechanism of calcium on weight control is tried to be explained.

  18. Influence of drug treatment on glucocorticoid receptor levels in patients with coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    JI Hong; GUO Wei-zao; YAN Zhi-hong; LI Di; LU Cui-lian

    2010-01-01

    Background Glucocorticoid signaling exerts major roles in inflammation, metabolism and depression, which are three crucial factors accompanying or underlying coronary heart disease. Although accumulating evidence indicates the influence of glucocorticoids on the pathology and treatment of coronary heart disease, there is still a dearth of pharmaceutical mechanisms for this relationship. This study aimed to investigate the influence of drug treatment on glucocorticoid receptor levels in coronary heart disease.Methods Eighty hospitalized patients (average age (59.0 7.5) years, 46 male and 34 female) with coronary heart disease were categorized into four groups with 20 members in each according to one of the four drugs they were treated with. The four drugs were: nitrated derivative isosorbide dinitrate, the beta-adrenergic receptor blocker metoprolol, the calcium antagonist nifedipine, and the HMG-CoA reductase inhibitor lovastatin. Glucocorticoid receptor protein levels of peripheral blood lymphocytes were tested using immunoblotting analysis before and after one month of treatment. Results Immunoblotting analysis showed increased glucocorticoid receptor levels after treatment with metoprolol and nifedipine. There were no statistically significant changes of glucocorticoid receptor levels after treatment with isosorbide dinitrate or lovastatin, although there were trends of up-regulation of glucocorticoid receptor expression after both treatments.Conclusions Both the beta-blocker and the calcium blocker can increase glucocorticoid receptor levels after chronic administration. This effect suggests a mechanism for their anti-inflammatory and other therapeutic roles for coronary heart disease and comorbid disorders.

  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. Serum Metabonomics Analysis of Phlegm and Blood Stasis Syndrome in Patients with Coronary Heart Disease by Gas Chromatogra-phy Mass Spectrometry Combined with Liquid Chromatography Mass Spectrometry%基于气相色谱质谱联用对冠心病“痰”“瘀”证候血清代谢组学的研究

    Institute of Scientific and Technical Information of China (English)

    鹿小燕; 顾焕; 徐浩; 赵铁; 李耿

    2016-01-01

    Objective To investigate the serum metabonomics characteristics of phlegm and blood stasis syndrome in patients with coronary heart disease(CHD).Methods Metabolites spectral differences were compared between 102 patients with CHD (52 pa-tients with phlegm syndrome and 51 with blood stasis syndrome)and 31 healthy individuals by analysis techniques of gas chromatog-raphy– mass spectrometry (GC MS),liquid chromatography mass spectrometry (LC/MS)and pattern recognition technology.Re-sults CHD group compared to healthy controls showed obvious difference in the metabolites including many kinds of amino acids, organic acids,long chain fatty acids,lysophospholipids,phospholipids,sphingomyelin;the most different metabolites also were com-mon metabolites of phlegm and blood stasis group.The contents of organic acids,maltose,a variety of amino acids in CHD patients obviously increased than that in healthy control;while the contents of a variety of unsaturated fatty acids,derivatives,VitE,and cho-lesterol obviously decreased in CHD patients.Characteristic different metabolites in phlegm group and blood stasis group were mainly malic acid and succinic acid,fructose and glucose,glycine and alanine and palmitoleic acid.Among them,in phlegm group the con-tents of 7,10 Hexadecadienoic acid and DPA reduced,while the rest of them in blood stasis group increased.Conclusion CHD had specific metabolic group characteristics,phlegm and blood stasis had both characteristic different metabolites,also had common me-tabolites,which had important significance in improving identification ability of phlegm and blood stasis syndrome of coronary heart disease,also provided objective basis for CHD syndrome essence research.Phlegm and blood stasis had common material basis, which was coincident with Chinese medicine phlegm and blood stasis homologous theory. As pathogenic factors,both in the body could change into each other,and caused disease commonly,so treating phlegm and blood stasis

  3. Dataset of calcified plaque condition in the stenotic coronary artery lesion obtained using multidetector computed tomography to indicate the addition of rotational atherectomy during percutaneous coronary intervention.

