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Echocardiographic Calcium Score of Aortic Valve Correlates with Coronary Artery Calcium Score in Heterozygous
Angelo Baldassare Cefalù1, Emilio Nardi1, Antonina Giammanco1
1Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro" (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy.
Insights
The echocardiographic calcium score (ECS) effectively predicts high coronary artery calcification (CAC) scores in patients with heterozygous familial hypercholesterolemia (HeFH). This non-invasive method can serve as a valuable tool for assessing cardiovascular risk in this high-risk population.
Area of Science:
- Cardiology
- Medical Imaging
- Biomarkers
Background:
- Patients with heterozygous familial hypercholesterolemia (HeFH) face elevated risks of atherosclerotic cardiovascular disease.
- A coronary artery calcification (CAC) score exceeding 100 on a CT scan (Agatston calcium score, ACS) indicates higher risk in FH patients.
- Echocardiographic calcium score (ECS) assesses aortic valve calcifications and predicts atherosclerotic burden and outcomes.
Purpose of the Study:
- To evaluate the echocardiographic calcium score (ECS) as a predictor for an Agatston calcium score (ACS) > 100 in patients with heterozygous familial hypercholesterolemia (HeFH).
Main Methods:
- 81 HeFH patients underwent coronary calcium CT scans (for ACS) and transthoracic echocardiograms (for ECS).
- Patients were categorized into high-risk (ACS > 100) and low-risk (ACS ≤ 100) groups.
- Stratification was also performed based on ECS (0 or > 0).
Main Results:
- High-ACS patients were older and had significantly higher BMI, waist circumference, and systolic blood pressure (p < 0.001).
- The ECS demonstrated strong predictive performance for ACS > 100: sensitivity 0.84, specificity 0.89, accuracy 0.86, and precision 0.76.
Conclusions:
- The echocardiographic calcium score (ECS) shows potential as a reliable surrogate for coronary calcium CT scans in assessing Agatston calcium scores (ACS) within the HeFH patient population.
Background:
Patients with heterozygous familial hypercholesterolemia (HeFH) are at a high risk of atherosclerotic cardiovascular disease. The coronary artery calcification (CAC) score by the Ct-scan Agatston calcium score (ACS) > 100 classifies FH at a higher risk. The echocardiographic calcium score (ECS) evaluates aortic valve calcifications and is considered a good predictor of the atherosclerotic burden and cardiovascular outcome.
Objective:
To test the ECS as a predictor of ACS > 100 in a HeFH cohort.
Methods:
A coronary calcium CT scan with the calculation of ACS and an at rest-transthoracic echocardiogram with ECS evaluation were performed in 81 HeFH patients. Patients were divided into two groups according to the ACS: high-risk ACS patients (High-ACS) with Agatston value > 100 and low risk ACS patients (Low-ACS) with Agatston value ≤ 100. Patients were stratified according to ECS = 0 or ECS > 0.
Results:
High-ACS patients were older than Low-ACS patients; BMI, waist circumference, and blood systolic pressure were significantly higher (p < 0.001) in High-ACS patients. The ECS predicted an ACS > 100 with sensitivity = 0.84, specificity = 0.89, accuracy = 0.86, and precision = 0.76.
Conclusions:
The ECS could be a good surrogate of a coronary calcium CT scan for ACS evaluation in the specific subset of HeFH patients.
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