Association of left ventricular diastolic function with coronary artery calcium score: A Project Baseline Health Study |
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| Affiliation: | 1. Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA;2. Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA;3. Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium;4. Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA;5. Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA;6. Stanford Prevention Research Center, Stanford University, Palo Alto, CA, USA;7. Departments of Ophthalmology and Neurology, Stanford University School of Medicine, Stanford, CA, USA;8. Verily Inc., South San Francisco, CA, USA;9. Stanford Center for Clinical Research (SCCR); Department of Medicine, Stanford School of Medicine, Stanford, CA, USA;1. Centre for Cardiovascular Innovation and Center for Heart Valve Innovation, St Paul''s and Vancouver General Hospital, Division of Cardiology and Department of Radiology University of British Columbia, Vancouver, BC, Canada;2. Department of Radiology, University of Lausanne, Lausanne, Switzerland;1. Department of Pediatrics, Division of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA;2. Division of Pediatric Cardiology, Department of Pediatrics, New York Presbyterian/Columbia University Irving Medical Center, New York, NY, USA;3. Department of Pediatrics, The Heart Center, Nationwide Children''s Hospital, The Ohio State University, Columbus, OH, USA;4. Division of Pediatric Radiology, Department of Radiology, Medical Physics Graduate Program, Duke University Medical Center, Durham, NC, USA;5. The Children''s Heart Clinic at The Children''s Hospitals and Clinics of Minnesota, Minneapolis, MN, USA;6. Division of Pediatric Cardiology, Goryeb Children''s Hospital, Atlantic Health System, Morristown, NJ, USA |
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| Abstract: | BackgroundCoronary 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.MethodsIn 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.ResultsThe 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.ConclusionIn the PBHS study, the subclinical coronary atherosclerotic disease burden detected using CAC scoring was independently associated with diastolic function.Clinicaltrials.gov identifierNCT03154346. |
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| Keywords: | Coronary artery calcium Left ventricular diastolic dysfunction Heart failure Coronary artery disease Cardiovascular disease Blood pressure Hypertension |
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