    Science.gov (United States)

    Akutsu, Yasushi; Hamazaki, Yuji; Sekimoto, Teruo; Kaneko, Kyouichi; Kodama, Yusuke; Li, Hui-Ling; Suyama, Jumpei; Gokan, Takehiko; Sakai, Koshiro; Kosaki, Ryota; Yokota, Hiroyuki; Tsujita, Hiroaki; Tsukamoto, Shigeto; Sakurai, Masayuki; Sambe, Takehiko; Oguchi, Katsuji; Uchida, Naoki; Kobayashi, Shinichi; Aoki, Atsushi; Kobayashi, Youichi

    2016-06-01

    Our data shows the regional coronary artery calcium scores (lesion CAC) on multidetector computed tomography (MDCT) and the cross-section imaging on MDCT angiography (CTA) in the target lesion of the patients with stable angina pectoris who were scheduled for percutaneous coronary intervention (PCI). CAC and CTA data were measured using a 128-slice scanner (Somatom Definition AS+; Siemens Medical Solutions, Forchheim, Germany) before PCI. CAC was measured in a non-contrast-enhanced scan and was quantified using the Calcium Score module of SYNAPSE VINCENT software (Fujifilm Co. Tokyo, Japan) and expressed in Agatston units. CTA were then continued with a contrast-enhanced ECG gating to measure the severity of the calcified plaque condition. We present that both CAC and CTA data are used as a benchmark to consider the addition of rotational atherectomy during PCI to severely calcified plaque lesions.

  4. Dataset of calcified plaque condition in the stenotic coronary artery lesion obtained using multidetector computed tomography to indicate the addition of rotational atherectomy during percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Yasushi Akutsu

    2016-06-01

    Full Text Available Our data shows the regional coronary artery calcium scores (lesion CAC on multidetector computed tomography (MDCT and the cross-section imaging on MDCT angiography (CTA in the target lesion of the patients with stable angina pectoris who were scheduled for percutaneous coronary intervention (PCI. CAC and CTA data were measured using a 128-slice scanner (Somatom Definition AS+; Siemens Medical Solutions, Forchheim, Germany before PCI. CAC was measured in a non-contrast-enhanced scan and was quantified using the Calcium Score module of SYNAPSE VINCENT software (Fujifilm Co. Tokyo, Japan and expressed in Agatston units. CTA were then continued with a contrast-enhanced ECG gating to measure the severity of the calcified plaque condition. We present that both CAC and CTA data are used as a benchmark to consider the addition of rotational atherectomy during PCI to severely calcified plaque lesions.

  5. NON-INVASIVE IMAGING OF CORONARY ARTERY WITH 16-SLICE SPIRAL COMPUTED TOMOGRAPHY

    Institute of Scientific and Technical Information of China (English)

    Zhu-hua Zhang; Wen-bin Mou; Li-Ren Zhang; Wen-ling Zhu; Chao Ni; Hua Ren; Hong-quan Yu; Qi Miao; Qi Fang; Zheng-yu Jin; Dong-jing Li; Song-bai Lin; Shu-yang Zhang; Ling-yan Kong; Yun Wang; Lin-hui Wang; Wen-min Zhao

    2004-01-01

    Objective To evaluate the value of 16-slice spiral CT in the demonstration of coronary artery and in the diagnose of coronary artery stenosis.Methods Plain and enhanced CT scans were performed with a 16-slice CT scanner (Sensation 16, Siemens, Germany)in 230 patients with suspected coronary heart disease (CHD). Parameters of the plain scan were: 120 kV, 133 mA, slice collimation 16 mm×1.5 mm, rotation time 0.42 seconds, increment 1.5 mm, and slice width 3 mm. Parameters of the enhanced scan were: 120 kV, 500 mA, slice collimation 16 mm×0.75 mm, rotation time 0.42 seconds, increment 0.5 mm, and slice width 1 mm. Enhanced CT scan was performed with a rapid intravenous injection of 100 mL iothalamate meglumine (Ultravist)(370 mgI/mL) or Omnipaque (350mgI/mL) and 30 mL 0.9% NaC1 chaser bolus at a flow rate of 3.5 mL/s. Calcium scoring with plain scan images and two and three dimensional reconstruction with enhanced scan images were made in all cases,among which 30 cases underwent conventional coronary angiography. Demonstration of coronary arteries and their stenosis were evaluated and the factors that might influence the image quality were analyzed.Results Coronary calcium scores were calculated and coronary artery was demonstrated in our study. In the evaluation of image quality with volume rendering technique (VRT) images, 78.3% of the images were of the first class, 12.2% the second class, and 9.6% the third class. Multi-planar reconstruction (MPR) and maximal intensity projection (MIP) were better than VRT in the demonstration of small branches. The image quality was related to the heart rate, with or without arrhythmia,and breath-hold ability of patients. Comparative study of the stenosis of coronary arteries in 30 cases showed that the sensitivity and specificity of 16-slice coronary CT angiography (CTA) to diagnose significant stenosis were 95.8% and 94.8% respectively.Conclusion As a non-invasive and quick method, 16-slice coronary CTA is sensitive and

