title: Right coronary wall CMR in the older asymptomatic advance cohort: positive remodeling and associations with type 2 diabetes and coronary calcium.
abstract: BACKGROUND
  Coronary wall cardiovascular magnetic resonance (CMR) is a promising noninvasive approach to assess subclinical atherosclerosis, but data are limited in subjects over 60 years old, who are at increased risk. The purpose of the study was to evaluate coronary wall CMR in an asymptomatic older cohort.
  
  
  RESULTS
  Cross-sectional images of the proximal right coronary artery (RCA) were acquired using spiral black-blood coronary CMR (0.7 mm resolution) in 223 older, community-based patients without a history of cardiovascular disease (age 60-72 years old, 38% female). Coronary measurements (total vessel area, lumen area, wall area, and wall thickness) had small intra- and inter-observer variabilities (r = 0.93~0.99, all p < 0.0001), though one-third of these older subjects had suboptimal image quality. Increased coronary wall thickness correlated with increased coronary vessel area (p < 0.0001), consistent with positive remodeling. On multivariate analysis, type 2 diabetes was the only risk factor associated with increased coronary wall area and thickness (p = 0.03 and p = 0.007, respectively). Coronary wall CMR measures were also associated with coronary calcification (p = 0.01-0.03).
  
  
  CONCLUSIONS
  Right coronary wall CMR in asymptomatic older subjects showed increased coronary atherosclerosis in subjects with type 2 diabetes as well as coronary calcification. Coronary wall CMR may contribute to the noninvasive assessment of subclinical coronary atherosclerosis in older, at-risk patient groups.
authors.affiliation: Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Terashima
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Nguyen
authors.forename: Geoffrey D
authors.initials: GD
authors.lastname: Rubin
authors.forename: Craig H
authors.initials: CH
authors.lastname: Meyer
authors.forename: Ann
authors.initials: A
authors.lastname: Shimakawa
authors.forename: Dwight G
authors.initials: DG
authors.lastname: Nishimura
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ehara
authors.forename: Carlos
authors.initials: C
authors.lastname: Iribarren
authors.forename: Brian K
authors.initials: BK
authors.lastname: Courtney
authors.forename: Alan S
authors.initials: AS
authors.lastname: Go
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hlatky
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Fortmann
authors.forename: Michael V
authors.initials: MV
authors.lastname: McConnell
mesh_terms: D000367:Age Factors; D000368:Aged; D058070:Asymptomatic Diseases; D002114:Calcinosis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D002140:California; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors