Prognostic application of thoracic aortic calcium scoring for adverse clinical outcome risk in elderly patients with left ventricular hypertrophy

In Jeong Cho, Hyuk Jae Chang, Sang Eun Lee, Chi Young Shim, Geu Ru Hong, Namsik Chung

Research output: Contribution to journalArticle

Abstract

Background and Objectives: Left ventricular hypertrophy (LVH) is associated with poor cardiovascular outcomes. Heavy aortic calcification exacerbates arterial stiffness, which consequently heightens left ventricular (LV) afterload. We assessed the usefulness of aortic calcification for predicting adverse cardiovascular outcomes and to determine whether the relationship, if any, differed as a function of LVH. Methods: The analytic sample was comprised of a total of 487 individuals 65 years of age or older. Thoracic aortic calcium score (TACS) was measured by coronary computed tomography, and patients were stratified according to the median (TACS, 446 mm3). LVH obtained from echocardiography was defined as LV mass index >115 g/m2 for men and >95 g/m2 for women. Cox regression reporting hazard ratios (HRs) with 95% confidence intervals (CIs) was performed to predict the risk for the composite study endpoint, defined as cardiac death, admission for heart failure, obstructive coronary artery disease (CAD) requiring revascularization, or stroke. Results: A total of 39 composite events (8.0%) occurred during a median follow-up of 65 months (interquartile range [IQR], 17-89 months). For those with LVH, the concurrent presence of high TACS appeared to be an independent predictor (HR, 4.51; 95% CI, 1.71-11.88; p=0.002) for the composite study endpoint. Other combined LVH and TACS subgroups were not associated with significant factors for predicting the composite study endpoint (p>0.050, all). Conclusion: TACS provides robust predictive utility for a composite of cardiovascular events and cardiac death in persons with LVH. This finding was less pronounced in those with a relatively healthy myocardium, defined by the absence of LVH.

Original languageEnglish
Pages (from-to)918-928
Number of pages11
JournalKorean Circulation Journal
Volume47
Issue number6
DOIs
Publication statusPublished - 2017 Nov

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Left Ventricular Hypertrophy
Thorax
Calcium
Confidence Intervals
Vascular Stiffness
Echocardiography
Coronary Artery Disease
Myocardium
Heart Failure
Stroke
Tomography

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

@article{1be959d2ae434ea987194ab69ad96d62,
title = "Prognostic application of thoracic aortic calcium scoring for adverse clinical outcome risk in elderly patients with left ventricular hypertrophy",
abstract = "Background and Objectives: Left ventricular hypertrophy (LVH) is associated with poor cardiovascular outcomes. Heavy aortic calcification exacerbates arterial stiffness, which consequently heightens left ventricular (LV) afterload. We assessed the usefulness of aortic calcification for predicting adverse cardiovascular outcomes and to determine whether the relationship, if any, differed as a function of LVH. Methods: The analytic sample was comprised of a total of 487 individuals 65 years of age or older. Thoracic aortic calcium score (TACS) was measured by coronary computed tomography, and patients were stratified according to the median (TACS, 446 mm3). LVH obtained from echocardiography was defined as LV mass index >115 g/m2 for men and >95 g/m2 for women. Cox regression reporting hazard ratios (HRs) with 95{\%} confidence intervals (CIs) was performed to predict the risk for the composite study endpoint, defined as cardiac death, admission for heart failure, obstructive coronary artery disease (CAD) requiring revascularization, or stroke. Results: A total of 39 composite events (8.0{\%}) occurred during a median follow-up of 65 months (interquartile range [IQR], 17-89 months). For those with LVH, the concurrent presence of high TACS appeared to be an independent predictor (HR, 4.51; 95{\%} CI, 1.71-11.88; p=0.002) for the composite study endpoint. Other combined LVH and TACS subgroups were not associated with significant factors for predicting the composite study endpoint (p>0.050, all). Conclusion: TACS provides robust predictive utility for a composite of cardiovascular events and cardiac death in persons with LVH. This finding was less pronounced in those with a relatively healthy myocardium, defined by the absence of LVH.",
author = "Cho, {In Jeong} and Chang, {Hyuk Jae} and Lee, {Sang Eun} and Shim, {Chi Young} and Hong, {Geu Ru} and Namsik Chung",
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Prognostic application of thoracic aortic calcium scoring for adverse clinical outcome risk in elderly patients with left ventricular hypertrophy. / Cho, In Jeong; Chang, Hyuk Jae; Lee, Sang Eun; Shim, Chi Young; Hong, Geu Ru; Chung, Namsik.

