Abstract
Abstract From examination of pathologic specimens, it is well known that calcium eventually becomes incorporated into the developing advanced atherosclerotic lesion. Early attempts to identify calcific lesions used the plain chest radiograph; how ever, the lesions had to be quite extensive to be seen as a radiopaque lesion using this technique. Advances in rapid acquisition computed tomography (CT) have led to a reliable, noninvasive technique for identifying, locating, and quantifying even small calcific lesions. This chapter provides background information on coronary artery calcification (CAC), a marker of subclinical atherosclerosis, and describes the results from investigations focused on validation of a non invasive method to detect and quantify CAC. The chapter summarizes the results from epidemiologic investigations of the association between CAC and current and previously measured coronary risk factor (CRF) levels, including childhood measures, genetic studies, and studies of the progression of CAC. In adolescents and young adults, assessment of CAC may provide a measure of the early atherosclerotic process before occlusive cardiovascular disease becomes evident. Very little is known about the detection of CAC during childhood. There is a need to study its utility in high-risk children, such as those with markedly elevated cholesterol levels. Clearly, from a clinical perspective, CT measurement of CAC should not be recommended for general pediatric practice.
Published Version
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