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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Is coronary artery calcium an independent risk factor for white matter hyperintensity?
Hui Jin1,2, Xue Qin1, Fanfan Zhao2
1Bengbu Medical College, Bengbu, 233030, China.
Insights
Coronary artery calcium (CAC) severity is linked to increased white matter hyperintensity (WMH) volume in elderly adults. This suggests a connection between vascular diseases beyond traditional risk factors.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Cardiovascular diseases are a leading cause of global mortality and disability.
- Coronary artery calcium (CAC) quantifies coronary atherosclerosis severity.
- White matter hyperintensity (WMH) is a marker of small vessel ischemic disease.
Purpose of the Study:
- To investigate the relationship between CAC and WMH.
- To explore the diagnostic utility of CAC in assessing WMH burden.
Main Methods:
- Retrospective analysis of 342 patients with WMH on MRI and CT scans.
- Automated WMH volume measurement using a lesion prediction algorithm.
- Multilevel mixed-effects linear regression to assess the association between CAC score and WMH volume, adjusting for vascular risk factors.
Main Results:
- Individuals with CAC (score > 0) exhibited larger WMH volumes compared to those without (score = 0).
- A significant positive correlation was observed between increasing CAC scores and WMH volumes.
- Linear regression indicated a 2.96% increase in WMH volume for every 1% increase in CAC score in the high CAC group, even after covariate adjustment.
Conclusions:
- The presence and severity of CAC are associated with increased WMH volume in elderly individuals.
- Findings suggest a potential comorbid mechanism linking vascular diseases in different vascular beds.
- This association exists independently of traditional vascular risk factors.
Background:
Cardiovascular diseases have been considered the primary cause of disability and death worldwide. Coronary artery calcium (CAC) is an important indicator of the severity of coronary atherosclerosis. This study is aimed to investigate the relationship between CAC and white matter hyperintensity (WMH) in the context of diagnostic utility.
Methods:
A retrospective analysis was conducted on 342 patients with a diagnosis of WMH on magnetic resonance images (MRI) who also underwent chest computed tomography (CT) scans. WMH volumes were automatically measured using a lesion prediction algorithm. Subjects were divided into four groups based on the CAC score obtained from chest CT scans. A multilevel mixed-effects linear regression model considering conventional vascular risk factors assessed the association between total WMH volume and CAC score.
Results:
Overall, participants with coronary artery calcium (CAC score > 0) had larger WMH volumes than those without calcium (CAC score = 0), and WMH volumes were statistically different between the four CAC score groups, with increasing CAC scores, the volume of WMH significantly increased. In the linear regression model 1 of the high CAC score group, for every 1% increase in CAC score, the WMH volume increases by 2.96%. After including other covariates in model 2 and model 3, the β coefficient in the high CAC group remains higher than in the low and medium CAC score groups.
Conclusion:
In elderly adults, the presence and severity of CAC is related to an increase in WMH volume. Our findings suggest an association between two different vascular bed diseases in addition to traditional vascular risk factors, possibly indicating a comorbid mechanism.
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