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Absence of left ventricular concentric hypertrophy: a prerequisite for zero coronary calcium score

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Abstract

The identification and intervention of factors associated with a coronary artery calcification (CAC) score of zero, suggesting the absence of significant coronary artery disease (CAD) with high probability, would be meaningful in the clinical setting. Thus far, the relationship between CAC and left ventricular (LV) hypertrophy has not been documented. We identified factors associated with a CAC score of zero and evaluated the relationship between this score and LV concentric hypertrophy in 309 consecutive patients with suspected CAD who were clinically indicated to undergo multislice computed tomography angiography for coronary artery evaluation. The quantitative CAC score was calculated according to Agatston’s method. The total coronary calcium score (TCS) was defined as the sum of the scores for each lesion. Four absolute TCS categories were considered: zero, mild (0–100), moderate (100–400), and severe (>400). LV hypertrophy was classified into concentric (LV mass index >104 g/m2 in women or >116 g/m2 in men; LV end-diastolic volume index ≤109.2 mL/m2) and eccentric (LV end-diastolic volume index >109.2 mL/m2) patterns. In the zero-TCS group, the frequency of LV concentric hypertrophy was extremely low (zero 6%, mild 17%, moderate 26%, severe 19%). Multivariate analysis revealed that age, hypercholesterolemia, diabetes mellitus, LV concentric hypertrophy, and LV mass index, but not hypertension, were the independent factors associated with a CAC score of zero. The present study demonstrated that the absence of LV concentric hypertrophy was a prerequisite for a CAC score of zero. That is, the presence of LV concentric hypertrophy, which indicated more severe underlying hypertension, long duration, or poor control of blood pressure, implicates the presence of CAC.

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Abbreviations

EBCT:

Electron-beam computed tomography

MSCT:

Multislice computed tomography

CAC:

Coronary artery calcification

CAD:

Coronary artery disease

LV:

Left ventricular

SD:

Standard deviation

BMI:

Body mass index

TCS:

Total coronary calcium score

EDV:

End-diastolic volume

ESV:

End-systolic volume

LA:

Left atrial

CI:

Confidence interval

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Authors and Affiliations

  1. Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    Shoichi Ehara, Nobuyuki Shirai, Takuhiro Okuyama, Kenji Matsumoto, Yoshiki Matsumura & Minoru Yoshiyama

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  1. Shoichi Ehara
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  2. Nobuyuki Shirai
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  3. Takuhiro Okuyama
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  4. Kenji Matsumoto
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  5. Yoshiki Matsumura
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  6. Minoru Yoshiyama
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Correspondence to Shoichi Ehara.

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Ehara, S., Shirai, N., Okuyama, T. et al. Absence of left ventricular concentric hypertrophy: a prerequisite for zero coronary calcium score. Heart Vessels 26, 487–494 (2011). https://doi.org/10.1007/s00380-010-0082-4

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  • DOI: https://doi.org/10.1007/s00380-010-0082-4

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