Abstract 19153: Brachial Artery Diastolic Diameter is Associated with Noncalcified Coronary Artery Plaque Volume
Background: Studies suggest that atherosclerosis in a primary vascular bed may be accompanied by generalized systemic remodeling in nonatherosclerotic vessels, resulting in larger arterial diameters, and that remodeling is related to plaque composition and stage of disease. We thus examined the extent to which diastolic brachial artery diameter (BAD) is associated with the extent of calcified (CP) and noncalcified coronary artery plaque (NCP) in an asymptomatic population of persons with a family history of early coronary artery disease.
Methods: In 405 subjects (58% women, 37% African-American, mean age 51.2 ± 10.6 years), we measured BAD using B-mode ultrasound. Coronary plaque was assessed using 256 multidetector dual-source coronary CT angiography and total volumes of CP and NCP were calculated using a validated automated quantitation method. The association of resting BAD with NCP and CP plaque volumes was tested using two separate linear mixed models adjusted for age, sex, race, current smoking, diabetes, hypertension, body mass index, total and HDL-cholesterol, and nonindependence among family members.
Results: NCP was present in 43.2% (N= 175) and CP in 37.5% (N= 152). The median BAD [IQR] was 4.6 [3.9 to 5.3] mm for persons with any plaque (n= 179) compared to 4.1 [3.6 to 4.6] mm for those without plaque (p < 0.001). The unadjusted Spearman rho of BAD with NCP was 0.38 (p < 0.001) and with CP was 0.32 (p < 0.001). Among persons with plaque, there was a significant independent association between BAD and the extent of NCP (beta 38%/1mm larger BAD, p < 0.001), but not with the extent of CP (beta 1%/1mm larger BAD, p=0.95).
Conclusions: This study demonstrates a strong relationship between BAD, as a marker of systemic arterial remodeling in non-atherosclerotic vessels, and an incremental amount of noncalcified coronary plaque but not calcified plaque. This suggests that expansive vascular remodeling may occur with larger amounts of soft noncalcified plaque as an early adaptive response, whereas calcified plaque may represent a later atherogenic stage with a decrease in BAD adaptive potential. Studies are needed to examine plaque composition and its relation to systemic arterial remodeling in order to address prevention implications.
- © 2012 by American Heart Association, Inc.