Abstract
BackgroundArteriosclerosis (arterial stiffening) is associated with future cardiovascular events, with this effect postulated to be due to its effect on cardiac afterload, atherosclerosis (plaque formation) progression or both, but with limited evidence examining these early in disease formation. The aim of the current study is to examine the association between arteriosclerosis, atherosclerosis and ventricular remodelling in a population at low-intermediate cardiovascular risk.MethodsOne thousand six hundred fifty-one subjects free of clinical cardiovascular disease and with a < 20% 10 year cardiovascular risk score underwent a cardiovascular magnetic resonance (CMR) study and whole body CMR angiogram. Arteriosclerosis was measured using total arterial compliance (TAC) - calculated as the indexed stroke volume divided by the pulse pressure. Atherosclerosis was quantified using a standardised atheroma score (SAS) which was calculated by scoring 30 arterial segments within the body based on the degree of stenosis, summating these scores and normalising it to the number of assessable segments. Left ventricular remodelling was measured using left ventricular mass to volume ratio (LVMVR).ResultsOne thousand five hundred fifteen (38% male, 53.8 ± 8.2 years old) completed the study. On univariate analysis TAC was associated with SAS but this was lost after accounting for cardiovascular risk factors in both males (B = − 0.001 (− 0.004–0.002),p = 0.62) and females (B = 0.000(95%CI -0.002--0.002),p = 0.78). In contrast compliance correlated with LVMVR after accounting for cardiovascular risk factors (B = − 0.12(95%CI -0.16--0.091),p < 0.001 in males; B = − 0.12(95%CI -0.15--0.086),p < 0.001 in females).ConclusionSystemic arteriosclerosis is associated with left ventricular remodelling but not atherosclerosis. Future efforts in cardiovascular risk prevention should thus seek to address both arteriosclerosis and atherosclerosis individually.
Highlights
Arteriosclerosis is associated with future cardiovascular events, with this effect postulated to be due to its effect on cardiac afterload, atherosclerosis progression or both, but with limited evidence examining these early in disease formation
The male population had a significantly higher systolic and diastolic blood pressure, a higher body mass index (BMI), a lower total cholesterol driven by lower HDL-cholesterol, higher random blood glucose, lower brain natriuretic peptide (BNP), higher Left ventricular (LV) mass, left ventricular mass to volume ratio (LVMVR) and compliance (p < 0.05 for all) (Table 1)
Arteriosclerosis In men: age, heart rate, systolic and diastolic blood pressure, low density lipoprotein (LDL) cholesterol, and socioeconomic deprivation were independently associated with total arterial compliance (TAC)
Summary
Arteriosclerosis (arterial stiffening) is associated with future cardiovascular events, with this effect postulated to be due to its effect on cardiac afterload, atherosclerosis (plaque formation) progression or both, but with limited evidence examining these early in disease formation. Whole body cardiovascular magnetic resonance angiography (WB-CMRA) allows systemic quantification of the global atherosclerosis burden within the body, with the results of this showing strong prognostic capabilities for future adverse cardiovascular events [9,10,11]. The aim of the current study was to compare early atherosclerotic plaque formation and arterial stiffening in a non-high risk cohort with no prior diagnosis of cardiovascular disease, to test the hypothesis that increased arterial stiffening would be associated with an increased atherosclerotic plaque burden
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Schedule a callMore From: Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
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