  6. Relationship between chronic obstructive pulmonary disease and subclinical coronary artery disease in long-term smokers

    DEFF Research Database (Denmark)

    Rasmussen, Thomas; Køber, Lars; Pedersen, Jesper Holst;

    2013-01-01

    Cardiovascular conditions are reported to be the most frequent cause of death in patients with chronic obstructive pulmonary disease (COPD). However, it remains unsettled whether severity of COPD per se is associated with coronary artery disease (CAD) independent of traditional cardiovascular risk...... factors. The aim of this study was to examine the relationship between the presence and severity of COPD and the amount of coronary artery calcium deposit, an indicator of CAD and cardiac risk, in a large population of current and former long-term smokers....

  7. Fantofarone (SR33557): effects on myocardial oxygen consumption and coronary blood flow.

    Science.gov (United States)

    Hodeige, D; Chatelain, P; Manning, A

    1994-01-01

    We have investigated the effects of a novel calcium antagonist, fantofarone (SR 33557) on myocardial oxygen consumption (MO2C) and coronary blood flow in anaesthetized dogs during periods of normal and elevated heart rate. 25 micrograms/kg i.v. fantofarone induced a transient increase in coronary blood flow (+25% after 2 min; p MO2C (-50% after 5 min; p MO2C was reduced by 67% after 5 min (p MO2C was observed during the pacing periods (32% after 10 min; p MO2C consumption during periods of elevated heart rate.

  8. Discrete-State Stochastic Models of Calcium-Regulated Calcium Influx and Subspace Dynamics Are Not Well-Approximated by ODEs That Neglect Concentration Fluctuations

    Directory of Open Access Journals (Sweden)

    Seth H. Weinberg

    2012-01-01

    Full Text Available Cardiac myocyte calcium signaling is often modeled using deterministic ordinary differential equations (ODEs and mass-action kinetics. However, spatially restricted “domains” associated with calcium influx are small enough (e.g., 10−17 liters that local signaling may involve 1–100 calcium ions. Is it appropriate to model the dynamics of subspace calcium using deterministic ODEs or, alternatively, do we require stochastic descriptions that account for the fundamentally discrete nature of these local calcium signals? To address this question, we constructed a minimal Markov model of a calcium-regulated calcium channel and associated subspace. We compared the expected value of fluctuating subspace calcium concentration (a result that accounts for the small subspace volume with the corresponding deterministic model (an approximation that assumes large system size. When subspace calcium did not regulate calcium influx, the deterministic and stochastic descriptions agreed. However, when calcium binding altered channel activity in the model, the continuous deterministic description often deviated significantly from the discrete stochastic model, unless the subspace volume is unrealistically large and/or the kinetics of the calcium binding are sufficiently fast. This principle was also demonstrated using a physiologically realistic model of calmodulin regulation of L-type calcium channels introduced by Yue and coworkers.

  9. Statins use and coronary artery plaque composition: Results from the International Multicenter CONFIRM Registry

    Science.gov (United States)

    Nakazato, Ryo; Gransar, Heidi; Berman, Daniel S.; Cheng, Victor Y.; Lin, Fay Y.; Achenbach, Stephan; Al-Mallah, Mouaz; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk-Jae; Cury, Ricardo C.; Chinnaiyan, Kavitha; Chow, Benjamin J.W.; Delago, Augustin; Hadamitzky, Martin; Hausleiter, Joerg; Kaufmann, Philipp; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J.; Villines, Todd C.; Dunning, Allison; Feuchtner, Gudrun; Kim, Yong-Jin; Leipsic, Jonathon; Min, James K.

