Association of Coronary Artery Disease Assessed by CT-calcium Score with Left Ventricular Diastolic Dysfunction

Background: Early onset and quiet progression are characteristics of atherosclerotic vascular disease, due to the release of vasoactive mediators and the reduced generation of nitric oxide by an endothelium that is dysfunctional, non-obstructive atherosclerotic plaques encourage functional changes in vascular tone, such as diastolic dysfunction. Aim of the work: Explore the relationship between sub clinical coronary atherosclerosis presenting by abnormal calcium score and left ventricular diastolic function. Patients and Methods: This study was an observational control study and conducted on 100 consecutive patients who presented mild symptomatic or asymptomatic for checkup at New Cairo Police Hospital during the study period, 50 patients had calcium score zero and the other 50 had calcium score more than zero. Patients were subjected to resting transthoracic echocardiography and CT-calcium score. Patients with common causes of diastolic dysfunction and patients with incomplete echocardiographic data precluding assessment of left atrial pressure were excluded. Results: In our study, we observed that patients with higher CAC(coronary artery calcium) score were older, more dyslipidemic, more diabetic, more likely to have Left ventricular diastolic dysfunction(LVDD), increased number of affected coronary arteries which more often calcific plaques, with higher (tricusspid jet velocity, Septal E/e, Lateral E/e’) & lower (Trans-mitral early diastolic annular (E) velocity, Trans-mitral late diastolic annular (A) velocity, Trans-mitral E/A velocity, Septal diastolic annular tissue doppler e’ velocity, Lateral diastolic annular tissue doppler e’ velocity) with p-value Conclusion: Our results revealed that sub- clinical coronary artery disease detected by coronary calcium score is related to development of Left ventricular diastolic dysfunction and to severity of coronary artery disease even after controlling for other covariates like age and hyperlipidemia calcium score and serum cholesterol levels found to be the only independent variables