Ratti C, Chiurlia E, Grimaldi T, Malagoli A, Ligabue G, Modena M G
Department of Cardiology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41100 Modena, Italy.
Minerva Cardioangiol. 2006 Oct;54(5):591-601.
The correlation between coronary calcifications and subclinical atherosclerotic disease has been well known for some years now. Today we are able to quantify coronary calcium deposits, the calcium score, by means of new imaging techniques such as electron beam computed tomography and multislice spiral computed tomography. A large number of studies performed using these methods has confirmed the association between coronary calcifications and atherosclerotic disease and has opened up the possibility of early diagnosis of any subclinical atherosclerotic disease in various subpopulations such as diabetics and nephropatics. The etiopathogenesis of coronary calcium has not yet been made clear; it appears to be an active process similar to bone formation that involves cells similar to those involved in the reabsorption of bone matrix. The calcium score, therefore, provides physicians with a further diagnostic tool able to better determine cardiovascular risk patients and supplements the Framingham risk score. International guidelines have not yet illustrated with any precision in which ambits to apply screening for the quantification of coronary calcium and consequently, for the time being, the use of such methods must be restricted to cases in which the possibility of any benefit can be scientifically shown. This review represents the state of the art on coronary calcification and its role in clinical practice.
冠状动脉钙化与亚临床动脉粥样硬化疾病之间的相关性在过去几年中已为人熟知。如今，我们能够通过电子束计算机断层扫描和多层螺旋计算机断层扫描等新成像技术对冠状动脉钙沉积即钙评分进行量化。使用这些方法进行的大量研究证实了冠状动脉钙化与动脉粥样硬化疾病之间的关联，并为在糖尿病患者和肾病患者等不同亚人群中早期诊断任何亚临床动脉粥样硬化疾病提供了可能性。冠状动脉钙化的病因发病机制尚未明确；它似乎是一个类似于骨形成的活跃过程，涉及与参与骨基质重吸收的细胞相似的细胞。因此，钙评分为医生提供了一种进一步的诊断工具，能够更好地确定心血管风险患者，并补充了弗明汉风险评分。国际指南尚未精确说明在哪些范围内应用冠状动脉钙定量筛查，因此，目前此类方法的使用必须限于能够科学证明有任何益处的情况。本综述介绍了冠状动脉钙化的最新情况及其在临床实践中的作用。