    2014-01-01

    Objective The effect of statins on coronary artery plaque features beyond stenosis severity is not known. Coronary CT angiography (CCTA) is a novel non-invasive method that permits direct visualization of coronary atherosclerotic features, including plaque composition. We evaluated the association of statin use to coronary plaque composition type in patients without known coronary artery disease (CAD) undergoing CCTA. Methods From consecutive individuals, we identified 6673 individuals (2413 on statin therapy and 4260 not on statin therapy) with no known CAD and available statin use status. We studied the relationship between statin use and the presence and extent of specific plaque composition types, which was graded as non-calcified (NCP), mixed (MP), or calcified (CP) plaque. Results The mean age was 59 ± 11 (55% male). Compared to the individuals not taking statins, those taking statins had higher prevalence of risk factors and obstructive CAD. In multivariable analyses, statin use was associated with increased the presence of MP [odds ratio (OR) 1.46, 95% confidence interval (CI) 1.27–1.68), p < 0.001] and CP (OR 1.54, 95% CI 1.36–1.74, p < 0.001), but not NCP (OR 1.11, 95% CI 0.96–1.29, p = 0.1). Further, in multivariable analyses, statin use was associated with increasing numbers of coronary segments possessing MP (OR 1.52, 95% CI 1.34–1.73, p < 0.001) and CP (OR 1.52, 95% CI 1.36–1.70, p < 0.001), but not coronary segments with NCP (OR 1.09, 95% CI 0.94–1.25, p = 0.2). Conclusion Statin use is associated with an increased prevalence and extent of coronary plaques possessing calcium. The longitudinal effect of statins on coronary plaque composition warrants further investigation. PMID:22981406

  10. 聚丙烯酸钠的合成及其相对分子质量对CaCO3分散性的影响%Synthesis of sodium polyacrylate and the effect of its relative molecular mass on dispersion of calcium carbonate

    Institute of Scientific and Technical Information of China (English)

    范宝安

    2011-01-01

    The author prepared sodium polyacrylate with different relative molecular mass via aqueous solution polymerization in the presence of Na2S2O8 as initiator and NaHSO3 as chain transfer agent by regulating the molar ratio of the initiator to the chain transfer agent. The effect of the relative molecular mass of sodium polyacrylate as dispersing agent on dispersancy of calcium carbonate was studied. The results show that the dispersancy effectiveness of the sodium polyacrylate is closely dependent on its relative molecular mass and is undesirable in the case of too high or too low relative molecular mass. The dispersancy to the calcium carbonate attains its maximum when the viscosity average molecular mass of sodium polyacrylate is in the range of 3 000 to 3 500.%采用水溶液聚合法,以NaSO作引发剂,NaHSO作链转移剂,通过调整引发剂和链转移剂之间的摩尔比制备了具有不同相对分子质量的聚丙烯酸钠.研究了聚丙烯酸钠作为分散剂时,其相对分子质量对CaCO分散性的影响.结果表明:聚丙烯酸钠的分散效果与其相对分子质量有很大关系,相对分子质量过高或过低,分散效果都不理想.当聚丙烯酸钠黏均分子量在3 000-3 500时,对CaCO的分散性最好.

  11. Chelation for Coronary Heart Disease

    Science.gov (United States)

    ... V W X Y Z Chelation for Coronary Heart Disease Share: © AHA Coronary heart disease is a leading cause of death among both ... health approach . The use of disodium EDTA for heart disease has not been approved by the U.S. Food ...

  12. 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.

  13. 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

  14. Calcium and Vitamin D

    Science.gov (United States)

    ... Pizza, cheese, frozen 1 serving 115 mg Pudding, chocolate, prepared with 2% milk 4 oz 160 mg ... Treatment Medication and Treatment Adherence Calcium/Vitamin D Nutrition Overall Health Fractures/Fall Prevention Exercise/Safe Movement ...

  15. Stoichiometry of Calcium Medicines

    Science.gov (United States)

    Pinto, Gabriel

    2005-01-01

    The topic of calcium supplement and its effects on human lives is presented in the way of questions to the students. It enables the students to realize the relevance of chemistry outside the classroom surrounding.

  16. Get Enough Calcium

    Science.gov (United States)

    ... Resources You may also be interested in: Calcium: Shopping list Menopause: Questions for ... A Federal Government website managed by the U.S. Department of Health and Human Services healthfinder.gov is ...

  17. Stoichiometry of Calcium Medicines

    Science.gov (United States)

    Pinto, Gabriel

    2005-01-01

    The topic of calcium supplement and its effects on human lives is presented in the way of questions to the students. It enables the students to realize the relevance of chemistry outside the classroom surrounding.

  18. Calcium and Your Child

    Science.gov (United States)

    ... for dinner. Create mini-pizzas by topping whole-wheat English muffins or bagels with pizza sauce, low- ... Minerals Do I Need to Drink Milk? Lactose Intolerance Becoming a Vegetarian Soy Foods and Health Calcium ...

