Document Detail

Coronary artery calcium score assessed by a 64 multislice computed tomography and early indexes of functional and structural vascular remodeling in cardiac syndrome X patients.
MedLine Citation:
PMID:  18761268     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Regardless of normal coronary angiograms, coronary artery calcium (CAC) can be found in cardiac syndrome X (CSX) patients. According to some data, a relationship between the CAC score and markers of early atherosclerosis in CSX has been observed. Our aim was to assess whether the extent of the CAC score assessed by multislice computed tomography (MSCT) with a 64-slice system in CSX patients is related to brachial artery reactivity, intima-media thickness (IMT), and arterial compliance indexes. METHODS AND RESULTS: High-resolution ultrasound was used to measure flow-mediated dilatation (FMD) and nitroglycerin-mediated vasodilatation, as well as the following parameters of arterial structural changes: IMT, pulse wave velocity, total arterial compliance, and stiffness index. MSCT was used to assess the presence and the quantity of CAC. The study group consisted of 46 CSX patients (mean age, 56.3 +/- 9 years), whereas the control group comprised 21 healthy subjects (mean age, 54.9 +/- 7 years). The assessment of the vascular parameters showed significantly decreased FMD and increased IMT in the CSX subjects (9.06% +/- 3.2% and 0.67 +/- 0.1 mm, respectively) in comparison to the control subjects (17.42% +/- 8.4% [P = .008] and 0.57 +/- 0.2 mm [P = .021], respectively). CAC was detectable in 19 CSX patients (41%) (CAC range according to Agatston score, 2-500; mean, 101.6; median, 26.5) and in 1 control subject (4.8%) (CAC value, 13). CSX patients with detectable CAC were characterized by a significantly higher age (P = .001), lower body mass index (P = .017), and increased stiffness index (P = .020); there were no differences in FMD and IMT values. In a multivariate logistic and linear regression analysis, age was the only risk factor independently associated with the presence of CAC (P = .001) and the log(CAC + 1) value (P = .01). In the subgroup of women, log(CAC + 1) significantly correlated with age (r = 0.587, P = .002) and stiffness index (r = 0.427, P = .024), and in a borderline significant manner, it correlated with weight (r = -0.329, P = .07) and waist-hip ratio (r = 0.315, P = .07). There were no significant correlations in the male subgroup. CONCLUSIONS: Low ranges of CAC are frequently detectable in CSX patients, and the results are age-related and independent of impaired early indexes of functional and structural vascular remodeling.
Katarzyna Mizia-Stec; Maciej Haberka; Magdalena Mizia; Artur Chmiel; Joanna Wierzbicka-Chmiel; Mariusz Skowerski; Zbigniew Gasior
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Publication Detail:
Type:  Journal Article     Date:  2008-07-26
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  15     ISSN:  1532-6551     ISO Abbreviation:  J Nucl Cardiol     Publication Date:    2008 Sep-Oct
Date Detail:
Created Date:  2008-09-01     Completed Date:  2009-04-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  655-62     Citation Subset:  IM    
Department of Cardiology, Medical University of Silesia, Katowice, Poland.
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MeSH Terms
Arteries / pathology
Brachial Artery / pathology
Calcium / metabolism*
Case-Control Studies
Coronary Vessels / pathology*
Echocardiography / methods
Microvascular Angina / diagnosis*,  pathology*
Middle Aged
Tomography, X-Ray Computed / methods*
Tunica Intima / pathology
Tunica Media / pathology
Reg. No./Substance:
Comment In:
J Nucl Cardiol. 2008 Sep-Oct;15(5):615-6   [PMID:  18761263 ]

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