Coronary Artery Calcium Is Associated with Left Ventricular Diastolic Function Independent of Myocardial Ischemia

Area of Science:

• Cardiology
• Medical Imaging
• Cardiac Physiology

Background:

• Coronary artery calcium (CAC) burden and progression are linked to heart failure.
• Left ventricular (LV) diastolic dysfunction is a key factor in heart failure development.
• Assessing LV diastolic parameters can aid in early detection and management of cardiac conditions.

Purpose of the Study:

• To investigate the association between the extent of coronary artery calcium (CAC) and left ventricular (LV) diastolic parameters.
• To determine if CAC is related to diastolic function in patients without evidence of myocardial ischemia.
• To explore the utility of gated myocardial perfusion single-photon emission computed tomography (SPECT) in assessing this relationship.

Main Methods:

• 157 patients undergoing coronary computed tomography (CT), gated SPECT, and transthoracic echocardiography (TTE) were analyzed.
• Coronary artery calcium (CAC) scores were calculated using the Agatston method.
• Left ventricular (LV) diastolic parameters, including peak filling rate (PFR) and one-third mean filling rate (1/3MFR), were derived from gated SPECT.

Main Results:

• Patients with CAC exhibited significantly lower PFR compared to those without (P=0.03).
• Multivariate regression revealed a significant inverse association between ln (CAC score + 1) and both PFR (β = -0.20, P=0.01) and 1/3MFR (β = -0.18, P=0.049).
• No significant differences were observed in LV end-diastolic volume (LVEDV) or LV ejection fraction (LVEF) between groups.

Conclusions:

• The extent of coronary artery calcium (CAC) is inversely associated with left ventricular (LV) diastolic parameters.
• These findings hold true even in the absence of myocardial ischemia, as assessed by gated SPECT.
• CAC burden may serve as an independent indicator of impaired LV diastolic function.