Prediction of Significant Conduction Disease through Noninvasive Assessment of Cardiac Calcification

Mainigi, Sumeet K.; Chebrolu, Lakshmi; Romero‐Corral, Abel; Mehta, Vinay; Machado, Rodolfo; Konečný, Tomáš; Pressman, Gregg S.

doi:10.1111/j.1540-8175.2012.01752.x

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…Degenerative calcification, reflective of either biological or abnormally accelerated aging process of the CV system (such as post‐insult in the latter), plays an inextricable role in the pathogenesis of cardiac conduction disorders (Angelini, Moreolo, Ruffatti, Milanesi, & Thiene, ; Isotalo et al, ; Pillai et al, ). For instance, imaging‐detected global cardiac calcification burden has been shown to correlate with the presence of cardiac conduction deficit and increased risk of pacemaker implantation (Mainigi et al, ). Furthermore, calcification occurring at sites of specific electro‐anatomical relevance, such as the AV node and the His‐Purkinje system, led to AV block (Angelini et al, ) and intraventricular conduction abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Osteogenic circulating endothelial progenitor cells are linked to electrocardiographic conduction abnormalities in rheumatic patients

Chan

Ngai

Chen

et al. 2019

Noninvasive Electrocardiol

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Background: Osteogenic circulating endothelial progenitor cells (EPC) play a patho-genic role in cardiovascular system degeneration through promulgating vasculature calcification, but its role in conduction disorders as part of the cardiovascular degenerative continuum remained unknown. Aim: To investigate the role of osteocalcin (OCN)-expressing circulating EPCs in cardiac conduction disorders in the unique clinical sample of rheumatoid arthritis (RA) susceptible to both abnormal bone metabolism and cardiac conduction disorders. Methods: We performed flow cytometry studies in 134 consecutive asymptomatic patients with rheumatoid arthritis to derive osteogenic circulating OCN-positive (OCN+) CD34+KDR+ vs. CD34+CD133+KDR+ conventional EPC. Study endpoint was the prespecified combined endpoint of electrocardiographic conduction abnormalities.Results: Total prevalence of cardiac conduction abnormality was 9% (n = 12). All patients except one had normal sinus rhythm. One patient had atrial fibrillation. No patient had advanced atrioventricular (AV) block. Prevalence of first-degree heart block (>200 ms), widened QRS duration (>120 ms) and right bundle branch block were 6.7%, 2.1%, and 2.2% respectively. Circulating osteogenic OCN + CD34 + KDR + EPCs were significantly higher among patients with cardiac conduction abnormalities (p = 0.039). Elevated OCN + CD34 + KDR + EPCs> 75th percentile was associated with higher prevalence of cardiac conduction abnormalities (58.3% vs. 20.02%, p = 0.003).Adjusted for potential confounders, elevated OCN + CD34 + KDR + EPCs> 75th percentile remained independently associated with increased risk of cardiac conduction abnormalities ], p = 0.028). No significant relation was found between conventional EPCs CD34+CD133+KDR+ and conduction abnormalities (p = 0.36).Conclusions: Elevated osteogenic OCN + CD34 + KDR + EPCs are independently associated with the presence of electrocardiographic conduction abnormalities in patients with rheumatoid arthritis, unveiling a potential novel pathophysiological mechanism.

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Section: Discussionmentioning

confidence: 99%

Osteogenic circulating endothelial progenitor cells are linked to electrocardiographic conduction abnormalities in rheumatic patients

Chan

Ngai

Chen

et al. 2019

Noninvasive Electrocardiol

View full text Add to dashboard Cite

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“…However, several large population‐based cohorts, such as the Cardiovascular Health Study and the Multi‐Ethnic Study of Atherosclerosis, have shown that atherosclerotic risk factors have an influence on the presence of valvular and aortic root calcification and its impact on increased cardiovascular mortality . Extensive interest in the assessment of extracoronary cardiac calcifications is arising from recent data indicating the relation between valvular and aortic root calcification and conduction disturbance, coronary artery stenosis, coronary atherosclerotic plaques, and myocardial ischemia . Most recently, several studies indicated that the multiple calcium deposits in heart valves improve the predictive power with respect to mortality .…”

Section: Discussionmentioning

confidence: 99%

Value of Resting Echocardiographic Findings and Dobutamine Stress Echocardiography for Diagnosing Myocardial Ischemia in Patients with Suspected Angina Pectoris

et al. 2015

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“…The electrophysiological role of hyperkalaemia in triggering bradyarrhythmias is likely potentiated by the presence of underlying structural abnormalities in the conduction system and/or abnormal cardiac autonomic regulation of the pacemaker activity that prevent adequate heart rate reactions in response to physiological stress. Cardiac valve calcification may affect the cardiac conduction system and has also been implicated in bradyarrhythmias (Mainigi et al, 2012). It is highly prevalent in HD (Matsuo et al, 2018) and peritoneal dialysis (PD) patients (Wang et al, 2003) and has been associated with increased cardiovascular mortality (Wang et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Sudden Cardiac Death in Dialysis: Arrhythmic Mechanisms and the Value of Non-invasive Electrophysiology

et al. 2019

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Sudden Cardiac Death (SCD) is the leading cause of cardiovascular death in dialysis patients. This review discusses potential underlying arrhythmic mechanisms of SCD in the dialysis population. It examines recent evidence from studies using implantable loop recorders and from electrophysiological studies in experimental animal models of chronic kidney disease. The review summarizes advances in the field of non-invasive electrophysiology for risk prediction in dialysis patients focusing on the predictive value of the QRS-T angle and of the assessments of autonomic imbalance by means of heart rate variability analysis. Future research directions in non-invasive electrophysiology are identified to advance the understanding of the arrhythmic mechanisms. A suggestion is made of incorporation of non-invasive electrophysiology procedures into clinical practice. Key Concepts : – Large prospective studies in dialysis patients with continuous ECG monitoring are required to clarify the underlying arrhythmic mechanisms of SCD in dialysis patients. – Obstructive sleep apnoea may be associated with brady-arrhythmias in dialysis patients. Studies are needed to elucidate the burden and impact of sleeping disorders on arrhythmic complications in dialysis patients. – The QRS-T angle has the potential to be used as a descriptor of uremic cardiomyopathy. – The QRS-T angle can be calculated from routine collected surface ECGs. Multicenter collaboration is required to establish best methodological approach and normal values. – Heart Rate Variability provides indirect assessment of cardiac modulation that may be relevant for cardiac risk prediction in dialysis patients. Short-term recordings with autonomic provocations are likely to overcome the limitations of out of hospital 24-h recordings and should be prospectively assessed.

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Prediction of Significant Conduction Disease through Noninvasive Assessment of Cardiac Calcification

Abstract: Echocardiographic-based calcium scoring correlates with the presence of severe conduction disease requiring a pacemaker.

Cited by 8 publications

References 22 publications

Osteogenic circulating endothelial progenitor cells are linked to electrocardiographic conduction abnormalities in rheumatic patients

Osteogenic circulating endothelial progenitor cells are linked to electrocardiographic conduction abnormalities in rheumatic patients

Value of Resting Echocardiographic Findings and Dobutamine Stress Echocardiography for Diagnosing Myocardial Ischemia in Patients with Suspected Angina Pectoris

Sudden Cardiac Death in Dialysis: Arrhythmic Mechanisms and the Value of Non-invasive Electrophysiology

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