TY - JOUR
T1 - Usefulness of Echocardiographic Assessment of Cardiac and Ascending Aorta Calcific Deposits to Predict Coronary Artery Calcium and Presence and Severity of Obstructive Coronary Artery Disease
AU - Nucifora, Gaetano
AU - Schuijf, Joanne D.
AU - van Werkhoven, Jacob M.
AU - Jukema, J. Wouter
AU - Marsan, Nina Ajmone
AU - Holman, Eduard R.
AU - van der Wall, Ernst E.
AU - Bax, Jeroen J.
N1 - Funding Information:
Dr. Nucifora was supported by a research grant from the European Association of Percutaneous Cardiovascular Interventions, Sophia Antipolis, France. Dr. Bax was supported by research grants from Biotronik, Berlin, Germany, BMS Medical Imaging, North Billerica, Massachusetts, Boston Scientific, Boston, Massachusetts, Edwards Lifesciences, Irvine, California, GE Healthcare, Buckinghamshire, United Kingdom, Medtronic, Minneapolis, Minnesota, and St. Jude Medical, St. Paul, Minnesota.
PY - 2009/4/15
Y1 - 2009/4/15
N2 - The presence of cardiac and aortic calcific deposits has been related to coronary artery disease (CAD) and cardiovascular events. The present study aimed to evaluate whether comprehensive echocardiographic assessment of cardiac and ascending aorta calcific deposits could predict coronary calcium and obstructive CAD. A total of 140 outpatients (age 61 ± 11 years; 90 men) without a history of CAD were studied. Aortic valve sclerosis and mitral annular, papillary muscle, and ascending aorta calcific deposits were assessed using echocardiography and semiquantified using an echocardiography-derived calcium score (ECS) ranging from 0 (no calcium visible) to 8 (severe calcific deposits). Coronary calcium scoring and noninvasive coronary angiography were performed using multislice computed tomography. Angiograms showing atherosclerosis were classified as having obstructive (≥50% luminal narrowing) CAD or not. The relation between ECS and multislice computed tomographic findings was explored using multivariate and receiver-operator characteristic curve analyses. Only ECS was associated with coronary calcium score >400 (odds ratio [OR] 3.6, 95% confidence interval [CI] 2.4 to 5.5, p <0.001). Similarly, only ECS (OR 1.8, 95% CI 1.4 to 2.4, p <0.001) and pretest likelihood of CAD (OR 1.7, 95% CI 1.0 to 2.8, p = 0.04) were associated with obstructive CAD. ECS ≥3 had high sensitivity and specificity in identifying patients with coronary calcium score >400 (87% for both) and obstructive CAD (74% and 82%, respectively). In conclusion, echocardiographic assessment of cardiac and ascending aorta calcium may allow detection of patients with extensive calcified coronary arterial atherosclerotic plaques.
AB - The presence of cardiac and aortic calcific deposits has been related to coronary artery disease (CAD) and cardiovascular events. The present study aimed to evaluate whether comprehensive echocardiographic assessment of cardiac and ascending aorta calcific deposits could predict coronary calcium and obstructive CAD. A total of 140 outpatients (age 61 ± 11 years; 90 men) without a history of CAD were studied. Aortic valve sclerosis and mitral annular, papillary muscle, and ascending aorta calcific deposits were assessed using echocardiography and semiquantified using an echocardiography-derived calcium score (ECS) ranging from 0 (no calcium visible) to 8 (severe calcific deposits). Coronary calcium scoring and noninvasive coronary angiography were performed using multislice computed tomography. Angiograms showing atherosclerosis were classified as having obstructive (≥50% luminal narrowing) CAD or not. The relation between ECS and multislice computed tomographic findings was explored using multivariate and receiver-operator characteristic curve analyses. Only ECS was associated with coronary calcium score >400 (odds ratio [OR] 3.6, 95% confidence interval [CI] 2.4 to 5.5, p <0.001). Similarly, only ECS (OR 1.8, 95% CI 1.4 to 2.4, p <0.001) and pretest likelihood of CAD (OR 1.7, 95% CI 1.0 to 2.8, p = 0.04) were associated with obstructive CAD. ECS ≥3 had high sensitivity and specificity in identifying patients with coronary calcium score >400 (87% for both) and obstructive CAD (74% and 82%, respectively). In conclusion, echocardiographic assessment of cardiac and ascending aorta calcium may allow detection of patients with extensive calcified coronary arterial atherosclerotic plaques.
UR - http://www.scopus.com/inward/record.url?scp=63749125423&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2008.12.031
DO - 10.1016/j.amjcard.2008.12.031
M3 - Article
C2 - 19361587
AN - SCOPUS:63749125423
SN - 0002-9149
VL - 103
SP - 1045
EP - 1050
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 8
ER -