Differential Coronary Calcification on Electron-Beam CT Between Syndrome X and Coronary Artery Disease in Patients With Chronic Stable Angina Pectoris

Chen, Lung Ching; Chen, Jaw Wen; Wu, Mei-Han; Liu, Ju Chi; Lan, Gong Yau; Ding, Philip Yu‐An; Chang, Mau Song

doi:10.1378/chest.120.5.1525

Cited by 10 publications

(5 citation statements)

References 38 publications

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“…Coronary artery calcification (CAC), as measured by chest computed tomography scanning, represents evidence of subclinical coronary artery disease and independently predicts future coronary events (6)(7)(8)(9). While most studies indicate that CAC scores are correlated with epicardial coronary artery atherosclerosis (10,11), some studies have reported elevated CAC scores in persons with microvascular angina without epicardial coronary stenosis (12)(13)(14). These latter observations raise an important question: Do persons with higher CAC levels have concomitant microvascular disease?…”

mentioning

confidence: 99%

Relation of Retinopathy to Coronary Artery Calcification: The Multi-Ethnic Study of Atherosclerosis

Wong

Cheung

Islam

et al. 2007

American Journal of Epidemiology

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Microvascular disease, reflected by retinal vascular changes, has been shown to predict clinical coronary heart disease. Whether retinal vascular changes are associated with subclinical coronary artery disease is unclear and was examined in this study. The authors conducted a multiethnic, population-based study of 6,147 persons aged 45-84 years, sampled from six US communities in 2002-2004, who were free of clinical cardiovascular disease. Coronary artery calcification (CAC), a noninvasive measure of subclinical coronary artery disease, was assessed by cardiac computed tomography scanning and categorized into three groups of increasing severity: none (average CAC score = 0), mild (1-100), and moderate-to-severe (>100). Retinopathy signs and retinal vascular caliber were graded from retinal photographs following standardized protocols. After adjustment for age, gender, race/ethnicity, blood pressure, diabetes, lipid profile, smoking, and other risk factors, retinopathy was associated with having a moderate-to-severe CAC score (odds ratio = 1.43, 95% confidence interval: 1.18, 1.75). This association remained significant in both men and women and in persons with and without diabetes or hypertension. Variations in retinal vascular caliber were not significantly associated with CAC score. This study shows that retinopathy signs are independently associated with CAC, supporting the concept that common pathophysiologic processes may underlie both micro- and macrovascular disease.

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confidence: 99%

Relation of Retinopathy to Coronary Artery Calcification: The Multi-Ethnic Study of Atherosclerosis

Wong

Cheung

Islam

et al. 2007

American Journal of Epidemiology

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“…It has been reported that CACS is statistically significantly lower in syndrome X patients than in CAD patients. 22 Thus, apart from CAD, CMD must be considered as a cause of chest pain because our study was limited to patients with mild calcification. Young women (20-39 years age group) with chest pain but no obstructive and no calcified CAD could have LVDD, which may be associated with CMD.…”

Section: Discussionmentioning

confidence: 99%

Chest Pain Without Coronary Artery Obstruction and Calcification in Young Women May Indicate Left Ventricular Diastolic Dysfunction

Watanabe¹,

Moroi²,

Isobe³

2017

Heart Res Open J

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Background: Left ventricular diastolic dysfunction (LVDD) and coronary artery calcification become worse with increasing age. However, it is unclear whether there is a gender difference in patients with chest pain but no obstructive coronary artery disease (CAD). Aim: This study's aim was to investigate whether gender and age differences existed in the association between LVDD and the coronary artery calcium score (CACS) in patients with chest pain but no obstructive CAD. Methods: We retrospectively studied a total of 705 patients (age 65±13 years; men 342, 49%) who had chest pain, normal LV ejection fraction on echocardiography, and no obstructive CAD on computed tomography (CT) coronary angiography. LVDD was defined by the American Society of Echocardiography recommendation of septal e'<8. Abnormal CACS was defined as CACS of >0. Results: Although, there was a significant difference in LVDD prevalence among patients with normal and abnormal CACS (76.1% vs. 88.9%; p<0.001), in a multiple logistic regression analysis, LVDD was not significantly associated with abnormal CACS. When the patients were divided according to gender and age (decades; 20-29, 30-39, 40-49, 50-59, 60-69, 70-79 years), the proportion of men and women with abnormal CACS increased with age. On the other hand, young women (age 20-39 years) with normal CACS showed a high LVDD prevalence, although older women (age 60-69 years) and young men (age 20-39 years) had a low LVDD prevalence. Conclusions: Young women with chest pain but no obstructive and no calcified CAD, which associated with LVDD. LV diastolic function assessment by echocardiography should be performed in young women with chest pain even with normal CT coronary angiogram.

