Enhanced Coronary Calcification Determined by Electron Beam CT Is Strongly Related to Endothelial Dysfunction in Patients With Suspected Coronary Artery Disease

• Published in: Chest Vol. 128; no. 2; pp. 810 - 815
• Main Authors: Huang, Po-Hsun, Chen, Lung-Ching, Leu, Hsin-Bang, Ding, Philip Yu-An, Chen, Jaw-Wen, Wu, Tao-Cheng, Lin, Shing-Jong
• Format: Journal Article
• Language: English
• Published: Northbrook, IL Elsevier Inc 01.08.2005; American College of Chest Physicians; Elsevier B.V
• Subjects: Aged; Atherosclerosis; Biological and medical sciences; C-reactive protein; C-Reactive Protein - physiology; Calcification; Calcinosis - diagnostic imaging; Cardiology. Vascular system; Cardiovascular disease; Chemokine CCL2 - physiology; coronary artery calcification; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - physiopathology; Coronary Disease - diagnostic imaging; Coronary Disease - physiopathology; Coronary heart disease; Coronary vessels; Diagnosis; Electron beam computed tomography; electron beam CT; Electrons; endothelial function; Endothelium; Endothelium, Vascular - physiopathology; Female; Health aspects; Heart; Humans; Hypotheses; Male; Medical sciences; Middle Aged; Pneumology; Proteins; Tomography, X-Ray Computed; Ultrasonic imaging; Vein & artery diseases; endothelial function; CCS; MCP-1; C-reactive protein; NMD; CAD; hsCRP; coronary artery calcification; FMD; electron beam CT; EBCT; Human; Radiodiagnosis; Respiratory disease; Coronary artery; endothehal function; Electron beam; Cardiovascular disease; Patient; Coronary heart disease; Endothelium; Dysfunction; Calcification; Medical imagery; Computerized axial tomography; C reactive protein
• ISSN: 0012-3692; 1931-3543
• DOI: 10.1378/chest.128.2.810

Coronary artery calcification determined by electron beam CT (EBCT) is strongly associated with total plaque burden but is not related to systemic vascular inflammation We sought to test the hypothesis that enhanced coronary artery calcification, a marker of atherosclerosis and plaque burden, was related to endothelial dysfunction in patients with suspected coronary artery disease (CAD) One hundred twenty-four subjects with suspected CAD were enrolled. Coronary artery calcification was detected by EBCT. A noninvasive method of brachial ultrasound was used to measure endothelium-dependent flow-mediated vasodilation (FMD) and endothelium-independent nitroglycerin-mediated vasodilation (NMD). Serum high-sensitivity C-reactive protein (hsCRP) and monocyte chemoattractant protein-1 (MCP-1) levels were also determined. Of the 124 patients, the calcium scores ranged from 0 to 4,394. All subjects were classified into three groups according to coronary calcium scores: group 1, score 0 (n = 26); group 2, scores 1 to 199 (n = 50); group 3, scores ≥ 200 (n = 48). There was an inverse association between the degree of coronary artery calcification and the endothelium-dependent FMD in the three groups (6.9 ± 0.6% vs 5.3 ± 0.3% vs 3.7 ± 0.3%, respectively; p < 0.001) but not the endothelium-independent NMD. Besides, no significant difference in serum levels of hsCRP and MCP-1 were found among the three groups. However, both the serum levels of hsCRP and MCP-1 were correlated significantly with endothelium-dependent FMD (r= − 0.211, p = 0.019; andr= − 0.188, p = 0.037, respectively). By multivariate analysis, enhanced coronary calcification was a strong independent predictor of endothelial dysfunction (p < 0.001) Enhanced coronary artery calcification strongly predicted endothelial dysfunction in patients with suspected CAD. Also, serum levels of hsCRP and MCP-1 were significantly correlated with endothelial function. These findings suggested that both calcium deposition and inflammation were involved in endothelial dysfunction