Coronary Artery Calcium Is Associated with Left Ventricular Diastolic Function Independent of Myocardial Ischemia Assessment by Myocardial Perfusion Single-Photon Emission Computed Tomography

It has been shown in several studies that coronary artery calcium (CAC) burden or CAC progression is associated with heart failure. We tested the hypothesis that the extent of CAC is associated with left ventricular (LV) diastolic parameters derived from gated myocardial perfusion single-photon emission computed tomography (SPECT) in patients with no evidence of myocardial ischemia. 157 patients undergoing coronary computed tomography (CT), gated SPECT, and transthoracic echocardiography (TTE) were enrolled in this study. The CAC score was calculated according to the Agatston method. The peak filling rate (PFR) and the one-third mean filling rate (1/3MFR) were obtained as LV diastolic parameters. There were 139 patients with CAC and 18 patients without. The CAC score ranged from 0 to 4,976.There were no significant differences in the LV end-diastolic volume (LVEDV) (61 +/- 21 mL versus 62 +/- 22 mL, P = 0.79) and LV ejection fraction (LVEF) (66 +/- 9% versus 68 +/- 9%. P = 0.43). Patients with CAC had lower PFR than those without (2.2 +/- 0.5 EDV/s versus 2.6 +/- 0.7 EDV/s, P = 0.03). Multivariate linear regression analysis showed that In (CAC score + 1) was significantly associated with PFR (beta = -0.20, P = 0.01) and 1/3MFR (beta = -0.18, P = 0.049). Our data suggest that the extent of CAC is inversely associated with LV diastolic parameters derived from gated SPECT independent of myocardial ischemia.