Coronary Artery Calcium Area by Electron-Beam Computed Tomography and Coronary Atherosclerotic Plaque Area

Abstract

This histopathologic study confirms an intimate relation between whole heart, coronary artery, and segmental coronary atherosclerotic plaque area and EBCT coronary calcium area but suggests that there is a threshold value for plaque area below which coronary calcium is either absent or not detectable by this methodology.

Structural epicardial disease and microvascular function are determinants of an abnormal longitudinal myocardial blood flow difference in cardiovascular risk individuals as determined with PET/CT

“…27 According to this, the intracoronary resistance depends on the coronary flow velocity and inversely on the fourth power of the vessel diameter, while interacting with branches along its length, that causes flow shunting from the parent artery and the longitudinal perfusion or MBF gradient. As it was observed, the extent of the longitudinal MBF difference was related to the severity of CAC, which has been shown to reflect overall CAD burden, 26 and also to the increase in hyperemic MBF or microvascular function. In cardiovascular risk individuals with CAC, increases in CAC were paralleled by a continuous decrease in the longitudinal MBF difference during pharmacologic vasodilation.…”

“…Coronary non-calcified plaque burden and proximal artery diameter were not entered into the multivariate model, because they correlated with log-CCS. 26 Statistical significance was assumed if a null hypothesis could be rejected at P = .05. All statistical analyses were performed with SPSS for Windows 17.0 (SPSS).…”

Vascular Calcification Mechanisms

“…However, the introduction of new techniques to measure vascular calcification noninvasively, such as electron beam computed tomography, have revolutionized our current thinking about the risks of vascular calcification. In coronary arteries, calcification is positively correlated with atherosclerotic plaque burden (11,12), increased risk of myocardial infarction (13)(14)(15), and plaque instability (2,16). Although some of these findings may relate to the correlation of coronary calcification with extent of underlying atherosclerotic disease, it is also possible that vascular calcification itself may contribute to initiation or progression of cardiovascular disease (CVD).…”

Increased coronary‐artery atherosclerosis in rheumatoid arthritis: Relationship to disease duration and cardiovascular risk factors

“…However, the prevalence of coronary-artery atherosclerosis and the mechanisms underlying the increased risk of ischemic heart disease in RA patients are not known. The presence and extent of coronary-artery calcification can be determined by computed tomography (CT) (16), and a correlation has been found between this calcification and the severity of atherosclerosis measured in pathologic specimens (17) or by angiography (18,19). Furthermore, there is accumulating evidence that coronary-artery calcification may be predictive of the risk of both myocardial infarction and death due to coronary heart disease (20)(21)(22).…”