Usefulness of Coronary Artery Calcium to Predict Heart Failure With Preserved Ejection Fraction in Men Versus Women (from the Multi-Ethnic Study of Atherosclerosis)

Sharma, Kavita; Rifai, Mahmoud Al; Ahmed, Haitham M.; Dardari, Zeina; Silverman, Michael G.; Yeboah, Joseph; Nasir, Khurram; Sklo, Moyses; Yancy, Clyde W.; Russell, Stuart D.; Blumenthal, Roger S.; Blaha, Michael J.

doi:10.1016/j.amjcard.2017.07.089

Cited by 22 publications

(10 citation statements)

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“…13,25 However, a recent report from the MESA revealed that a CAC score >300 was significantly predictive of incident heart failure with preserved ejection fraction among women but not men. 29 Our findings and that of others support a working hypothesis that atherosclerotic plaque impairing vascular function and diastolic function may uniquely impact risk in women, even among those without obstructive CAD. 29,30 Explorations regarding plaque density and cardiovascular disease mortality The Agatston score is calculated by multiplying the area of calcified plaque by mean CAC density.…”

Section: Figuresupporting

confidence: 83%

“…29 Our findings and that of others support a working hypothesis that atherosclerotic plaque impairing vascular function and diastolic function may uniquely impact risk in women, even among those without obstructive CAD. 29,30 Explorations regarding plaque density and cardiovascular disease mortality The Agatston score is calculated by multiplying the area of calcified plaque by mean CAC density. 17 Recent evidence, from the MESA, revealed an inverse relationship between calcified plaque density and CVD and CHD events.…”

Section: Figuresupporting

confidence: 83%

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Sex differences in calcified plaque and long-term cardiovascular mortality: observations from the CAC Consortium

Shaw

Min

Nasir

et al. 2018

European Heart Journal

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157

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Section: Figuresupporting

confidence: 83%

Section: Figuresupporting

confidence: 83%

Sex differences in calcified plaque and long-term cardiovascular mortality: observations from the CAC Consortium

Shaw

Min

Nasir

et al. 2018

European Heart Journal

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157

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“…Moreover, to define the presence of atherosclerosis, the cut off values were arbitrarily chosen. While CIMT >0.9 mm is commonly used and easily understood by most clinicians 37 , the impact of age and sex cannot be neglected 38 . Furthermore, CIMT measurements were usually performed at the common carotid artery, however previous studies differed according to measurement side (left side versus right side), measurement wall (far wall versus near wall) and method of combination of single measurements (mean versus mean‐maximum) 39,40 .…”

Section: Limitationsmentioning

confidence: 99%

H₂FPEF score predicts atherosclerosis presence in patients with systemic connective tissue disease

Васильев

Popović

Ristić

et al. 2021

Clinical Cardiology

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Background Cardiovascular diseases are common cause of morbidity and mortality in patients with systemic connective tissue diseases (SCTD) due to accelerated atherosclerosis which couldn't be explained by traditional risk factors (CVDRF). Hypothesis We hypothesized that recently developed score predicting probability of heart failure with preserved ejection fraction (H2FPEF), as well as a measure of right ventricular‐pulmonary vasculature coupling [tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) ratio], are predictive of atherosclerosis in SCTD. Methods 203 patients (178 females) diagnosed with SCTD underwent standard and stress‐echocardiography (SE) with TAPSE/PASP and left ventricular (LV) diastolic filling pressure (E/e') measurements, carotid ultrasound and computed tomographic coronary angiography. Patients who were SE positive for ischemia underwent coronary angiography (34/203). The H2FPEF score was calculated according to age, body mass index, presence of atrial fibrillation, ≥2 antihypertensives, E/e' and PASP. Results Mean LV ejection fraction was 66.3 ± 7.1%. Atherosclerosis was present in 150/203 patients according to: 1) intima‐media thickness>0.9 mm; and 2) Agatstone score > 300 or Syntax score ≥ 1. On binary logistic regression analysis, including CVDRF prevalence, echocardiographic parameters and H2FPEF score, only H2FPEF score remained significant for the prediction of atherosclerosis presence (χ2 = 19.3, HR 2.6, CI 1.5‐4.3, p < 0.001), and resting TAPSE/PASP for the prediction of a SE positive for ischemia (χ2 = 10.4, HR 0.01, CI = 0.01‐0.22, p = 0.004). On ROC analysis, the optimal threshold value for identifying patients with atherosclerosis was a H2FPEF score ≥2 (Sn 60.4%, Sp 69.4%, area 0.67, SE = 0.05, p < 0.001). Conclusions H2FPEF score and resting TAPSE/PASP demonstrated clinical value for an atherosclerosis diagnosis in patients diagnosed with SCTD.

