Coronary artery calcium and plaque association with left ventricular mass, assessed by multi-row detector computed tomography.
BACKGROUND
Few studies have been published describing the association of coronary plaques and coronary artery calcium (CAC) to left ventricular (LV) mass and LV function using multi-detector computed tomography (MDCT). Coronary plaques can potentially influence the LV function. We sought to evaluate LV mass and function on MDCT and its correlation with CAC and plaque burden in the coronary arteries.


METHODS
We included 197 symptomatic patients from the multicenter ACCURACY Study. The LV mass was measured manually using Advantage 4.4 workstation. Interobserver variability of LV mass was assessed using 34 randomly selected studies. LV mass was indexed to the body surface area. The coronary plaque severity was assessed in each segment using MDCT, following the 15 segment American Heart Association model. Plaque and segment scores were calculated accordingly. Statistical analysis using multiple logistic regression analysis was performed.


RESULTS
We divided the cohort into those with CAC=0 [n=67 (34%)] and those with CAC greater than 0 [n=130 (66%)]. A significant correlation was found between indexed LV mass and CAC, plaque, and segment scores in both adjusted and unadjusted models. A significant association was observed between nonindexed LV mass with CAC, MDCT plaque score and segment score upon adjusting for various cardiovascular risk factors. A significant correlation was found between hyperlipidemia, hypertension, family history of CAD, and greater than 50% and greater than 70% stenosis on invasive cardiac catheterization with LV mass (all P<0.05).


CONCLUSIONS
To our knowledge, this is the first study evaluating coronary plaque on computed tomographic angiography with LV mass. We were able to show a significant correlation of LV mass with CAC score, and with total plaque and total segment scores. The poor prognosis associated with increased CAC scores may be partially explained by this association with increased LV mass.
Madaj
Paul M
PM
Department of Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, California, USA.
Pagali
Sandeep R
SR
Hamirani
Yasmin S
YS
Raina
Sameer
S
Nair
Subu
S
Zeb
Irfan
I
Mao
Songshou
S
Budoff
Matthew J
MJ
D000367:Age Factors; D000368:Aged; D002114:Calcinosis; D003324:Coronary Artery Disease / Q000175:diagnosis*; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016276:Ventricular Function