Impact of coronary artery calcium on progression of diastolic dysfunction: a cohort study

被引：0

作者：

Choi, Ki Hong ^{[1
]}

Kang, Danbee ^{[2
,3
]}

Lee, Seung Hun ^{[4
]}

Kim, Darae ^{[1
]}

Cho, Sung Won ^{[5
]}

Choi, Soo-Hee ^{[5
]}

Park, Taek Kyu ^{[1
]}

Lee, Joo Myung ^{[1
]}

Song, Young Bin ^{[1
]}

Hahn, Joo-Yong ^{[1
]}

Choi, Seung-Hyuk ^{[1
]}

Gwon, Hyeon-Cheol ^{[1
]}

Cho, Soo Jin ^{[5
]}

Yang, Jeong Hoon ^{[1
,6
]}

机构：

[1] Sungkyunkwan Univ, Heart Vasc Stroke Inst, Samsung Med Ctr, Dept Internal Med,Sch Med,Div Cardiol, 81 Irwon Ro, Seoul 06351, South Korea

[2] Sungkyunkwan Univ, SAIHST, Dept Clin Res Design & Evaluat, Seoul, South Korea

[3] Sungkyunkwan Univ, Samsung Med Ctr, Ctr Clin Epidemiol, Sch Med, Seoul, South Korea

[4] Chonnam Natl Univ, Chonnam Natl Univ Hosp, Heart Ctr,Med Sch, Dept Internal Med,Div Cardiol, Gwangju, South Korea

[5] Sungkyunkwan Univ, Samsung Med Ctr, Ctr Hlth Promot, Sch Med, 81 Irwon Ro, Seoul 06351, South Korea

[6] Sungkyunkwan Univ, Samsung Med Ctr, Sch Med, Dept Crit Care Med, Seoul, South Korea

来源：

BMC MEDICINE | 2025年 / 23卷 / 01期

关键词：

Coronary artery calcium; Diastolic dysfunction; Mortality; Echocardiography; Heart failure; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; HEART-FAILURE; ECHOCARDIOGRAPHY; RECOMMENDATIONS; QUANTIFICATION; CALCIFICATION; UPDATE; RISK;

D O I：

10.1186/s12916-025-03956-9

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background The relationship between coronary artery calcium (CAC) and progression of diastolic dysfunction (DD) during longitudinal follow-up is uncertain. This study aimed to investigate the prevalence and progression of DD according to severity of CAC and understand their synergistic effect on mortality. Methods This was a population-based cohort study. All 15,193 adults who underwent a health screening exam with simultaneous echocardiography and CAC scan were enrolled. Definite DD (>= 3/4 abnormal parameters for DD [e ', E/e ', tricuspid regurgitation velocity, and left atrial volume index]) and definite or probable DD (>= 2/4) were defined. All-cause mortality was assessed based on the CAC and DD. Results Among the population, 7995 participants (52.6%) had CAC = 0; 4661 (30.7%) had 0 < CAC < 100; and 2537 (16.7%) had CAC >= 100. The prevalence ratios for definite (adjusted ratio: 1.72, 95% CI: 1.23-2.22) and definite or probable DD (adjusted ratio: 1.83, 95% CI: 1.31-2.36) were significantly higher in individuals with CAC >= 100 than in those with CAC = 0. There was significant linear association of CAC with E/e ' (adjusted p for linearity = 0.001). Compared with CAC < 100 without definite DD, the adjusted HRs with 95% CI for mortality of CAC >= 100 without definite DD, CAC < 100 with definite DD, and CAC >= 100 with definite DD were 2.56 (95% CI: 1.67-3.94), 3.08 (95% CI: 1.28-7.39), and 3.91 (95% CI: 1.68-9.10). Among participants without DD at CAC measurement who had at least two echocardiographic measurements, the presence of significant CAC (>= 100) was significantly associated with accelerated progression in definite DD over time (adjusted HR: 1.46, 95% CI: 1.13-1.88), with more rapid elevation of E/e ' during follow-up (difference: 0.06, 95% CI: 0.02-0.10, p = 0.003). Conclusions In the general population, there was a significant relationship between CAC and prevalence of DD, and both subclinical parameters were associated with increased mortality. Moreover, CAC >= 100 significantly affects the progression of DD independently of other clinical factors.

引用

页数：10

共 28 条

[1] QUANTIFICATION OF CORONARY-ARTERY CALCIUM USING ULTRAFAST COMPUTED-TOMOGRAPHY [J].