Affiliation:
1. Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Abstract
Background: Left ventricular diastolic dysfunction (LVDD) and coronary artery calcium (CAC) are common in patients with hypertension and are strong predictors of cardiovascular events. Aim: This study aims to investigate the association between CAC and LVDD in patients with hypertension without coronary artery disease (CAD). Methods: Consecutive patients with hypertension who underwent echocardiography and non-contrast coronary CT were studied. CAC was quantified using the Agatston score. Patients with a history of CAD, AF or left ventricular ejection fraction (LVEF) <50% were excluded. Characteristics of patients with and without LVDD were compared and the association between LVDD and CAC was evaluated. Univariable and multivariable analyses were performed to determine the predictors of LVDD and high CAC (>median CAC). A p value of <0.05 was considered statistically significant. Results: A total of 250 patients were included, with a mean age of 64.3 ± 10.1 years, 59% women and 26.4% had diabetes. The prevalence of LVDD was 64.8% (grade I LVDD 48%; grade II LVDD 16.8%) and the median CAC score was 58.2 (interquartile range [IQR] 0.7–349.8). Patients with LVDD had a significantly higher median CAC score than those without LVDD (142.8 [IQR 18.8–514.8] versus 5.0 [IQR 0–64.4]; p<0.001). Multivariable analysis showed that the CAC score was independently associated with LVDD (OR 1.003; 95% CI [1.001–1.004]; p<0.001). Left atrial volume index and E-wave deceleration time were independently associated with high CAC (OR 1.05; 95% CI [1.01–1.09]; p=0.008 and OR 1.008; 95% CI [1.002–1.02]; p=0.01), respectively. Conclusion: CAC scoring was associated with LVDD in patients with hypertension.
Publisher
Radcliffe Media Media Ltd
Reference31 articles.
1. Budoff MJ, Achenbach S, Blumenthal RS, et al. Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation. 2006;114:1761–91. https://doi.org/10.1161/CIRCULATIONAHA.106.178458; PMID: 17015792.
2. Raggi P, Cooil B, Shaw LJ, et al. Progression of coronary calcium on serial electron beam tomographic scanning is greater in patients with future myocardial infarction. Am J Cardiol 2003;92:827–9. https://doi.org/10.1016/s0002-9149(03)00892-0; PMID: 14516885.
3. Visseren FLJ, Mach F, Smulders YM, et al. ESC guidelines on cardiovascular disease prevention in clinical practice: developed by the task force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies with the special contribution of the European Association of Preventive Cardiology (EAPC). Eur Heart J 2021;42:3227–337. https://doi.org/10.1093/eurheartj/ehab484; PMID: 34458905.
4. McClelland RL, Chung H, Detrano R, et al. Distribution of coronary artery calcium by race, gender, and age: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 2006;113:30–7. https://doi.org/10.1161/CIRCULATIONAHA.105.580696; PMID: 16365194.
5. Kalra SS, Shanahan CM. Vascular calcification and hypertension: cause and effect. Ann Med 2012;44(Suppl 1):S85–92. https://doi.org/10.3109/07853890.2012.660498; PMID: 22713153.