  19. A Calcium Antagonist vs a Non-Calcium Antagonist Hypertension Treatment Strategy for Patients With Coronary Artery Disease The International Verapamil-Trandollapril Study (INVEST):A Randomized Controlled Trial%冠心病患者钙拮抗剂与非钙拮抗剂降压治疗策略国际维拉帕米与群多普利随机对照试验

    Institute of Scientific and Technical Information of China (English)

    Carl J. Pepine, MD; Matyas Keltai, MD; Serap Erdine, MD; Heather A. Bristol, MS; H. Robert Kolb, RN; George L. Bakris, MD; Jerome D. Cohen, MD; William W. Parmley, MD; 陈江天; Eileen M. Handberg, PhD; Rhonda M. Cooper-DeHoff, PharmD; Ronald G. Marks, PhD; Peter Kowey, MD; Franz H. Messerli, MD; Giuseppe Mancia, MD; Jose L. Cangiano, MD; David Garcia-Barreto, MD

    2005-01-01

    @@ 随着冠心病(coronary arterydisease,CAD)主要危险因素(血压高、年龄大、糖尿病、肥胖和不好运动)的增加,冠心病的发生率不断增加.血压对CAD的进展具有重要作用,但是尚缺乏在CAD患者中评价降压治疗的大型临床试验.所以,CAD患者的降压治疗只能以其他针对高危患者的较小型的亚组临床试验数据作为依据.

  20. Calcium and bone disorders in pregnancy

    Directory of Open Access Journals (Sweden)

    Shriraam Mahadevan

    2012-01-01

    Full Text Available Significant transplacental calcium transfer occurs during pregnancy, especially during the last trimester, to meet the demands of the rapidly mineralizing fetal skeleton. Similarly, there is an obligate loss of calcium in the breast milk during lactation. Both these result in considerable stress on the bone mineral homeostasis in the mother. The maternal adaptive mechanisms to conserve calcium are different in pregnancy and lactation. During pregnancy, increased intestinal absorption of calcium from the gut mainly due to higher generation of calcitriol (1,25 dihydroxy vitamin D helps in maintaining maternal calcium levels. On the other hand, during lactation, the main compensatory mechanism is skeletal resorption due to increased generation of parathormone related peptide (PTHrP from the breast. Previous studies suggest that in spite of considerable changes in bone mineral metabolism during pregnancy, parity and lactation are not significantly associated with future risk for osteoporosis. However, in India, the situation may not be the same as a significant proportion of pregnancies occur in the early twenties when peak bone mass is not yet achieved. Further, malnutrition, anemia and vitamin D deficiency are commonly encountered in this age group. This may have an impact on future bone health of the mother. It may also probably provide an opportunity for health care providers for prevention. Other metabolic bone diseases like hypoparathyroidism, hyperparathyroidism and pseudohypoparathyroidism are rarely encountered in pregnancy. Their clinical implications and management are also discussed.

  1. Calcium's Role in Mechanotransduction during Muscle Development

    Directory of Open Access Journals (Sweden)

    Tatiana Benavides Damm

    2014-01-01

    Full Text Available Mechanotransduction is a process where cells sense their surroundings and convert the physical forces in their environment into an appropriate response. Calcium plays a crucial role in the translation of such forces to biochemical signals that control various biological processes fundamental in muscle development. The mechanical stimulation of muscle cells may for example result from stretch, electric and magnetic stimulation, shear stress, and altered gravity exposure. The response, mainly involving changes in intracellular calcium concentration then leads to a cascade of events by the activation of downstream signaling pathways. The key calcium-dependent pathways described here include the nuclear factor of activated T cells (NFAT and mitogen-activated protein kinase (MAPK activation. The subsequent effects in cellular homeostasis consist of cytoskeletal remodeling, cell cycle progression, growth, differentiation, and apoptosis, all necessary for healthy muscle development, repair, and regeneration. A deregulation from the normal process due to disuse, trauma, or disease can result in a clinical condition such as muscle atrophy, which entails a significant loss of muscle mass. In order to develop therapies against such diseased states, we need to better understand the relevance of calcium signaling and the downstream responses to mechanical forces in skeletal muscle. The purpose of this review is to discuss in detail how diverse mechanical stimuli cause changes in calcium homeostasis by affecting membrane channels and the intracellular stores, which in turn regulate multiple pathways that impart these effects and control the fate of muscle tissue.

  2. 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.