In: Korean Circulation Journal, Vol. 47, No. 6, 11.2017, p. 918-928.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic application of thoracic aortic calcium scoring for adverse clinical outcome risk in elderly patients with left ventricular hypertrophy

AU - Cho, In Jeong

AU - Chang, Hyuk Jae

AU - Lee, Sang Eun

AU - Shim, Chi Young

AU - Hong, Geu Ru

AU - Chung, Namsik

PY - 2017/11

Y1 - 2017/11

N2 - Background and Objectives: Left ventricular hypertrophy (LVH) is associated with poor cardiovascular outcomes. Heavy aortic calcification exacerbates arterial stiffness, which consequently heightens left ventricular (LV) afterload. We assessed the usefulness of aortic calcification for predicting adverse cardiovascular outcomes and to determine whether the relationship, if any, differed as a function of LVH. Methods: The analytic sample was comprised of a total of 487 individuals 65 years of age or older. Thoracic aortic calcium score (TACS) was measured by coronary computed tomography, and patients were stratified according to the median (TACS, 446 mm3). LVH obtained from echocardiography was defined as LV mass index >115 g/m2 for men and >95 g/m2 for women. Cox regression reporting hazard ratios (HRs) with 95% confidence intervals (CIs) was performed to predict the risk for the composite study endpoint, defined as cardiac death, admission for heart failure, obstructive coronary artery disease (CAD) requiring revascularization, or stroke. Results: A total of 39 composite events (8.0%) occurred during a median follow-up of 65 months (interquartile range [IQR], 17-89 months). For those with LVH, the concurrent presence of high TACS appeared to be an independent predictor (HR, 4.51; 95% CI, 1.71-11.88; p=0.002) for the composite study endpoint. Other combined LVH and TACS subgroups were not associated with significant factors for predicting the composite study endpoint (p>0.050, all). Conclusion: TACS provides robust predictive utility for a composite of cardiovascular events and cardiac death in persons with LVH. This finding was less pronounced in those with a relatively healthy myocardium, defined by the absence of LVH.

AB - Background and Objectives: Left ventricular hypertrophy (LVH) is associated with poor cardiovascular outcomes. Heavy aortic calcification exacerbates arterial stiffness, which consequently heightens left ventricular (LV) afterload. We assessed the usefulness of aortic calcification for predicting adverse cardiovascular outcomes and to determine whether the relationship, if any, differed as a function of LVH. Methods: The analytic sample was comprised of a total of 487 individuals 65 years of age or older. Thoracic aortic calcium score (TACS) was measured by coronary computed tomography, and patients were stratified according to the median (TACS, 446 mm3). LVH obtained from echocardiography was defined as LV mass index >115 g/m2 for men and >95 g/m2 for women. Cox regression reporting hazard ratios (HRs) with 95% confidence intervals (CIs) was performed to predict the risk for the composite study endpoint, defined as cardiac death, admission for heart failure, obstructive coronary artery disease (CAD) requiring revascularization, or stroke. Results: A total of 39 composite events (8.0%) occurred during a median follow-up of 65 months (interquartile range [IQR], 17-89 months). For those with LVH, the concurrent presence of high TACS appeared to be an independent predictor (HR, 4.51; 95% CI, 1.71-11.88; p=0.002) for the composite study endpoint. Other combined LVH and TACS subgroups were not associated with significant factors for predicting the composite study endpoint (p>0.050, all). Conclusion: TACS provides robust predictive utility for a composite of cardiovascular events and cardiac death in persons with LVH. This finding was less pronounced in those with a relatively healthy myocardium, defined by the absence of LVH.

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