Abstract 9941: Coronary Artery Calcification Score is Associated with Left Ventricular Diastolic Function in Patients Without Coronary Artery Disease

Abstract

Introduction: Left ventricular (LV) diastolic dysfunction is a strong predictor of cardiovascular events, and it shares several risk factors with coronary artery disease (CAD). It is not well elucidated whether coronary atherosclerosis could affect LV diastolic function even in patients without CAD. Hypothesis: Coronary artery calcification (CAC) score by computer tomography (CT) might be associated with LV diastolic function even in non-ischemic patients. Methods: We enrolled non-ischemic patients who underwent CT coronary angiography (CTA) and echocardiography, using the following inclusion criteria; (1) age ≥65 years (2) no history of ischemic events, coronary revascularization or mitral valve operation, (3) no significant stenotic lesion on CTA, and (4) regular sinus rhythm at echocardiography study. We measured CAC score on CT and diastolic parameters including median E/e’ ratio on echocardiogram. Continuous variables were expressed as median [interquartile range] and were compared using Kruskal-Wallis rank sum test. Results: We enrolled consecutive 242 patients for the present study (72 [68, 77] years, male; 56.2%). We divided them based on CAC score, as no (N: score 0, n=61), low- (L: 1-99, n=86), and high (H: ≥100, n=95) CAC group. There was difference in gender and history of diabetes among the groups, but not in age, BMI, hypertension and dyslipidemia. Significant difference was observed in E/e’ ratio among 3 groups (N: 8.1[6.9,9.9], L:8.7 [7.3,10.8], H: 9.1 [7.5,11.0], p=0.035), and the H-group had higher E/e’ than the N-group (p=0.036). There were also difference in left atrial volume (N: 35.2ml [26.8, 44.0], L:41.6 ml [30.5, 55.5], H: 42.5 [34.5 ,58.3], p=0.002) and in LV mass index (N: 82.7 g/m 2 [71.2, 93.3], L:84.1 g/m 2 [75.4, 97.7], H: 95.2 g/m 2 [80.8, 109.9], p=0.0004), and those in the H-groups were higher than those in the N-group. No difference was observed in LV ejection fraction or in E/A ratio. CAC score could detect E/e’ ratio ≥14 with 57% sensitivity and 63% specificity, using 71.0 as the cutoff value (AUC 0.64). Conclusions: High CAC score was associated with impaired LV diastolic function, implying the relationship between coronary artery atherosclerosis and LV diastolic dysfunction in patients without CAD.