  3. Calcium and Calcium-Base Alloys

    Science.gov (United States)

    1949-01-01

    should be satisfactory, because the electrolytic process for •(!>: A. H. Everts and G. D. Baglev’, " Physical «nrt m<„.+„4 i «_ of Calcium«, Electrochem...Rev. Metalurgie , 3j2, (1), 129 (1935). 10 ^sm^mssss^ma^^ extension between two known loads, is preferable to the value of 3,700,000 p.B.i. obtained

  4. Calcium supplementation does not augment bone gain in young women consuming diets moderately low in calcium.

    Science.gov (United States)

    Barger-Lux, M Janet; Davies, K Michael; Heaney, Robert P

    2005-10-01

    In earlier observational work, the dietary calcium:protein ratio was directly related to bone accrual in healthy postadolescent women. In this study, we sought to test the hypothesis that augmented calcium intake would increase postadolescent skeletal consolidation, using a double-blind, randomized, placebo-controlled design. We recruited 152 healthy young women (age 23.1 +/- 2.7 y, BMI 22.5 +/- 3.0 kg/m2); their usual diets, as assessed by 7-d food diaries, were low in calcium (605 +/- 181 mg/d; 15.1 +/- 4.5 mmol/d) and in the calcium:protein ratio (10.1 +/- 2.0 mg/g). The subjects were randomly assigned to supplemental calcium [500 mg calcium (12.5 mmol) as the carbonate, 3 times/d, with meals] or placebo capsules identical in appearance; all participants also took a daily multivitamin, and they were followed for up to 36 mo with bone densitometry (dual energy X-ray absorptiometry; DXA) at 6-mo intervals. A total of 121 subjects remained in the study for at least 12 mo (median time in the study, 35 mo), with a mean compliance level (observed/expected tablet consumption) of 87.7%. DXA data for these 121 subjects indicated modest but significant mean rates of increase (i.e., 0.24 to 1.10%/y) in bone mineral content (BMC; total body, total hip, and lumbar spine) and in lumbar spine bone mineral density (BMD) but no change in total hip BMD. None of these rates of change differed by group, i.e., calcium supplementation did not have any measurable effect on bone mass accrual. By midstudy, the calcium content of the subjects' usual diets for both groups had risen by approximately 15%. The combined effect of improved intakes of dietary calcium and the small amount of calcium added by the multivitamin tablets resulted in a mean calcium intake for the control group > 800 mg (20 mmol)/d, possibly at or near the threshold beyond which additional calcium has no further effect on bone accrual.

  5. Evaluation of coronary calcifications with 64-slice CT - variability of the scores and the influence of the reconstruction interval; Bestimmung des koronaren Kalzium-Scores mittels 64-Zeilen-CT - Variabilitaet der Scores und Einfluss des Rekonstruktionszeitpunktes

    Energy Technology Data Exchange (ETDEWEB)

    Weininger, M.; Ritter, C.O.; Beer, M.; Hahn, D.; Beissert, M. [Inst. fuer Roentgendiagnostik, Universitaetsklinikum Wuerzburg (Germany)

    2007-09-15

    Purpose: To evaluate the variability of coronary calcium scores depending on the image reconstruction interval using a 64-slice CT scanner. Materials and Methods: 30 patients (18 male, 12 female; mean age 57 {+-} 9 yrs; mean heart rate 66 {+-} 10 bpm) underwent coronary calcium scoring using a 64-slice CT scanner (Somatom Sensation 64, Siemens Medical Solutions, Erlangen) and a standardized scanning protocol. Oral {beta}-blockers were administered to 12 patients with a baseline heart rate > 70 bpm. Images were reconstructed in 10 % increments from 10 - 100 % of the RR interval. Two blinded experienced observers independently calculated Agatston (AS), calcium mass (MS) and volume scores (VS) for every reconstructed image series. The results were compared to similar studies for 16-slice CT scanners. Results: The mean values and mean coefficients of variation among all patients were as follows: AS, 397 {+-} 829, 109 % MS, 88 {+-} 225, 154 % VS, 335 {+-} 669, 100 %. Regarding the reconstruction intervals, the mean coefficients of variation were as follows: 107 % (AS), 97 % (VS), 116 % (MS). No specific image reconstruction interval with statistically significant lower variability for each score could be identified. High inter-observer agreement was achieved (K = 0.98). With statistical significance (p < 0.05) 10/30 patients (pts) were able to be allocated to more than one risk group (RG): 6 pts = 2 RG; 3 pts = 3 RG; 1 pts = 4 RG. The scores for 5/30 patients were zero for at least one reconstruction interval, but further reconstructions revealed calcifications. The number of patients assignable to different risk groups was significantly lower compared to published data using a 16-slice scanner (p < 0.05). Conclusion: Coronary calcium scores determined using a 64-slice scanner display a wide range of variability depending on the image reconstruction interval as already described for 16-slice CT scanners. However, compared to previous studies, our data indicate that this

  6. Scanning protocol optimization and dose evaluation in coronary stenosis using multi-slices computed tomography

    Science.gov (United States)

    Huang, Yung-hui; Chen, Chia-lin; Sheu, Chin-yin; Lee, Jason J. S.

