The coronary artery calcium score correlates with left atrial low‐voltage area: Sex differences

Abstract

Introduction:In patients with coronary artery disease, a high coronary artery calcium score (CACS) correlates with atrial fibrillation (AF); however, the association between left atrial (LA) remodeling progression and coronary arteriosclerosis is unclear. This study aimed to evaluate the relationship between LA remodeling progression and the CACS. Methods: This retrospective study enrolled 148 patients with AF (paroxysmal AF, n = 94) who underwent catheter ablation. Voltage mapping for the left atrium and coronary computed tomography for CACS calculations were performed. The ratio of the LA low-voltage area (LA-LVA), defined by values less than 0.5 mV divided by the total LA surface without pulmonary veins, was calculated. Patients with LA-LVA (<0.5 mV) >5% and ≤5% were classified as the LVA (n = 30) and non-LVA (n = 118) groups, respectively. Patient characteristics and CACS values were compared between the two groups.Results: LA volume, age, CHA 2 DS 2 VASc score, and percentage of female patients were significantly higher, and the estimated glomerular filtration rate was lower in the LVA group than in the non-LVA group. The CACS was significantly higher in the LVA group (248.4 vs. 13.2; p = .001). Multivariate analysis identified the LA volume index and CACS as independent predictors of LA-LVA (<0.5 mV) greater than 5%.The areas under the receiver operating characteristic curves for predicting LA-LVA (<0.5 mV) greater than 5% with CACS were 0.695 in the entire population, 0.782 in men, and 0.587 in women. Conclusion: Progression of LA remodeling and coronary artery calcification may occur in parallel. A high CACS may indicate advanced LA remodeling, especially in men.

Predictors of low‐voltage zones in patients with persistent atrial fibrillation eligible for catheter ablation: An observational study

“…However, it is noted in existing literature that patients with CAD have a higher risk of developing AF 28,29 . Hojo et al 30 reported that a high coronary artery calcium score, as measured by coronary CT, serves as an independent predictor of LVZs, with this association being particularly pronounced in men. The arterial supply to the LA is primarily provided by branches originating from the right coronary artery or the left circumflex artery.…”

“…However, it is noted in existing literature that patients with CAD have a higher risk of developing AF. 28,29 Hojo et al 30 in conjunction with ventricular infarctions and this is also associated with supraventricular arrhythmias. 31 Research conducted on pigs has also demonstrated that atrial infarctions induced in these animals correspond to LVZs detected through voltage mapping.…”