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Low computed tomography coronary artery calcium scores in familial longevity: the Leiden Longevity Study.

Kroft LJ, van der Bijl N, van der Grond J, Altmann-Schneider I, Slagboom PE, Westendorp RG, de Roos A, de Craen AJ - Age (Dordr) (2014)

Bottom Line: Differences remained significant after correction for age (men, p = 0.043 and women, p = 0.003) and further correction for major risk factors in women, indicating genetic influence for lower calcium scores.Men and women with a familial propensity to become long-lived have lower coronary artery calcium scores than controls.Low scores may indicate a younger biologic arterial age associated with a low risk for incident cardiovascular disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, C2S, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands, L.J.M.Kroft@lumc.nl.

ABSTRACT
Offspring of long-lived parents have a low prevalence of cardiovascular disease in middle age. The purposes of this study were to investigate calcium scores in offspring as compared to controls and to determine the influence of cardiovascular risk factors. CT coronary artery calcium score was measured in offspring of long-lived families (n = 244, 125 males) and their partners (n = 223, 96 males) who served as controls. Calcium scores were analyzed separately for sexes. Subjects were grouped by very low calcium score ≤10 and scores above 10. Nonparametric Mann-Whitney test, chi-squared tests, and logistic regression analyses were performed to determine the association between calcium scores, familial longevity, and cardiovascular risk factors. More offspring of long-lived parents had lower calcium scores than controls. In men, 34 % of offspring had score ≤10 versus 21 % of controls (odds ratio (OR) and 95 % confidence interval (CI) 2.0, 1.08-3.7, p = 0.028). In women, 70 % of offspring had score ≤10 versus 54 % of controls (OR 1.9, 95 % CI 1.13-3.4, p = 0.019). Differences remained significant after correction for age (men, p = 0.043 and women, p = 0.003) and further correction for major risk factors in women, indicating genetic influence for lower calcium scores. In men, the association was found to be influenced by cardiovascular risk factors. Men and women with a familial propensity to become long-lived have lower coronary artery calcium scores than controls. Low scores may indicate a younger biologic arterial age associated with a low risk for incident cardiovascular disease.

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Computed tomography images in axial view showing coronary artery Agatston calcium scores on single slice levels. Total score is summed up for all slices. Left, offspring; 68-year-old male, height 1.79 m, weight 89 kg, no risk factors. Total Agatston calcium score was 3, by added scores of 0 in right coronary artery (RCA), 3 in left anterior descending artery (LAD), and 0 in circumflex artery (Cx). Right, control; 64-year-old male, height 1.77 m, weight 82 kg, with risk factor hypertension. Total Agatston calcium score was 68, by added scores of 5 in RCA, 19 in LAD, and 44 in Cx. AA ascending aorta, S sternum
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Fig1: Computed tomography images in axial view showing coronary artery Agatston calcium scores on single slice levels. Total score is summed up for all slices. Left, offspring; 68-year-old male, height 1.79 m, weight 89 kg, no risk factors. Total Agatston calcium score was 3, by added scores of 0 in right coronary artery (RCA), 3 in left anterior descending artery (LAD), and 0 in circumflex artery (Cx). Right, control; 64-year-old male, height 1.77 m, weight 82 kg, with risk factor hypertension. Total Agatston calcium score was 68, by added scores of 5 in RCA, 19 in LAD, and 44 in Cx. AA ascending aorta, S sternum

Mentions: Nonoverlapping 3.0-mm datasets were reconstructed, and images were transferred to a workstation for analysis (Vitrea FX, version 1.0, Vital Images). Dedicated CT calcium score analysis software (VScore, Vital Images) was used. Pixels exceeding the threshold value of 130 HU were automatically recognized by the postprocessing tool. These areas were manually encircled in the course of the coronary arteries. The amount of coronary artery calcification was automatically calculated according to Agatston et al. (1990). The Agatston score is a weighted score dependent on peak attenuation in Hounsfield units and a calcium area, summed up for all slices in the volume covering the coronary arteries (Agatston et al. 1990). Calcium score was expressed as Agatston total score (Fig. 1). Scores were categorized into very low calcium score (≤10) and low-to-extensive calcium score (>10). This was done because very low scores (0–10) identify subjects with very low risk for coronary artery disease, and low-to-extensive calcium scores (>10) identify subjects with increasing severity grades reflecting increasing likelihood of coronary artery disease (Bellasi et al. 2007; Blaha et al. 2009; Budoff et al. 2007; Geluk et al. 2008; Raggi et al. 2004; Shaw et al. 2003; 2006a, b). In addition, the threshold of calcium scores 0–10 versus >10 was chosen as this seems the most discriminating by means of risk for mortality. Because of the effects on risk, we therefore combined calcium scores 0 and 1–10 versus higher scores. For overview of calcium score distribution, participants were also categorized according to Rumberger: zero score (no measurable calcified plaque), 1–10 minimal, 11–100 mild, 101–400 moderate, and >400 extensive calcified plaque (Rumberger et al. 1999). All imaging data were analyzed blinded, both for group (offspring or partner) and clinical information.Fig. 1


Low computed tomography coronary artery calcium scores in familial longevity: the Leiden Longevity Study.

