The heart of patients with aortic aneurysms: evidence from cardiac computed tomography.
To determine in patients with abdominal aortic aneurysm (AAA) the coronary calcium burden and prevalence of coronary artery disease (CAD) in relation to cardiovascular risk factors, and to assess the left ventricular (LV) function using cardiac computed tomography (CT). Sixty consecutive patients (six females; 72.2+/-9.0 years) with AAA underwent dual-source CT calcium scoring and coronary angiography prior to AAA repair. In the 60 patients, the Framingham risk score (FRS) ranged from 5-43%. Twenty patients (33%) were at low, 16 (27%) at intermediate, and 24 (40%) at high risk for cardiovascular disease. The median Agatston score (AS) was 393 (0-3538). No significant correlation was found between AS and FRS (P=0.76). 846/851 coronary segments (99%) in 57/60 patients (95%) were depicted with a diagnostic image quality. Significant stenoses were found in 132/846 segments (16%) in 33/60 patients (55%). Five patients (8%) with significant coronary artery stenosis showed reduced LV function [ejection fraction (EF)<50%]. The extent of CAD was significantly correlated with AS (r=0.43, P<0.01), whereas no correlation was found for FRS (P=0.55). Cardiac CT is feasible in patients with AAA and allows for the assessment of coronary calcium, coronary stenoses, and LV function. The calcium burden and coronary stenoses assessment with cardiac CT provides incremental information beyond traditional cardiovascular risk factors alone.
Stolzmann
Paul
P
Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland. paul.stolzmann@usz.ch
Phan
Catherine
C
Desbiolles
Lotus
L
Lachat
Mario
M
Pfammatter
Thomas
T
Marincek
Borut
B
Prokop
Mathias
M
Alkadhi
Hatem
H
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001027:Aortography / Q000379:methods*; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016277:Ventricular Function, Left