Related Experiment Video
Updated: Mar 13, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Cardiac Calcifications on Echocardiography Are Associated with Mortality and Stroke
Marvin Louis Roy Lu1, Shuchita Gupta2, Abel Romero-Corral2
1Department of Internal Medicine, Einstein Medical Center, Philadelphia, Pennsylvania.
Insights
A new Global Cardiac Calcium Score (GCCS) using echocardiography effectively predicts mortality and stroke. This simple scoring method offers a graded assessment of cardiac calcification, improving cardiovascular risk prediction.
Area of Science:
- Cardiology
- Medical Imaging
- Preventive Medicine
Background:
- Cardiac calcifications in the aortic valve and mitral annulus are linked to cardiovascular events and mortality.
- Current methods for scoring cardiac calcifications are often simplistic and lack standardization.
- There is a need for a reliable method to quantify cardiac calcium burden.
Purpose of the Study:
- To test the hypothesis that a semiquantitative Global Cardiac Calcium Score (GCCS), accounting for all visible echocardiographic calcium, can predict all-cause mortality and stroke.
- To establish a graded association between GCCS and adverse cardiovascular outcomes.
Main Methods:
- A retrospective study of 443 subjects from a general echocardiography database.
- Application of a Global Cardiac Calcium Score (GCCS) evaluating aortic root/valve, mitral annulus/valve, and submitral apparatus calcification, plus leaflet mobility.
- Primary outcome: all-cause mortality; Secondary outcome: stroke.
Main Results:
- Over a mean follow-up of 3.8 years, 116 deaths and 34 strokes occurred.
- Crude mortality showed a graded increase with higher GCCS.
- The GCCS was significantly associated with total mortality (HR 1.26) and stroke (HR 1.23), even after adjusting for multiple clinical factors.
Conclusions:
- The Global Cardiac Calcium Score (GCCS) is easily applicable to routine echocardiograms.
- The GCCS demonstrates clinically significant associations with total mortality and stroke.
- This scoring method offers a valuable tool for enhanced cardiovascular risk stratification.
Background:
Calcium deposits in the aortic valve and mitral annulus have been associated with cardiovascular events and mortality. However, there is no accepted standard method for scoring such cardiac calcifications, and most existing methods are simplistic. The aim of this study was to test the hypothesis that a semiquantitative score, one that accounts for all visible calcium on echocardiography, could predict all-cause mortality and stroke in a graded fashion.
Methods:
This was a retrospective study of 443 unselected subjects derived from a general echocardiography database. A global cardiac calcium score (GCCS) was applied that assigned points for calcification in the aortic root and valve, mitral annulus and valve, and submitral apparatus, and points for restricted leaflet mobility. The primary outcome was all-cause mortality, and the secondary outcome was stroke.
Results:
Over a mean 3.8 ± 1.7 years of follow-up, there were 116 deaths and 34 strokes. Crude mortality increased in a graded fashion with increasing GCCS. In unadjusted proportional hazard analysis, the GCCS was significantly associated with total mortality (hazard ratio, 1.26; 95% CI, 1.17-1.35; P < .0001) and stroke (hazard ratio, 1.23; 95% CI, 1.07-1.40; P = .003). After adjusting for demographic and clinical factors (age, gender, body mass index, diabetes, hypertension, dyslipidemia, smoking, family history of coronary disease, chronic kidney disease, history of atrial fibrillation, and history of stroke), these associations remained significant.
Conclusions:
The GCCS is easily applied to routinely acquired echocardiograms and has clinically significant associations with total mortality and stroke.
Related Concept Videos
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
01:28Imaging Studies for Cardiovascular System V: CT
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests