Subspecialty Clinics: CardiologyElectron Beam Computed Tomography and Coronary Artery Disease: Scanning for Coronary Artery Calcification
Section snippets
Pathophysiologic Mechanisms Of Calcification And Atherosclerotic Disease
Calcification of the coronary arteries is actually calcium phosphate in the form of hydroxyapatite, which also is the major inorganic component of bone. Although the role of calcification in coronary artery disease is unclear, recent data demonstrate its pathophysiologic mechanisms. Fitzpatrick and associates8 used special staining techniques to examine coronary artery specimens obtained at autopsy and found that mural mineralization was present to some extent and diffuse in virtually all
Electron Beam Computed Tomography
With conventional CT, a single x-ray source mechanically rotates around the patient in concert with a stationary or rotating collimator-detector combination. Scan speeds of 1 to 2 seconds for conventional scanners and even 600 ms for the new spiral technology are still too slow to capture cardiac motion or evaluate fine details of cardiac and coronary anatomy. EBCT (introduced commercially in 1983) employs a stationary source-detector pair coupled to a unique technology whereby x-rays are
Coronary Artery Calcification, Coronary Artery Disease, And Ebct
Tanenbaum and coworkers13, 14 described EBCT detection of coronary artery calcium in 54 patients undergoing clinically indicated coronary angiography. In 11 patients with no angiographically detectable coronary artery disease, none had detectable calcium on EBCT (“negative” test results). Conversely, discrete coronary artery calcium was detected by EBCT in 88&x0025; of patients who had at least one hemodynamically significant coronary artery lesion (defined as greater than 70&x0025; diameter
Age, Gender, Atherosclerotic Plaque, And Coronary Artery Calcification
Janowitz and colleagues21 have published the most extensive investigation to date on the prevalence and extent of coronary artery calcium detected by EBCT. This study was conducted in 1,898 men and women, whose ages ranged from 20 to older than 80 years (Fig. 2). The pertinent points about these data are as follows. First, regardless of gender, the prevalence of coronary artery calcium increases with advancing age. Second, the prevalence of coronary calcium is lower in women than in men until
Clinical Applications And Interpretation
A relationship between the fluoroscopic presence of coro&x00AD;nary artery calcification and cardiovascular prognosis has been suggested. Detrano and associates26 recently described the clinical significance of digital fluoroscopic examination for coronary artery calcium in a prospective assessment of 1,461 asymptomatic adults older than 45 years of age who were at high risk for coronary disease (Framingham risk calculation, 10&x0025; or higher over 8 years). At 1-year follow&x00AD;-up, 53
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Cited by (0)
This study was supported in part by Grants HL 46292 and HL 51736 from the National Institutes of Health, Public Health Service, and by Mayo Foundation. Dr. Rumberger is supported in part by an Established Investigator Award from the American Heart Association.