Association of Coronary Artery Calcium With Severity of Myocardial Ischemia in Left Anterior Descending, Left Circumflex, and Right Coronary Artery Territories

Lai, Hoang M.; Holtzman, Dvorah; Aronow, Wilbert S.; DeLuca, Albert J.; Ahn, Chul Min; Matayev, Svetlana; Belkin, Robert N.

doi:10.1002/clc.20997

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…11 In stable patients, lower coronary artery calcium scores were also reported in the LCx when compared with the LAD or RCA. 12 These findings in largely smaller cohorts suggest a varied milieu for atherosclerosis development. To date, comprehensive comparisons between the epicardial coronary arteries concerning the presence and severity of coronary atherosclerosis have not been reported.…”

Section: Graphical Abstractmentioning

confidence: 98%

Comparative differences in the atherosclerotic disease burden between the epicardial coronary arteries: quantitative plaque analysis on coronary computed tomography angiography

Bax

Rosendael

et al. 2020

European Heart Journal - Cardiovascular Imaging

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Aims Anatomic series commonly report the extent and severity of coronary artery disease (CAD), regardless of location. The aim of this study was to evaluate differences in atherosclerotic plaque burden and composition across the major epicardial coronary arteries. Methods and results A total of 1271 patients (age 60 ± 9 years; 57% men) with suspected CAD prospectively underwent coronary computed tomography angiography (CCTA). Atherosclerotic plaque volume was quantified with categorization by composition (necrotic core, fibrofatty, fibrous, and calcified) based on Hounsfield Unit density. Per-vessel measures were compared using generalized estimating equation models. On CCTA, total plaque volume was lowest in the LCx (10.0 ± 29.4 mm3), followed by the RCA (32.8 ± 82.7 mm3; P < 0.001), and LAD (58.6 ± 83.3 mm3; P < 0.001), even when correcting for vessel length or volume. The prevalence of ≥2 high-risk plaque features, such as positive remodelling or spotty calcification, occurred less in the LCx (3.8%) when compared with the LAD (21.4%) or RCA (10.9%, P < 0.001). In the LCx, the most stenotic lesion was categorized as largely calcified more often than in the RCA and LAD (55.3% vs. 39.4% vs. 32.7%; P < 0.001). Median diameter stenosis was also lowest in the LCx (16.2%) and highest in the LAD (21.3%; P < 0.001) and located more distal along the LCx when compared with the RCA and LAD (P < 0.001). Conclusion Atherosclerotic plaque, irrespective of vessel volume, varied across the epicardial coronary arteries; with a significantly lower burden and different compositions in the LCx when compared with the LAD and RCA. These volumetric and compositional findings support a diverse milieu for atherosclerotic plaque development and may contribute to a varied acute coronary risk between the major epicardial coronary arteries.

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Section: Graphical Abstractmentioning

confidence: 98%

Comparative differences in the atherosclerotic disease burden between the epicardial coronary arteries: quantitative plaque analysis on coronary computed tomography angiography

Bax

Rosendael

et al. 2020

European Heart Journal - Cardiovascular Imaging

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“…Косвенным критерием, отражающим степень коронарного атеросклероза, является количество кальция, содержащегося в сосудах сердца, так называемый коронарный кальциевый индекс (индекс Агатстона). Он используется для обнаружения и оценки субклинического атеросклероза даже в отсутствие симптомов у пациентов [28][29][30][31][32].…”

Section: обзор §unclassified

“…Известно, что количество кальция коррелирует с тяжестью атеросклероза у разных пациентов, а также с поражением различных сегментов артерий венечного русла одного и того же индивидуума [33]. Это подтверждается данными компьютерной томографии (КТ) [28][29][30][31][32].…”

Section: обзор §unclassified

“…Септальные ветви обычно оказываются свободными от АСБ. На характер поражения влияют гемодинамические факторы, а также наличие ветвления сосудов с образованием локальных турбулентных потоков [28][29][30][31][32].…”