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“…It has been thought that, slow coronary flow and syndrome X are part of this process (2)(3)(4)(5)(6)(7)(8)(9). The relation between oxidant enzyme level and coronary artery disease has been revealed by previous studies (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 95%

The effect of antioxidant enzyme levels and exercise on syndrome X and coronary slow flow phenomenon: an observational study

Kaplan¹,

Meriç²,

Acar³

et al. 2013

Anadolu Kardiyol Derg

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Objective: In this study the antioxidant enzyme [catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) ] levels at rest in patients with syndrome X and coronary slow flow are measured. Then it has been investigated whether there is any enzymatic difference between the normal controls and syndrome X patients or patients with coronary slow flow and ascertain if exercise has any effects on the antioxidant enzyme levels. Methods: Fifty-five patients were included in this prospective observational controlled study. Patients were divided into 3 groups: Group 1-normal controls (n=20); Group 2-patients with coronary slow flow (n=20); and Group 3-patients diagnosed with syndrome X (n=15). In all patients, blood samples were collected at rest and after maximal exercise. The antioxidant enzymes (SOD, CAT, Gpx) in the erythrocytes were studied for these three groups of blood sample. Statistical analysis was performed using Student t-test, Mann-Whitney U and Chi-square tests, KruskalWallis variance analysis and ANOVA. Results: Under basal conditions the lowest SOD and GPx levels were measured in the 2 nd Group, whereas significant differences in paired comparisons were observed only between the 2 nd and 3 rd Groups (p=0.024 vs. p<0.01, respectively) during paired comparisons. The postexercise SOD levels were decreased significantly in the 3 rd Groups when compared with the basal concentrations (p=0.014), however no significant pre-and post-exercise differences were observed in the CAT and GPx concentrations (p>0.05). Conclusion: The post-exercise SOD level when compared with basal SOD levels were decreased significantly in the syndrome X group, however no differences were observed between the other groups. This can be interpreted as the reduction in the exercise related symptoms and ischemic findings are resulting from the decrease of SOD activity. (Anadolu Kardiyol Derg 2013; 13: 641-6) Key words: Coronary slow flow, syndrome X, antioxidant enzymes Original Investigation Özgün Araşt›rma 641ÖZET Amaç: Bu çalışmada, sendrom X ve yavaş koroner akım hastalarında istirahatte antioksidan enzim [katalaz (CAT), süperoksid dismutaz (SOD) ve glutatyon peroksidaz (GPx)] düzeyleri ölçülerek normal kontrollerle fark gösterip göstermediği, egzersizin enzim düzeylerine etkisi olup olmadı-ğı araştırılmak istenmiştir.Yöntemler: Prospektif kontrollü gözlemsel bu çalışmaya 55 kişi alındı. Hastalar, normal kontroller (Grup 1, n= 20), koroner yavaş akımı olan hastalar (Grup 2, n=20) ve Sendrom X tanısı konan hastalar (Grup 3, n=15) olmak üzere 3 gruba ayrıldı. Tüm hastalardan istirahatte ve maksimum efor sonrası kanlar alındı ve eritrosit içindeki antioksidan enzimler (SOD, CAT, GPx) çalışıldı. İstatistiksel analiz Student t-testi, Mann-Whitney U, Ki-kare testi, Kruskal-Wallis varyans analizi ve ANOVA (post-hoc) kullanılarak yapıldı. Bulgular: Bazal şartlarda ölçülen SOD ve GPx değerleri en düşük olarak Grup 2'de saptanırken, ikili karşılaştırmada yalnızca Grup 2 ve 3 arasın-da anlamlı fark vardı (p sırasıyla 0,02...

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Differential Coronary Calcification on Electron-Beam CT Between Syndrome X and Coronary Artery Disease in Patients With Chronic Stable Angina Pectoris

Cited by 10 publications

References 38 publications

Relation of Retinopathy to Coronary Artery Calcification: The Multi-Ethnic Study of Atherosclerosis

Relation of Retinopathy to Coronary Artery Calcification: The Multi-Ethnic Study of Atherosclerosis

Chest Pain Without Coronary Artery Obstruction and Calcification in Young Women May Indicate Left Ventricular Diastolic Dysfunction

The effect of antioxidant enzyme levels and exercise on syndrome X and coronary slow flow phenomenon: an observational study

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