Related Experiment Video
Updated: Sep 3, 2025
Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection
Published on: September 22, 2023
Association of left ventricular diastolic function with coronary artery calcium score: A Project Baseline Health
Francois Haddad1, Nicholas Cauwenberghs2, Melissa A Daubert3
1Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA; Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA.
Insights
Coronary artery calcium (CAC) and left ventricular diastolic dysfunction (LVDD) are linked. Subclinical coronary atherosclerosis detected by CAC is independently associated with impaired diastolic function, highlighting a shared pathway for cardiovascular risk.
Area of Science:
- Cardiology
- Imaging
- Preventive Medicine
Background:
- Coronary artery calcium (CAC) and left ventricular diastolic dysfunction (LVDD) are key predictors of cardiovascular events.
- Both conditions share common risk factors, but their independent association is not well understood.
Purpose of the Study:
- To investigate the independent association between subclinical coronary atherosclerosis (CAC) and left ventricular diastolic function (LVDD).
Main Methods:
- Utilized data from 2082 participants in the Project Baseline Health Study (PBHS).
- Assessed cardiac-gated computed tomography (CT) for CAC and echocardiography for LV diastolic function.
- Employed multivariable-adjusted regression analyses and network analysis, adjusting for cardiometabolic risk factors.
Main Results:
- An intertwined network was observed between diastolic parameters, CAC score, age, LV mass index, and pulse pressure.
- Left ventricular diastolic parameters (e', E/e') and LV mass index were independently associated with CAC.
- The association was confirmed using categorical analysis of LVDD, present in 26.6% of participants.
Conclusions:
- Subclinical coronary atherosclerotic disease burden, as measured by CAC scoring, is independently associated with impaired diastolic function.
- This finding suggests a shared pathophysiological link between coronary atherosclerosis and diastolic dysfunction.
Background:
Coronary artery calcium (CAC) and left ventricular diastolic dysfunction (LVDD) are strong predictors of cardiovascular events and share common risk factors. However, their independent association remains unclear.
Methods:
In the Project Baseline Health Study (PBHS), 2082 participants underwent cardiac-gated, non-contrast chest computed tomography (CT) and echocardiography. The association between left ventricular (LV) diastolic function and CAC was assessed using multidimensional network and multivariable-adjusted regression analyses. Multivariable analysis was conducted on continuous LV diastolic parameters and categorical classification of LVDD and adjusted for traditional cardiometabolic risk factors. LVDD was defined using reference limits from a low-risk reference group without established cardiovascular disease, cardiovascular risk factors or evidence of CAC, (n = 560). We also classified LVDD using the American Society of Echocardiography recommendations.
Results:
The mean age of the participants was 51 ± 17 years with 56.6% female and 62.6% non-Hispanic White. Overall, 38.1% had hypertension; 13.7% had diabetes; and 39.9% had CAC >0. An intertwined network was observed between diastolic parameters, CAC score, age, LV mass index, and pulse pressure. In the multivariable-adjusted analysis, e', E/e', and LV mass index were independently associated with CAC after adjustment for traditional risk factors. For both e' and E/e', the effect size and statistical significance were higher across increasing CAC tertiles. Other independent correlates of e' and E/e' included age, female sex, Black race, height, weight, pulse pressure, hemoglobin A1C, and HDL cholesterol. The independent association with CAC was confirmed using categorical analysis of LVDD, which occurred in 554 participants (26.6%) using population-derived thresholds.
Conclusion:
In the PBHS study, the subclinical coronary atherosclerotic disease burden detected using CAC scoring was independently associated with diastolic function.
Gov Identifier:
NCT03154346.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:30Acute Coronary Syndrome III: Diagnostic Studies
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...
01:24Cardiac Catheterization III: Left Heart Catheterization
01:26Coronary Artery Disease IV: Preventive Measures
01:28Imaging Studies for Cardiovascular System V: CT