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The role of lipids in the calcification of different cardiac structures: a cardiac CT study
Session:
Posters (Sessão 6 - Écran 8) - Tomografia Computorizada Cardíaca
Speaker:
Inês Miranda
Congress:
CPC 2023
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.2 Computed Tomography
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Inês Pereira De Miranda; Mariana Passos; Filipa Gerardo; Carolina Mateus; Inês Fialho; Marco Beringuilho; Joana Lima Lopes; Pedro Magno; José Loureiro; David Roque; Carlos Morais; João Bicho Augusto
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Background:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"> The role of dyslipidemia is well established as a risk factor of atherosclerotic plaque in coronary artery disease. However, beyond coronary disease, the role of lipids in valve and aortic calcification is yet to be understood.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Objective:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"> To assess the role of lipids in the calcification of different cardiac structures as measured by cardiac CT.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Methods:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"> We conducted a single-centre study on 316 consecutive patients who underwent cardiac CT scan between January 2018 and December 2019. We excluded patients with poor imaging quality, constrictive pericarditis, prosthetic valves and/or devices. The calcium score of coronary arteries (CA), mitral valve (MV), aortic valve (AoV), ascending aorta (AAo) and aortic arch (AAc) were calculated from non-contrast ECG-gated CT using the Agatston method and were combined to derive a valvular (VA=MV+AoV), total cardiac (TC=CA+VA), total vascular (TV=AAo+AAc) and total cardiovascular (TCV=TC+TV) calcium scores. We then collected data regarding lipid values (total cholesterol, LDL and HDL cholesterol and triglycerides).</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Results:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"> 275 CT scans were suitable for analysis, 142 were male (52%), with a mean age of 60±12 years (range 26–93 years). A total of 183 (66.7%) patients presented calcification in at least one location. Patients with calcification on any of the prespecified locations had higher prevalence of hypertension, dyslipidemia and type 2 diabetes mellitus (DM) than those without any calcium (p<0.05). The best regression models (using backwards conditional input method) showed that age was a significant predictor of calcification in all locations (and combinations of locations, p<0.05 for all) and HDL cholesterol was a part of these models across all calcifications types, being significant for TC score (p=0.010) and TCV score (p=0.024, see Figure). Patients above the fourth quartile (Q4) of TCV had significantly lower HDL cholesterol levels (47±12 vs 53±16mg/dL, p=0.007). Of note, total cholesterol, LDL cholesterol and triglycerides were not significant predictors of calcification for any location. </span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Conclusion: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">Low HDL cholesterol levels are consistently associated with calcification across the cardiovascular system, extending beyond the classically described coronary disease. This calcification effect of HDL is more important than other lipids, but the specific role of HDL subtypes is yet to be understood.</span></span></span></p>
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