(Circulation. 1995;92:2157-2162.)
© 1995 American Heart Association, Inc.
Articles |
Coronary Artery Calcium Area by Electron-Beam Computed Tomography and Coronary Atherosclerotic Plaque Area
A Histopathologic Correlative Study
Presented in part at the 67th Annual Scientific Sessions of the American Heart Association, Dallas, Tex, November 14-17, 1994.
From the Departments of Cardiovascular Diseases and Internal Medicine (J.A.R., D.B.S., R.S.S.), Diagnostic Radiology (P.F.S.), and Endocrinology and Internal Medicine (L.A.F.), Mayo Clinic and Foundation, Rochester, Minn.
Correspondence to John A. Rumberger, PhD, MD, Department of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
Background Coronary calcium identified by electron-beam computed tomography (EBCT) correlates poorly with luminal atherosclerotic narrowing, but calcium, an intimate part of coronary plaque, may be more directly related to atheromatous plaque area.
Methods and Results Thirty-eight coronary arteries from 13 autopsy hearts were dissected, straightened, and scanned with EBCT in 3-mm contiguous increments. Coronary calcium area was defined as one or more pixels with a density >130 Hounsfield units (0.18 mm2/pixel). Each artery was divided into corresponding 3-mm segments, representative histological sections were stained, and atherosclerotic plaque area per segment (mm2) was quantified. Coronary artery calcium and coronary artery plaque areas were correlated for the hearts as a whole, for individual coronary arteries, and for individual coronary artery segments. The sums of histological plaque areas versus the sums of calcium areas were highly correlated for each heart and for each coronary artery. However, coronary plaque area was on the order of five times greater than calcium area. Furthermore, minimal diffuse segmental coronary plaque could be present despite the absence of coronary calcium detectable by EBCT.
Conclusions This histopathologic study confirms an intimate relation between whole heart, coronary artery, and segmental coronary atherosclerotic plaque area and EBCT coronary calcium area but suggests that there is a threshold value for plaque area below which coronary calcium is either absent or not detectable by this methodology.
Key Words: calcium • arteries • tomography • atherosclerosis • diagnosis
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 K. A. Matthews, S. Zhu, D. C. Tucker, and M. A. Whooley Blood Pressure Reactivity to Psychological Stress and Coronary Calcification in the Coronary Artery Risk Development in Young Adults Study Hypertension, March 1, 2006; 47(3): 391 - 395. [Abstract] [Full Text] [PDF]
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J. A. Rumberger The Promise of Quantitative Computed Tomography Coronary Angiography and Noninvasive Segmental Coronary Plaque Quantification: Pushing the "Edge" J. Am. Coll. Cardiol., February 7, 2006; 47(3): 678 - 680. [Full Text] [PDF]
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K. R. Nandalur, E. Baskurt, K. D. Hagspiel, M. Finch, C. D. Phillips, S. R. Bollampally, and C. M. Kramer Carotid Artery Calcification on CT May Independently Predict Stroke Risk Am. J. Roentgenol., February 1, 2006; 186(2): 547 - 552. [Abstract] [Full Text] [PDF]
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A. Schmermund, S. Achenbach, T. Budde, Y. Buziashvili, A. Forster, G. Friedrich, M. Henein, G. Kerkhoff, F. Knollmann, V. Kukharchuk, et al. Effect of Intensive Versus Standard Lipid-Lowering Treatment With Atorvastatin on the Progression of Calcified Coronary Atherosclerosis Over 12 Months: A Multicenter, Randomized, Double-Blind Trial Circulation, January 24, 2006; 113(3): 427 - 437. [Abstract] [Full Text] [PDF]
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M. E. Clouse, J. Chen, H. M. Krumholz, M. E. Clouse, J. Chen, and H. M. Krumholz Noninvasive Screening for Coronary Artery Disease With Computed Tomography Is Useful Circulation, January 3, 2006; 113(1): 125 - 146. [Full Text] [PDF]
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A. Khera, J. A. de Lemos, R. M. Peshock, H. S. Lo, H. G. Stanek, S. A. Murphy, F. H. Wians Jr, S. M. Grundy, and D. K. McGuire Relationship Between C-Reactive Protein and Subclinical Atherosclerosis: The Dallas Heart Study Circulation, January 3, 2006; 113(1): 38 - 43. [Abstract] [Full Text] [PDF]
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D. S. Berman, R. Hachamovitch, L. J. Shaw, J. D. Friedman, S. W. Hayes, L. E.J. Thomson, D. S. Fieno, G. Germano, P. Slomka, N. D. Wong, et al. Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease J. Nucl. Med., January 1, 2006; 47(1): 74 - 82. [Abstract] [Full Text] [PDF]
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T. Edvardsen, R. Detrano, B. D. Rosen, J. J. Carr, K. Liu, S. Lai, S. Shea, L. Pan, D. A. Bluemke, and J. A.C. Lima Coronary Artery Atherosclerosis Is Related to Reduced Regional Left Ventricular Function in Individuals Without History of Clinical Cardiovascular Disease: The Multiethnic Study of Atherosclerosis Arterioscler Thromb Vasc Biol, January 1, 2006; 26(1): 206 - 211. [Abstract] [Full Text] [PDF]
