Association between diastolic dysfunction with coronary artery calcium score in stable coronary artery disease patients
H I L F A N Lubis, T E N G K U Ardini, C U T Andra, A N G G I A Lubis, J U A N G Zebua, C U T Putri, I S F A N Rialdy, A N D R E W Brahmana- Cardiology and Cardiovascular Medicine
- Radiology, Nuclear Medicine and imaging
- General Medicine
Abstract
Funding Acknowledgements
Type of funding sources: None.
Objectives
Diastolic dysfunction is a common problem in patients with obesity, hypertension, diabetes, or coronary artery disease (CAD) including stable CAD. The coronary artery calcium score (CACS) is used to non-invasively evaluate cardiovascular risk in asymptomatic patients with a low to intermediate pre-test probability for CAD. The purpose of this study was to evaluate the association of diastolic dysfunction with an abnormal CAC score.
Materials and Methods
This study considered a cohort of patients > 18 years of age with normal ejection fraction who were admitted to the hospital with chest pain but low risk presentation for acute myocardial infarction. Patients then underwent cardiac CT for measurement of CAC score. Patients were excluded if they had prior history of CAD, ECG findings diagnostic of an acute coronary syndrome, an elevated troponin level, or hemodynamic instability.
Results
A total of 200 patients were included and 96 (48%) patients had echocardiographic evidence of diastolic dysfunction. Patients with diastolic dysfunction were more likely to have a higher mean calcium score (12,154.68 ± 17,588.30 vs 2,666.38 ± 9,725.82; p<0.001). Receiver operating characteristics (ROC) analysis showed the area under the curve was 86.3% and cut off was 129.5 with sensitivity 85% and specificity 74%.
Conclusions
Our study demonstrates that left ventricular diastolic dysfunction is associated with an abnormal CAC score. Patients without known CAD that present with chest pain with evidence of abnormal diastolic function on echocardiogram may warrant more thorough evaluation for coronary atherosclerotic disease with CAC score assessment.