Clinical Significance of Coronary Calcification.

Yamanaka, Osamu; Sawano, Masato; Nakayama, Riichiro; Nemoto, Masaaki; Nakamura, Toyohide; Fujiwara, Yoshihiro; Suzuki, Shinji; Hayashi, Yoshitaka; Yamagami, Shinichiro; Minamisawa, Kousuke; Wada, Atsushi; Nyui, Nobuo

doi:10.1253/circj.66.473

Cited by 19 publications

(12 citation statements)

References 25 publications

(25 reference statements)

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“…6,10 Furthermore, Yamanaka et al reported that the coronary artery calcification score assessed by cinefluoroscopy in patients with ACS was significantly lower than that in those with SAP. 13 Although it is true, as shown in the present study, that larger and longer calcifications are associated with SAP, small calcifications are common in patients with ACS. Our IVUS results do not contradict these previous findings.…”

Section: Discussionmentioning

confidence: 42%

“…15 What are the clinical implications of this study? Calcium deposits were assessed along the long axis of the coronary artery by cinefluoroscopy 13 or MSCT. 16 Our finding, that calcium deposits of longer length can be interpreted as having a larger arc, is important to physicians performing percutaneous coronary intervention (PCI) with only information on calcium deposits detected by cinefluoroscopy or MSCT without that by IVUS, because the extent of calcium deposits influences the effectiveness of PCI.…”

Section: Discussionmentioning

confidence: 99%

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Quantification of Coronary Calcification by Intravascular Ultrasound Do Calcium Deposits With Larger Arcs Have Longer Lengths?

Ehara

Kobayashi

Kataoka

et al. 2007

Circ J

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alcification is a common finding in human coronary arteries, and has usually been interpreted as an indicator of advanced atherosclerosis. 1 In the past few decades, arterial calcification has been considered passive and degenerative. With recent clinical and basic research, however, there is increasing recognition that arterial calcification is an active, regulated process. 2 In particular, following the introduction of electron-beam computed tomography (EBCT), which permits the quantitative assessment of coronary artery calcification, there have been rapidly increasing numbers of clinical studies of coronary calcification. Some studies have shown that EBCT-detected coronary calcification correlates with the degree of plaque burden in the entire coronary tree. 3 More recently, multislice computed tomography (MSCT) has allowed for the detection of not only coronary artery calcification but also coronary artery stenoses and plaques. 4 Coronary calcifications detected by MSCT can be assessed along the long axis of the coronary artery. However, it is difficult to assess the circumference of calcium deposits using cross-sectional images obtained by MSCT.Intravascular ultrasound (IVUS), in contrast, enables the identification of calcium deposits and exact measurements of vessel diameters and areas, including those associated with culprit lesions. A number of IVUS studies have focused on detailed assessment of calcification. However, neither total areas nor volumes of calcium deposits can be accurately determined using current IVUS technology, because calcium deposits produce acoustic shadowing.Previous studies with IVUS have demonstrated that calcification can be quantified as the arc on cross-sections. 5,6 For IVUS, this approach of quantification of vessel calcium is generally accepted and acknowledged as the most reliable method of assessment of plaque calcium along the length of lesions. Another approach is to determine the length of calcium using serial cross-sectional IVUS images. 7,8 However, little is known about the correlation between the largest arc and the length of each calcium deposit within the culprit lesion segment in patients with coronary artery disease. The combination of the largest arc and the length is quite complex in IVUS analysis. The question arises whether calcium deposits with larger arcs have a longer length. The present study was designed to answer this question. MethodsThe study was approved by the hospital ethics committee, and written informed consent was obtained from all patients before the study. PatientsPreinterventional IVUS images were obtained from 212 Shoichi Ehara, MD; Yoshiki Kobayashi, MD; Toru Kataoka, MD; Minoru Yoshiyama, MD; Makiko Ueda, MD*; Junichi Yoshikawa, MD** Background Previous intravascular ultrasound (IVUS) studies have shown that calcification can be quantified by the determination of the arc on one cross-section. However, because calcium levels change along the length of lesions, it is important to assess the length of calcium using serial cross-sectional i...

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Section: Discussionmentioning

confidence: 42%

Section: Discussionmentioning

confidence: 99%

Quantification of Coronary Calcification by Intravascular Ultrasound Do Calcium Deposits With Larger Arcs Have Longer Lengths?

Ehara

Kobayashi

Kataoka

et al. 2007

Circ J

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“…Calcium deposits in the coronary artery and extracoronary arterial beds indicate the extent of atherosclerotic lesions, and may be markers of subclinical cardiovascular disease. [11][12][13] Studies of the coronary arteries using electron-beam computed tomography (EBCT) demonstrate an association between calcification and cardiovascular events. [14][15][16][17][18] In their population-based study, Iribarren et al reported that aortic arch calcification on chest radiography was independently related to the risk of CAD.…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Aortic Knob Width and Calcification in Unstable Angina

Yun

Jeong

et al. 2006

Circ J

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Background Chest radiography is a routine examination evaluating those patients with chest pain. There are few data about the correlation between aortic knob width, calcification and coronary atherosclerosis. Methods and ResultsThe aortic knob width was measured and the presence of aortic knob calcification was assessed via a chest posteroanterior view in 178 consecutive patients. The aortic knob width and calcification were compared to the risk factor and the extent of coronary artery disease. Patient's age (69.5±7.95 vs 61.1± 10.29 years, p=0.010), the prevalence of hypertension (65.9 vs 46.3%, p=0.024) and diabetes (43.2 vs 26.1%, p=0.033), the level of total cholesterol (196.8±63.21 vs 188.6±44.45 mg/dl, p=0.049) and the incidence of multivessel disease (65.9 vs 38.1%, p<0.001) were higher in patients with aortic knob calcification than in patients without calcification. The aortic knob width and the prevalence of aortic knob calcification were significantly correlated with the severity of coronary artery disease. Multivariate analysis demonstrated that aortic knob calcification and diabetes were independent factors for multi-vessel disease (p=0.018 and p=0.012). Conclusions The observation of aortic knob on a chest radiograph can provide important predictive information of coronary atherosclerosis. (Circ J 2006; 70: 1280 -1283

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“…Procedure angiographic images and iliofemoral MSCT, when available, were analyzed retrospectively with respect to iliofemoral calcification, atherosclerosis, tortuosity and femoral bifurcation location. A femoral artery calcification score using angiographic images just before contrast injection was adapted from the coronary artery calcification score first described by Yamanaka et al, allowing for a semiquantitative and reproducible assessment of iliofemoral vessel calcification [7]. Briefly, it is defined as follows: 0 = no calcification; 1 = spotty wall calcification; 2 = unilateral linear calcification; 3 = unilateral linear calcification with spotty wall calcification on the opposite wall; 4 = bilateral linear calcification.…”

Section: Data Collectionmentioning

confidence: 99%