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A. B. Sevrukov, J. M. Bland, and G. T. Kondos Serial Electron Beam CT Measurements of Coronary Artery Calcium: Has Your Patient's Calcium Score Actually Changed? Am. J. Roentgenol., December 1, 2005; 185(6): 1546 - 1553. [Abstract] [Full Text] [PDF]
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 M. Prabhakar and D. T. Ko Can coronary calcification measured by CT predict future coronary events? Can. Med. Assoc. J., October 25, 2005; 173(9): 1034 - 1034. [Full Text] [PDF]
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M. J. LaMonte, S. J. FitzGerald, T. S. Church, C. E. Barlow, N. B. Radford, B. D. Levine, J. J. Pippin, L. W. Gibbons, S. N. Blair, and M. Z. Nichaman Coronary Artery Calcium Score and Coronary Heart Disease Events in a Large Cohort of Asymptomatic Men and Women Am. J. Epidemiol., September 1, 2005; 162(5): 421 - 429. [Abstract] [Full Text] [PDF]
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P.-H. Huang, L.-C. Chen, H.-B. Leu, P. Y.-A. Ding, J.-W. Chen, T.-C. Wu, and S.-J. Lin Enhanced Coronary Calcification Determined by Electron Beam CT Is Strongly Related to Endothelial Dysfunction in Patients With Suspected Coronary Artery Disease Chest, August 1, 2005; 128(2): 810 - 815. [Abstract] [Full Text] [PDF]
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M. P.S. Dunphy, A. Freiman, S. M. Larson, and H. W. Strauss Association of Vascular 18F-FDG Uptake with Vascular Calcification J. Nucl. Med., August 1, 2005; 46(8): 1278 - 1284. [Abstract] [Full Text] [PDF]
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P. Raggi, M. Davidson, T. Q. Callister, F. K. Welty, G. A. Bachmann, H. Hecht, and J. A. Rumberger Aggressive Versus Moderate Lipid-Lowering Therapy in Hypercholesterolemic Postmenopausal Women: Beyond Endorsed Lipid Lowering With EBT Scanning (BELLES) Circulation, July 26, 2005; 112(4): 563 - 571. [Abstract] [Full Text] [PDF]
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Y. Arad, K. J. Goodman, M. Roth, D. Newstein, and A. D. Guerci Coronary Calcification, Coronary Disease Risk Factors, C-Reactive Protein, and Atherosclerotic Cardiovascular Disease Events: The St. Francis Heart Study J. Am. Coll. Cardiol., July 5, 2005; 46(1): 158 - 165. [Abstract] [Full Text] [PDF]
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H. Kramer, D. R. Jacobs Jr, D. Bild, W. Post, M. F. Saad, R. Detrano, R. Tracy, R. Cooper, and K. Liu Urine Albumin Excretion and Subclinical Cardiovascular Disease Hypertension, July 1, 2005; 46(1): 38 - 43. [Abstract] [Full Text] [PDF]
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F. Moselewski, C. J. O'Donnell, S. Achenbach, M. Ferencik, J. Massaro, A. Nguyen, R. C. Cury, S. Abbara, I.-K. Jang, T. J. Brady, et al. Calcium Concentration of Individual Coronary Calcified Plaques as Measured by Multidetector Row Computed Tomography Circulation, June 21, 2005; 111(24): 3236 - 3241. [Abstract] [Full Text] [PDF]
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 P. K. Agatisa, K. A. Matthews, J. T. Bromberger, D. Edmundowicz, Y.-F. Chang, and K. Sutton-Tyrrell Coronary and Aortic Calcification in Women With a History of Major Depression Arch Intern Med, June 13, 2005; 165(11): 1229 - 1236. [Abstract] [Full Text] [PDF]
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L. Djousse, D. K. Arnett, J. J. Carr, J. H. Eckfeldt, P. N. Hopkins, M. A. Province, and R. C. Ellison Dietary Linolenic Acid Is Inversely Associated With Calcified Atherosclerotic Plaque in the Coronary Arteries: The National Heart, Lung, and Blood Institute Family Heart Study Circulation, June 7, 2005; 111(22): 2921 - 2926. [Abstract] [Full Text] [PDF]
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 S. Jimenez, M. A. Garcia-Criado, D. Tassies, J. C. Reverter, R. Cervera, M. R. Gilabert, D. Zambon, E. Ros, C. Bru, and J. Font Preclinical vascular disease in systemic lupus erythematosus and primary antiphospholipid syndrome Rheumatology, June 1, 2005; 44(6): 756 - 761. [Abstract] [Full Text] [PDF]
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J. C. Nelson, R. A. Kronmal, J. J. Carr, M. F. McNitt-Gray, N. D. Wong, C. M. Loria, J. G. Goldin, O. D. Williams, and R. Detrano Measuring Coronary Calcium on CT Images Adjusted for Attenuation Differences Radiology, May 1, 2005; 235(2): 403 - 414. [Abstract] [Full Text] [PDF]
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G. T. Lau, L. J. Ridley, M. C. Schieb, D. B. Brieger, S. B. Freedman, L. A. Wong, S. K. Lo, and L. Kritharides Coronary Artery Stenoses: Detection with Calcium Scoring, CT Angiography, and Both Methods Combined Radiology, May 1, 2005; 235(2): 415 - 422. [Abstract] [Full Text] [PDF]
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C. M. Giachelli, M. Y. Speer, X. Li, R. M. Rajachar, and H. Yang Regulation of Vascular Calcification: Roles of Phosphate and Osteopontin Circ. Res., April 15, 2005; 96(7): 717 - 722. [Abstract] [Full Text] [PDF]
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D. E. Bild, R. Detrano, D. Peterson, A. Guerci, K. Liu, E. Shahar, P. Ouyang, S. Jackson, and M. F. Saad Ethnic Differences in Coronary Calcification: The Multi-Ethnic Study of Atherosclerosis (MESA) Circulation, March 15, 2005; 111(10): 1313 - 1320. [Abstract] [Full Text] [PDF]
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