The evaluation of the coronary arteries calcification degree by the method of cardiovascular MSCT in patients with vitamin D and homocysteine metabolism disturbance

Abstract

In spite of diagnostics and treatment methods development, the ischemic heart disease (IHD) is still the leading cause of disabilities and mortality level in the population. The main reason for IHD pathogenesis is endothelial vascular dysfunction, which further initiates the atherogenesis. The revealing of hyperhomocysteinemia and vitamin D deficiency is determined to increase the risk of the early coronary arteries (CA) atherosclerosis and thrombosis development and to be the prognostic marker of a lethal case.Traditionally, the selective coronary angiography is used to obtain an image of the CAs. However, with the advent of multispiral computed tomography (MSCT), the technique of CT angiography of coronary vessels was introduced, which today has opened wide prospects for determining the degree of coronary calcification and non-invasive evaluation of the anatomy and the degree of CAs narrowing.The objective of the research is to evaluate the degree of CA calcification by the MSCT method in patients with hyperhomocysteinemia and vitamin D deficiency and to determine the correlation between these parameters.Materials and methods. The data of 39 patients who were diagnosed with the CAs pathology by MSCT CAG were analyzed.Results. Patients with high calcium index, greater than 400, with an average cholesterol level of 20.69 ± 2.10 mmol/l, had significantly higher plasma cholesterol levels (P < 0.022 by Mann–Whitney criteria) compared to patients with calcium index less than 400 (mean homocysteine was 13.51 ± 0.97 mmol/l), and greater area of CAs lesions.Conclusions. The MSCT CAG can be used as a screening method to diagnose and clarify the nature of CA lesion. Due to the proven correlation between CI and homocysteine levels, the careful treatment of hyperhomocysteinemia is required both before and after CA surgery.