Section: особенности локализации атеросклероза каunclassified

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Specific Characteristics of Coronary Atherosclerosis

Pykhteev

Lashevich

Bogdan

et al. 2017

CARDIO

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В настоящее время наряду с общепринятой липидноинфильтрационной теорией существуют и другие гипотезы патогенеза атеросклероза: «ответ на повреждение» эндотелия артерий, дефицита эссенциальных полиеновых жирных кислот, гипотеза перекисного окисления липидов. Анализ последних научных публикаций показал, что исключительная роль на этапах формирования атеросклеротической бляшки (АСБ) принадлежит воспалительным клеткам. Маркерами выраженности атеросклероза могут являться соотношение нейтрофилы / лимфоциты и средний объем тромбоцитов [1-4]. Активированные макрофаги, продуцирующие металлопротеиназы и коллагеназу, в определенных ситуациях способствуют распаду коллагена в бляшке и возникнове-нию разрыва, образованию тромба и развитию инфаркта миокарда (ИМ). Таким образом, макрофаги играют ключевую роль в развитии атеросклеротических повреждений, а образование пенистых клеток позволяет воедино связать морфологические и биохимические признаки этого заболевания [5-7]. Отмечена положительная корреляция между риском развития атеросклероза и инфекционным воспалением. В ходе исследований в АСБ были обнаружены бактерии, вирусы, многочисленные бактериальные антигены, в том числе нуклеиновые кислоты, пептидогликаны [8, 9]. R. Andrews и соавт. (2005) провели мета-анализ 11 плацебо-контролируемых клинических испытаний по эрадикации Chlamydia рneumoniae с помощью антибиотиков.

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The evolution and investigation of native coronary arteries in patients after coronary stent implantation: a study by 320-detector CT angiography

Juan

Huang

Sun

et al. 2014

Int J Cardiovasc Imaging

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To study the role of 320-detector coronary computed tomography angiography (CTA) in assessing native coronary arteries in patients treated with coronary stents. 123 patients with coronary stenting received both CTA and conventional coronary angiography (CCA) within 1 day. The clinical parameters, coronary calcium scoring, CTA and CCA were analyzed to determine the prevalence of significant stenosis of native coronary arteries (SSNCA), the predictive value of CTA and the factors correlating with SSNCA and newly developed SSNCA after stenting (NDSSNCAS), with CCA as the standard of reference, using both vessel-based analysis (VBA) and patient-based analysis (PBA). Both the source and the reconstructed images were analyzed by CTA. All native coronary arteries were interpretable independent of cardiac motion. CTA showed a sensitivity/specificity of 93.5%/97.3% and 92.5%/92.5% in diagnosing SSNCA in VBA and PBA, respectively. The significant factors related to SSNCA were higher calcium scores (P = 0.003), a higher serum glucose level (P = 0.048), a greater number of vessels without previous stent placement (P = 0.003) and fewer stents implanted within the vessels (P = 0.003). The risk factors showed no significant correlation from PBA on SSNCA or from NDSSNCAS on either VBA or PBA. CTA demonstrates excellent correlation with CCA. The prevalence of SSNCA is significantly correlated with the presence of higher calcium scores in the arteries, a higher serum glucose level, a greater number of vessels without previous stent placement and fewer stents implanted within the vessels; PBA on SSNCA and NDSSNCAS on both VBA and PBA showed no significance.

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Association of Coronary Artery Calcium With Severity of Myocardial Ischemia in Left Anterior Descending, Left Circumflex, and Right Coronary Artery Territories

Cited by 7 publications

References 9 publications

Comparative differences in the atherosclerotic disease burden between the epicardial coronary arteries: quantitative plaque analysis on coronary computed tomography angiography

Comparative differences in the atherosclerotic disease burden between the epicardial coronary arteries: quantitative plaque analysis on coronary computed tomography angiography

Specific Characteristics of Coronary Atherosclerosis

The evolution and investigation of native coronary arteries in patients after coronary stent implantation: a study by 320-detector CT angiography

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