abdulameer abudi mohammed almosawi

Abstract Background: Little data currently exist supporting the correlation of socioeconomic status (SES) to markers of subclinical coronary atherosclerosis. Aim: The main aim was to investigate the relationship of SES measured by economic status and educational level with coronary artery calcification (CAC) and pericardial fat volume (PFV) assessed by multi-detector computed tomography (MDCT). Methods: A total of 220 consecutive patients with suspected coronary artery disease, who underwent 64-slice MDCT angiography for assessment of coronary atherosclerosis, were recruited between January 2014 and March 2015. Of these, 186 patients were enrolled in this cross sectional study. Results: Low economic status patients showed higher PFV values; median (inter-quartile range [IQR] was 94 [50–140] cm3, p = 0.00001 and r = 0.37, compared to patients with high economic status, and this association persisted even after multiple logistic regression to conventional cardiac risk factors (p = 0.004, CI 7.3–30.4), while patients with low economic status reported a higher calcium score (but statistically non significant) (p = 0.12) compared to high economic status patients. Patients with no formal education showed higher PFV (median [IQR] was 93 [48–140] cm3, p = 0.01) compared to patients with bachelor’s degree (median [IQR] was 56 [28–92] cm3), but this association was attenuated after further adjustment for conventional cardiac risk factors (p = 0.1, CI –9.52–10.88), while CAC showed no significant correlation with educational level (p = 0.2, r = 0.117). Conclusions: Socioeconomic status, particularly economic status measure, reported a significant inverse relationship with PFV independent of conventional cardiac risk factors. Key words: atherosclerosis, coronary artery, calcification, multi-detector computed tomography, pericardial fat, socioeconomic status Kardiol Pol 2017; 75, 4: 368–375

Abstract Objectives: To assess the correlation between aortic root calcification (ARC) and coronary atherosclerotic markers (coronary luminal stenosis, calcified coronary plaque, and coronary artery calcification) in postmenopausal women with coronary artery disease using multidetector CT (MDCT). Patients and methods: We recruited a total of 196 consecutive Iraqi patients with intermediate pretest probability of ischemic heart disease who underwent 64-MDCT angiography examinations in the Cardiology Center of our hospital between January and December 2013 for assessment of coronary artery disease. We enrolled 65 postmenopausal women with absence of menses > 5 years and not taking hormone replacement therapy. Results: The prevalence of aortic root calcification was 35.4% (calcium score > zero) while the total coronary artery calcification prevalence was 41.5% (calcium score > zero). ARC was significantly associated with coronary artery calcification and coronary luminal stenosis (P = 0.001 and P = 0.02, respectively) with no significant association between ARC and the presence of calcified coronary plaque (P = 0.14). ARC was also significantly associated with the calcification pattern in the left main-stem (P = 0.020, r = 0.288) and left circumflex arteries (P = 0.029, r =0.271) with no significant associations with the right coronary artery (P = 0.067, r = 0.229) and left anterior descending artery (P = 0.388, r = 0.109). ARC was significantly correlated with patients’ age (P = 0.017, r = 0.295). Conclusion: ARC was significantly associated with coronary artery stenosis and calcification, highlighting the role of ARC as a bioimaging marker for coronary artery disease.

abstract: Objectives: This study aimed to assess the effect of body mass index (BMI) on the relationship between pericardial fat volume (PFV), aortic root calcification (ARC) and coronary artery calcification (CAC) among patients with suspected coronary artery disease (CAD). Methods: This cross-sectional study took place between January and December 2014 at the Kufa University Teaching Hospital, Najaf, Iraq. A total of 130 consecutive patients with an intermediate pretest probability of ischaemic heart disease who underwent 64-slice multidetector computed tomography (CT) angiography during the study period were recruited. Of these, 111 were included in the study and divided into groups according to BMI. Imaging markers were measured on CT angiography. Results: A total of 28 patients were obese, while 42 and 41 were overweight and normal weight, respectively. The median PFV, CAC and ARC was 109 cm3 (interquartile range [IQR]: 52–176 cm3), 0 Agatston score (IQR: 0–52 Agatston score) and 0 Agatston score (IQR: 0–15 Agatston score), respectively, in the normal weight group in comparison to 79 cm3 (IQR: 43–138 cm3), 0 Agatston score (IQR: 0–54 Agatston score) and 0 Agatston score (IQR: 0–0 Agatston score), respectively, in the obese group. Significant correlations were observed between PFV and CAC (r2 = 0.22; P = 0.002) and ARC and CAC (r2 = 0.37; P <0.001) in the normal weight group. However, no significant correlations were observed for obese and overweight patients. Conclusion: These findings indicate that BMI may not be an accurate tool for measuring adiposity or assessing subclinical coronary atherosclerosis in patients with suspected CAD.

Objective: To investigate the association of pericardial fat volume (PFV) with coronary artery disease (CAD) in patients with intermediate pre-test probability of ischaemic heart disease assessed by coronary CT angiography. Methods: From a total of 115 consecutive Iraqi patients who underwent 64-multislice multidetector CT angiography examinations, only 74 patients (females, 38% and males, 68%) with a mean age of 5468 years were found to be eligible for statistical analysis. The patients were divided into two groups according to the median value of PFV (above and below 100ml). Results: The median value of PFV in our study was 100ml (range, 17–319ml). A significant association was observed between high PFV and significant coronary artery stenosis (p50.005), between high PFV and significant left circumflex stenosis (p50.021) and between high PFV and the presence of coronary plaque (p50.005). Whereas there was no significant correlation between high PFV and coronary calcium score (p50.188), between high PFV and number of diseased coronary vessels (p.0.3), and between high PFV and body weight and body mass index. Conclusion: Increased PFV is strongly associated with the presence and severity of CAD. Advances in knowledge: Our study highlights the role of pericardial fat as an emerging biomarker in cardiovascular risk assessment and supports its association with the magnitude of CAD

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