Key result
Higher CAC scores are linked to subclinical LV dysfunction in hypertensive patients with mild LAD stenosis.
Why the study?
The relationship between coronary artery calcium score and subclinical left ventricular systolic dysfunction in hypertensive patients with mild to intermediate coronary stenosis and negative stress testing was unclear.
Does a higher coronary artery calcium score correlate with subclinical systolic left ventricular dysfunction in hypertensive patients with mild LAD stenosis and negative stress testing?
Cross-Sectional (n=53)
Yes
Does a higher coronary artery calcium score correlate with subclinical systolic left ventricular dysfunction in hypertensive patients with mild LAD stenosis and negative stress testing?
Absolute Event Rate: 157% vs 44.5%
p-value: p=0.019
In hypertensive patients with non-significant LAD stenosis and negative stress testing, higher CAC scores can help identify those with early, subclinical left ventricular dysfunction.
May aid early identification of subclinical LV dysfunction; hypothesis-generating and requires prospective validation before clinical use.
AIM: To investigate the relationship between coronary artery calcium (CAC) score and left ventricular global longitudinal strain (LV GLS) in patients with arterial hypertension who had a negative treadmill exercise stress test but mild to intermediate coronary stenosis on coronary computed tomography angiography (CCTA). METHODS: A total of 53 hypertensive patients (mean age 54.8 ± 4.8 years; 50.9% male) with 30-50% coronary stenosis on CCTA were included. Patients with diabetes, malignancy, or established coronary/peripheral artery disease were excluded. CAC score, left ventricular ejection fraction (LVEF, Simpson's method), and LV GLS (speckle-tracking echocardiography) were measured. Groups were stratified by GLS (< 18.5% vs. ≥ 18.5%) and LVEF (< 60% vs. ≥ 60%), and CAC score differences were assessed using the Mann-Whitney U test. RESULTS: The median CAC score was 27 (IQR 16-44.5), median LVEF 60% (IQR 58-63%), and mean GLS 19.37 ± 0.89%. No overall association was found between CAC score and LV function by LVEF or GLS. In patients with left anterior descending (LAD) stenosis (30-50%), reduced LV function was linked to significantly higher CAC score. Median CAC score was higher in patients with GLS ≤ 18.5% (157 vs. 44.5; p = 0.019) and LVEF <60% (157 vs. 44.5; p = 0.019). No significant associations were found in right coronary artery (RCA), circumflex artery (Cx), or three-vessel stenosis subgroups. CONCLUSION: Higher CAC score in hypertensive patients with mild LAD stenosis and negative stress testing identify those at risk of subclinical LV dysfunction.
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Begić et al. (2026) conducted a cross-sectional in Arterial hypertension with mild to intermediate coronary stenosis and negative stress test (n=53). Coronary artery calcium (CAC) score was evaluated on Median CAC score in patients with LAD stenosis and subclinical LV dysfunction (GLS ≤ 18.5%) vs normal LV function (p=0.019). In hypertensive patients with mild LAD stenosis, higher coronary artery calcium scores were significantly associated with subclinical left ventricular dysfunction (p=0.019).
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