Abstract 14814: Left Ventricular Wall Motion Abnormalities in a Community Population are Associated with Increased Coronary Artery Calcium
Introduction: Left ventricular wall motion abnormalities (WMAs) may represent subclinical evidence of coronary artery disease (CAD). We sought to determine the association of WMAs with extent of coronary artery calcification (CAC) in a free-living, community population.
Methods: Cardiovascular magnetic resonance imaging (CMR) and multidetector coronary computed tomography (MDCT) were performed in 1009 Framingham Heart Study participants (64±9 years, 460 males). CMR images were analyzed according to a 17-segment model. A WMA was defined as ≥2 adjacent segments hypokinetic or ≥1 segment akinetic or dyskinetic. A calcified lesion on MDCT was ≥3 adjacent pixels with density >130 Hounsfield units. Agatston score (AS) was computed using the lesion area and a weighted attenuation score. AS was log-transformed to normalize the distribution. Clinically apparent CAD or heart failure was adjudicated by endpoint review as evidence of prevalent cardiovascular disease (CVD).
Results: WMAs were present in 49 (4.9%) participants. CAC was present in 688 (68%) participants. Prevalent CVD was present in 65 (15.5%) participants (5% without WMAs, 35% with WMAs). Participants with WMAs had a >2-fold odds of CAC >75%ile and a nearly 3-fold odds of having an AS >100 (Table). These associations remained significant after adjustment for age and sex but not after adjustment for prevalent CVD. Mean AS was greater in participants with WMAs than those without WMAs (4.76±2.54 vs. 3.07±2.65, p=0.003), which was attenuated after adjustment for prevalent CVD (p=0.063).
Conclusions: In this community population, left ventricular WMAs were significantly associated with CAC, a measure of subclinical coronary atherosclerosis. Although the majority of participants with WMAs did not have CVD, the associations between WMAs and CAC were largely mediated through prevalent CVD.
- © 2010 by American Heart Association, Inc.