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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Overlapping Genetic Background of Coronary Artery and Carotid/Femoral Atherosclerotic Calcification
Anita Hernyes1, Marton Piroska1, Bence Fejer1
1Medical Imaging Centre, Semmelweis University, 78/A Üllői Street, 1083 Budapest, Hungary.
Insights
Atherosclerotic plaque calcification is moderately heritable across coronary, carotid, and femoral arteries. Significant shared genetic factors influence calcification, suggesting predispositions for co-localization and supporting extracoronary artery screening.
Area of Science:
- Cardiovascular Genetics
- Atherosclerosis Research
- Twin Studies
Background:
- Atherosclerosis commonly affects multiple vessels but its genetic basis is under-researched.
- Coronary artery calcification (CAC) assessment lacks investigation into genetic links with other arterial beds.
- Twin studies offer a unique model to explore the heritability of atherosclerosis dissemination.
Purpose of the Study:
- To assess the heritability of atherosclerotic plaque types in coronary, carotid, and femoral arteries.
- To investigate the genetic correlation between calcification in different arterial locations.
- To explore genetic predispositions for the co-localization of atherosclerosis.
Main Methods:
- Evaluated plaque types in 190 twins (monozygotic and dizygotic pairs) using CT (coronary) and ultrasound (carotid, femoral).
- Calculated heritability for coronary artery calcification (CAC) and plaque dissemination scores (4S_hyper) in extracoronary arteries.
- Determined genetic correlation between phenotypically linked plaque types across arteries.
Main Results:
- Coronary artery calcification (CAC) and plaque dissemination in carotid/femoral arteries (4S_hyper) showed moderate heritability (0.67 and 0.69).
- Mixed plaques exhibited intermediate heritability (0.50), while hypoechoic plaques showed none.
- Strong genetic correlation (0.86) was found between CAC and 4S_hyper, indicating shared genetic factors.
Conclusions:
- Atherosclerotic plaque calcification is moderately heritable across major arteries.
- Significant overlapping genetic factors contribute to the resemblance of calcification between coronary and extracoronary arteries.
- Findings support screening extracoronary arteries and propose distinct genetic predispositions for carotid-coronary and femoral-coronary atherosclerosis co-localization.
Background And Objectives:
Multivessel atherosclerosis and its genetic background are under-investigated, although atherosclerosis is seldom local and still causes high mortality. Alternative methods to assess coronary calcification (CAC) might incorporate genetic links between different arteries' atherosclerotic involvement, however, co-occurrences of coronary calcification have not been investigated in twins yet.
Materials And Methods:
We assessed the heritability of radio morphologically distinct atherosclerotic plaque types in coronary (non-enhanced CT, Agatston score), carotid, and femoral arteries (B-mode ultrasound) in 190 twin subjects (60 monozygotic, 35 dizygotic pairs). Four-segment scores were derived in order to assess the dissemination of the distinct plaque types in the carotid and femoral arteries taking bilaterality into account. We calculated the genetic correlation between phenotypically correlating plaque types in these arteries.
Results:
CAC and dissemination of calcified plaques in the carotid and femoral arteries (4S_hyper) were moderately heritable (0.67 [95% CI: 0.37-1] and 0.69 [95% CI: 0.38-1], respectively) when adjusted for age and sex. Hypoechoic plaques in the carotid and femoral arteries showed no heritability, while mixed plaques showed intermediate heritability (0.50 [95% CI: 0-0.76]). Age and sex-adjusted phenotypic correlation between CAC and 4segm_hyper was 0.48 [95% CI: 0.30-0.63] and the underlying genetic correlation was 0.86 [95% CI: 0.42-1].
Conclusions:
Calcification of atherosclerotic plaques is moderately heritable in all investigated arteries and significant overlapping genetic factors can be attributed to the phenotypical resemblance of coronary and carotid or femoral atherosclerotic calcification. Our findings support the idea of screening extracoronary arteries in asymptomatic individuals. We also propose a hypothesis about primarily carotid-coronary and femoral-coronary atherosclerosis as two distinct genetic predispositions to co-localization.
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