    2007-02-01

    Cardiovascular diseases are the most common incidence for premature death in developed countries. A major fraction is attributable to atherosclerotic coronary artery disease, which may result in sudden cardiac failure. A reduction of mortality caused by myocardial infarction may be achieved if coronary atherosclerosis can be detected and treated at an early stage before symptoms occur. Therefore, there is need for an effective tool that allows identification of patients at increased risk for future cardiac events. The current multi-detector CT has been widely used for detection and quantification of coronary calcifications as a sign of coronary atherosclerosis. The aim of this study is to optimize the diagnostic values and radiation exposure in coronary artery calcium-screening examination using multi-slice CT (MSCT) with different image scan protocols. The radiation exposure for all protocols is evaluated by using computed tomography dose index (CTDI) phantom measurements. We chose an optimal scanning protocol and evaluated patient radiation dose in the MSCT coronary artery screenings and preserved its expecting diagnostic accuracy. These changes make the MSCT have more operation flexibility and provide more diagnostic values in current practice.

  7. [Calcium suppletion for patients who use gastric acid inhibitors: calcium citrate or calcium carbonate?].

    NARCIS (Netherlands)

    Jonge, H.J. de; Gans, R.O.; Huls, G.A.

    2012-01-01

    Various calcium supplements are available for patients who have an indication for calcium suppletion. American guidelines and UpToDate recommend prescribing calcium citrate to patients who use antacids The rationale for this advice is that water-insoluble calcium carbonate needs acid for adequate ab

  8. [Calcium suppletion for patients who use gastric acid inhibitors: calcium citrate or calcium carbonate?].

    NARCIS (Netherlands)

    Jonge, H.J. de; Gans, R.O.; Huls, G.A.

    2012-01-01

    Various calcium supplements are available for patients who have an indication for calcium suppletion. American guidelines and UpToDate recommend prescribing calcium citrate to patients who use antacids The rationale for this advice is that water-insoluble calcium carbonate needs acid for adequate ab

  9. [Calcium suppletion for patients who use gastric acid inhibitors: calcium citrate or calcium carbonate?].

    NARCIS (Netherlands)

    Jonge, H.J. de; Gans, R.O.; Huls, G.A.

    2012-01-01

    Various calcium supplements are available for patients who have an indication for calcium suppletion. American guidelines and UpToDate recommend prescribing calcium citrate to patients who use antacids The rationale for this advice is that water-insoluble calcium carbonate needs acid for adequate

  10. Relationship between dietary calcium intake and adiposity in female adolescents.

    Science.gov (United States)

    Castro Burbano, José; Fajardo Vanegas, Pamela; Robles Rodríguez, Julieta; Pazmiño Estévez, Karina

    2016-02-01

    The prevalence and magnitude of obesity in children and adolescents increase rapidly. Besides genetic and environmental factors, calcium intake has recently been identified as a dietary factor that is inversely related with body mass index and development of overweight and obesity. The purpose of this study was to assess the correlation between dietary calcium intake and body mass index and fat distribution in female adolescents. This was a cross-sectional study where anthropometric variables (weight, height, body mass index, waist and hip circumference) were collected in 244 female adolescents to establish total body adiposity and fat distribution. A 24-hour recall and a food frequency questionnaire were used to assess total calorie, calcium, and dairy products intake. Calcium intake was inversely related to body mass index (P.05), and waist to hip ratio (P<.05).Overweight (8.3%) and obese (0.7%) adolescents had a lower mean calcium intake than adolescents of normal weight (P=.06). Dietary calcium intake and, to a lesser extent, consumption of dairy products are inversely related to total and abdominal adiposity, and also to the prevalence of overweight in this group of adolescents. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  11. Use of calcium, folate, and vitamin D₃-fortified milk for 6 months improves nutritional status but not bone mass or turnover, in a group of Australian aged care residents.

