杂合子家族性高胆固醇血症患者主动脉瓣的超声心动图钙评分与冠状动脉钙评分相关。
Echocardiographic Calcium Score of Aortic Valve Correlates with Coronary Artery Calcium Score in Heterozygous Familial Hypercholesterolemia.
作者信息
Cefalù Angelo Baldassare, Nardi Emilio, Giammanco Antonina, Gagliardo Carola Maria, Barbagallo Carlo Maria, La Grutta Ludovico, Toia Patrizia, Brucato Federica, Scrimali Chiara, Fasciana Teresa Maria Grazia, Spina Rossella, Lanza Marina, Vitale Francesco, Noto Davide, Averna Maurizio
机构信息
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro" (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy.
Section of Radiology, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University Hospital "Paolo Giaccone", 90127 Palermo, Italy.
出版信息
Life (Basel). 2025 Mar 20;15(3):506. doi: 10.3390/life15030506.
BACKGROUND
Patients with heterozygous familial hypercholesterolemia (HeFH) are at a high risk of atherosclerotic cardiovascular disease. The coronary artery calcification (CAC) score by the Ct-scan Agatston calcium score (ACS) > 100 classifies FH at a higher risk. The echocardiographic calcium score (ECS) evaluates aortic valve calcifications and is considered a good predictor of the atherosclerotic burden and cardiovascular outcome.
OBJECTIVE
To test the ECS as a predictor of ACS > 100 in a HeFH cohort.
METHODS
A coronary calcium CT scan with the calculation of ACS and an at rest-transthoracic echocardiogram with ECS evaluation were performed in 81 HeFH patients. Patients were divided into two groups according to the ACS: high-risk ACS patients (High-ACS) with Agatston value > 100 and low risk ACS patients (Low-ACS) with Agatston value ≤ 100. Patients were stratified according to ECS = 0 or ECS > 0.
RESULTS
High-ACS patients were older than Low-ACS patients; BMI, waist circumference, and blood systolic pressure were significantly higher ( < 0.001) in High-ACS patients. The ECS predicted an ACS > 100 with sensitivity = 0.84, specificity = 0.89, accuracy = 0.86, and precision = 0.76.
CONCLUSIONS
The ECS could be a good surrogate of a coronary calcium CT scan for ACS evaluation in the specific subset of HeFH patients.
背景
杂合子家族性高胆固醇血症（HeFH）患者患动脉粥样硬化性心血管疾病的风险很高。通过计算机断层扫描阿加斯顿钙评分（ACS）>100计算得出的冠状动脉钙化（CAC）评分将FH分类为更高风险。超声心动图钙评分（ECS）可评估主动脉瓣钙化，被认为是动脉粥样硬化负担和心血管结局的良好预测指标。
目的
在HeFH队列中测试ECS作为ACS>100的预测指标。
方法
对81例HeFH患者进行了计算ACS的冠状动脉钙化CT扫描和评估ECS的静息经胸超声心动图检查。根据ACS将患者分为两组：阿加斯顿值>100的高危ACS患者（High-ACS）和阿加斯顿值≤100的低危ACS患者（Low-ACS）。根据ECS = 0或ECS>0对患者进行分层。
结果
High-ACS患者比Low-ACS患者年龄更大；High-ACS患者的BMI、腰围和收缩压显著更高（<0.001）。ECS预测ACS>100的敏感性为0.84，特异性为0.89，准确性为0.86，精确性为0.76。
结论
在HeFH患者的特定亚组中，ECS可能是用于ACS评估的冠状动脉钙化CT扫描的良好替代指标。
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