Combined presence of aortic valve calcification and mitral annular calcification as a marker of the extent and vulnerable characteristics of coronary artery plaque assessed by 64-multidetector computed tomography

被引：39

作者：

Utsunomiya, Hiroto ^{[1
]}

Yamamoto, Hideya ^{[1
]}

Kunita, Eiji ^{[1
]}

Kitagawa, Toshiro ^{[1
]}

Ohashi, Norihiko ^{[1
]}

Oka, Toshiharu ^{[1
]}

Yamazato, Ryo ^{[1
]}

Horiguchi, Jun ^{[2
]}

Kihara, Yasuki ^{[1
]}

机构：

[1] Hiroshima Univ, Dept Cardiovasc Med, Grad Sch Biomed Sci, Minami Ku, Hiroshima 7348551, Japan

[2] Hiroshima Univ, Dept Clin Radiol, Grad Sch Biomed Sci, Hiroshima 7348551, Japan

来源：

ATHEROSCLEROSIS | 2010年 / 213卷 / 01期

关键词：

Aortic valve calcification; Computed tomography; Mitral annular calcification; Coronary artery plaque; Vulnerability; PREDICTS ALL-CAUSE; CARDIOVASCULAR MORTALITY; ANGIOGRAPHY; DISEASE; ASSOCIATION; QUANTIFICATION; SCLEROSIS; CALCIUM; LESIONS; TRIAL;

D O I：

10.1016/j.atherosclerosis.2010.08.070

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: We examined the association of aortic valve calcification (AVC) and mitral annular calcification (MAC) to coronary atherosclerosis using 64-multidetector computed tomography (MDCT). Background: Valvular calcification is considered a manifestation of atherosclerosis. The impact of multiple heart valve calcium deposits on the distribution and characteristics of coronary plaque is unknown. Methods: We evaluated 322 patients referred for 64-MDCT, and assessed valvular calcification and the extent of calcified (CAP), mixed (MCAP), and noncalcified coronary atherosclerotic plaque (NCAP) in accordance with the 17-coronary segments model. We assessed the vulnerable characteristics of coronary plaque with positive remodeling, low-density plaque (CT density <= 38 Hounsfield units), and the presence of adjacent spotty calcification. Results: In 49 patients with both AVC and MAC, the segment numbers of CAP and MCAP were larger than in those with a lack of valvular calcification and an isolated AVC (p < 0.001 for both). Multivariate analyses revealed that a combined presence of AVC and MAC was independently associated with the presence (odds ratio [OR] 9.36, 95% confidence interval [95% CI] 1.55-56.53, p = 0.015) and extent (beta-estimate 1.86, p < 0.001) of overall coronary plaque. When stratified by plaque composition, it was associated with the extent of CAP (beta-estimate 1.77, p < 0.001) and MCAP (beta-estimate 1.04, p < 0.001), but not with NCAP. Moreover, it was also related to the presence of coronary plaque with all three vulnerable characteristics (OR 4.87, 95% CI 1.85-12.83, p = 0.001). Conclusion: The combined presence of AVC and MAC is highly associated with the presence, extent, and vulnerable characteristics of coronary plaque identified by 64-MDCT. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

引用

页码：166 / 172

页数：7