    Science.gov (United States)

    Grieger, Jessica A; Nowson, Caryl A

    2009-07-01

    In residential care, inadequate calcium and folate intakes and low serum vitamin D (25(OH)D) concentrations are common. We assessed whether daily provision of calcium, folate, and vitamin D₃-fortified milk for 6 months improved nutritional status (serum micronutrients), bone quality (heel ultrasound), bone turnover markers (parathyroid hormone, C-terminal collagen I telopeptide, terminal propeptide of type I procollagen), and/or muscle strength and mobility in a group of Australian aged care residents. One hundred and seven residents completed the study (mean (SD) age: 79.9 (10.1) years; body weight: 68.4 (15.4) kg). The median (inter-quartile range) volume of fortified milk consumed was 160 (149) ml/day. At the end of the study, the median daily vitamin D intake increased to 10.4 (8.7) μg (P < .001), which is 70% of the adequate intake (15 μg); and calcium density (mg/MJ) was higher over the study period compared with baseline (161 ± 5 mg/MJ vs. 142 ± 4 mg/MJ, P < .001). Serum 25(OH)D concentrations increased by 23 ± 2 nmol/L (83 (107)%, P < .001), yet remained in the insufficient range (mean 45 ± 2 nmol/L). Consumption of greater than the median intake of milk (160 ml/day) (n = 54, 50%) increased serum 25(OH)D levels into the adequate range (53 ± 2 nmol/L) and reduced serum parathyroid hormone by 24% (P = .045). There was no effect on bone quality, bone turnover markers, muscle strength, or mobility. Consumption of fortified milk increased dietary vitamin D intake and raised serum 25(OH)D concentrations, but not to the level thought to reduce fracture risk. If calcium-fortified milk also was used in cooking and milk drinks, this approach could allow residents to achieve a dietary calcium intake close to recommended levels. A vitamin D supplement would be recommended to ensure adequate vitamin D status for all residents.

  12. Subendocardial viability ratio as an index of impaired coronary flow reserve in hypertensives without significant coronary artery stenoses.

    Science.gov (United States)

    Tsiachris, D; Tsioufis, C; Syrseloudis, D; Roussos, D; Tatsis, I; Dimitriadis, K; Toutouzas, K; Tsiamis, E; Stefanadis, C

    2012-01-01

    Subendocardial viability ratio (SEVR), calculated through pulse wave analysis, is an index of myocardial oxygen supply and demand. Our aim was to evaluate the relationship between coronary flow reserve (CFR) and SEVR in 36 consecutive untreated hypertensives (aged 57.9 years, 12 males, all Caucasian) with indications of myocardial ischaemia and normal coronary arteries in coronary angiography. CFR was calculated by a 0.014-inch Doppler guidewire (Flowire, Volcano, San Diego, CA, USA) in response to bolus intracoronary administration of adenosine (30-60 μg). SEVR was calculated by radial applanation tonometry, while diastolic function was evaluated by means of transmitral flow and tissue Doppler imaging. Hypertensive patients with low CFR (n=24) compared with those with normal CFR (n=12) exhibited significantly decreased SEVR by 24.5% (P=0.002). In hypertensives with low CFR, CFR was correlated with SEVR (r=0.651, P=0.001). After applying multivariate linear regression analysis, age, left ventricular mass index, Em/Am, 24-h diastolic blood pressure (BP) and SEVR turned out to be the only independent predictors of CFR (adjusted R(2)=0.718). Estimation of SEVR by using applanation tonometry may provide a reliable tool for the assessment of coronary microcirculation in essential hypertensives with indications of myocardial ischaemia and normal coronary arteries.

  13. [The character of calcium distribution in developing anther of lettuce (Lactuca sativa L.)].

    Science.gov (United States)

    Qiu, Yi Lan; Liu, Ru Shi; Xie, Chao Tian; Yang, Yan Hong; Xu, Qing; Tian, Hui Qiao

    2005-10-01

    Potassium antimonite was used to locate calcium in the anther of lettuce (Lactuca sativa L) during its development. At the early stage of anther development there were few calcium granules in microspore mother cells and the cells of anther wall. After meiosis of microspore mother cells, calcium granules first appeared in the tapetal cells in which some small secretive vacuoles containing many calcium granules were formed and secreted into locule. Then, the tapetal cells began to degenerate. At the late stage of microspore, tapetal cells completely degenerated and its protoplast masses moved into anther locule with many calcium granules. Few calcium granules were precipitated in the microspores just being released from tetrad, but some on the surface of exine. Then calcium granules appeared in the nucleus and cytoplasm of early microspores, as wall as i