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“…Sex differences in underlying mechanisms may partially explain the observed difference in HFpEF prevalence. Women more often present with coronary microvascular dysfunction (CMD) 22. CMD may lead to myocardial stiffening and LV filling problems, both features of LVDD and HFpEF.…”

Section: Introductionmentioning

confidence: 99%

“…CMD may lead to myocardial stiffening and LV filling problems, both features of LVDD and HFpEF. Men more often present with pronounced coronary macrovascular disease, a hallmark of HFrEF 22…”

Section: Introductionmentioning

confidence: 99%

Discovery of biomarkers for the presence and progression of left ventricular diastolic dysfunction and HEart faiLure with Preserved ejection Fraction in patients at risk for cardiovascular disease: rationale and design of the HELPFul case-cohort study in a Dutch cardiology outpatient clinic

et al. 2019

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IntroductionLeft ventricular diastolic dysfunction (LVDD) is a common condition in both sexes that may deteriorate into heart failure (HF) with preserved ejection fraction (pEF), although this seems to happen more often in women than in men. Both LVDD and HFpEF often go unrecognised, necessitating the discovery of biomarkers that aid both the identification of individuals with LVDD at risk of developing HF and identification of individuals most likely to benefit from treatment.Methods and analysisHELPFul is an ongoing case-cohort study at a Dutch cardiology outpatient clinic enrolling patients aged 45 years and older without history of cardiovascular disease, who were referred by the general practitioner for cardiac evaluation. We included a random sample of patients and enriched the cohort with cases (defined as an E/e’ ≥8 measured with echocardiography). Information about medical history, cardiovascular risk factors, electrocardiography, echocardiography, exercise test performance, common carotid intima-media thickness measurement and standard cardiovascular biomarkers was obtained from the routine care data collected by the cardiology outpatient clinic. Study procedure consists of extensive venous blood collection for biobanking and additional standardised questionnaires. Follow-up will consist of standardised questionnaires by mail and linkage to regional and national registries. We will perform cardiac magnetic resonance imaging and coronary CT angiography in a subgroup of patients to investigate the extent of macrovascular and microvascular coronary disease.Ethics and disseminationThe study protocol was approved by the Institutional Review Board of the University Medical Center Utrecht. Results will be disseminated through national and international conferences and in peer-reviewed journals in cardiovascular disease.Trial registrationNTR6016;Pre-results.

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Usefulness of Coronary Artery Calcium to Predict Heart Failure With Preserved Ejection Fraction in Men Versus Women (from the Multi-Ethnic Study of Atherosclerosis)

Cited by 22 publications

References 29 publications

Sex differences in calcified plaque and long-term cardiovascular mortality: observations from the CAC Consortium

Sex differences in calcified plaque and long-term cardiovascular mortality: observations from the CAC Consortium

H₂FPEF score predicts atherosclerosis presence in patients with systemic connective tissue disease

Discovery of biomarkers for the presence and progression of left ventricular diastolic dysfunction and HEart faiLure with Preserved ejection Fraction in patients at risk for cardiovascular disease: rationale and design of the HELPFul case-cohort study in a Dutch cardiology outpatient clinic

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Usefulness of Coronary Artery Calcium to Predict Heart Failure With Preserved Ejection Fraction in Men Versus Women (from the Multi-Ethnic Study of Atherosclerosis)

Cited by 22 publications

References 29 publications

Sex differences in calcified plaque and long-term cardiovascular mortality: observations from the CAC Consortium

Sex differences in calcified plaque and long-term cardiovascular mortality: observations from the CAC Consortium

H2FPEF score predicts atherosclerosis presence in patients with systemic connective tissue disease

Discovery of biomarkers for the presence and progression of left ventricular diastolic dysfunction and HEart faiLure with Preserved ejection Fraction in patients at risk for cardiovascular disease: rationale and design of the HELPFul case-cohort study in a Dutch cardiology outpatient clinic

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H₂FPEF score predicts atherosclerosis presence in patients with systemic connective tissue disease