Kroft LJ, van der Bijl N, van der Grond J, Altmann-Schneider I, Slagboom PE, Westendorp RG, de Roos A, de Craen AJ - Age (Dordr) (2014)

Computed tomography images in axial view showing coronary artery Agatston calcium scores on single slice levels. Total score is summed up for all slices. Left, offspring; 68-year-old male, height 1.79 m, weight 89 kg, no risk factors. Total Agatston calcium score was 3, by added scores of 0 in right coronary artery (RCA), 3 in left anterior descending artery (LAD), and 0 in circumflex artery (Cx). Right, control; 64-year-old male, height 1.77 m, weight 82 kg, with risk factor hypertension. Total Agatston calcium score was 68, by added scores of 5 in RCA, 19 in LAD, and 44 in Cx. AA ascending aorta, S sternum
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4150887&req=5

Fig1: Computed tomography images in axial view showing coronary artery Agatston calcium scores on single slice levels. Total score is summed up for all slices. Left, offspring; 68-year-old male, height 1.79 m, weight 89 kg, no risk factors. Total Agatston calcium score was 3, by added scores of 0 in right coronary artery (RCA), 3 in left anterior descending artery (LAD), and 0 in circumflex artery (Cx). Right, control; 64-year-old male, height 1.77 m, weight 82 kg, with risk factor hypertension. Total Agatston calcium score was 68, by added scores of 5 in RCA, 19 in LAD, and 44 in Cx. AA ascending aorta, S sternum
Mentions: Nonoverlapping 3.0-mm datasets were reconstructed, and images were transferred to a workstation for analysis (Vitrea FX, version 1.0, Vital Images). Dedicated CT calcium score analysis software (VScore, Vital Images) was used. Pixels exceeding the threshold value of 130 HU were automatically recognized by the postprocessing tool. These areas were manually encircled in the course of the coronary arteries. The amount of coronary artery calcification was automatically calculated according to Agatston et al. (1990). The Agatston score is a weighted score dependent on peak attenuation in Hounsfield units and a calcium area, summed up for all slices in the volume covering the coronary arteries (Agatston et al. 1990). Calcium score was expressed as Agatston total score (Fig. 1). Scores were categorized into very low calcium score (≤10) and low-to-extensive calcium score (>10). This was done because very low scores (0–10) identify subjects with very low risk for coronary artery disease, and low-to-extensive calcium scores (>10) identify subjects with increasing severity grades reflecting increasing likelihood of coronary artery disease (Bellasi et al. 2007; Blaha et al. 2009; Budoff et al. 2007; Geluk et al. 2008; Raggi et al. 2004; Shaw et al. 2003; 2006a, b). In addition, the threshold of calcium scores 0–10 versus >10 was chosen as this seems the most discriminating by means of risk for mortality. Because of the effects on risk, we therefore combined calcium scores 0 and 1–10 versus higher scores. For overview of calcium score distribution, participants were also categorized according to Rumberger: zero score (no measurable calcified plaque), 1–10 minimal, 11–100 mild, 101–400 moderate, and >400 extensive calcified plaque (Rumberger et al. 1999). All imaging data were analyzed blinded, both for group (offspring or partner) and clinical information.Fig. 1

Bottom Line: Differences remained significant after correction for age (men, p = 0.043 and women, p = 0.003) and further correction for major risk factors in women, indicating genetic influence for lower calcium scores.Men and women with a familial propensity to become long-lived have lower coronary artery calcium scores than controls.Low scores may indicate a younger biologic arterial age associated with a low risk for incident cardiovascular disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, C2S, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands, L.J.M.Kroft@lumc.nl.

ABSTRACT
Offspring of long-lived parents have a low prevalence of cardiovascular disease in middle age. The purposes of this study were to investigate calcium scores in offspring as compared to controls and to determine the influence of cardiovascular risk factors. CT coronary artery calcium score was measured in offspring of long-lived families (n = 244, 125 males) and their partners (n = 223, 96 males) who served as controls. Calcium scores were analyzed separately for sexes. Subjects were grouped by very low calcium score ≤10 and scores above 10. Nonparametric Mann-Whitney test, chi-squared tests, and logistic regression analyses were performed to determine the association between calcium scores, familial longevity, and cardiovascular risk factors. More offspring of long-lived parents had lower calcium scores than controls. In men, 34 % of offspring had score ≤10 versus 21 % of controls (odds ratio (OR) and 95 % confidence interval (CI) 2.0, 1.08-3.7, p = 0.028). In women, 70 % of offspring had score ≤10 versus 54 % of controls (OR 1.9, 95 % CI 1.13-3.4, p = 0.019). Differences remained significant after correction for age (men, p = 0.043 and women, p = 0.003) and further correction for major risk factors in women, indicating genetic influence for lower calcium scores. In men, the association was found to be influenced by cardiovascular risk factors. Men and women with a familial propensity to become long-lived have lower coronary artery calcium scores than controls. Low scores may indicate a younger biologic arterial age associated with a low risk for incident cardiovascular disease.

Show MeSH
Related in: MedlinePlus