Physiological correlates of densely calcified coronary lesions on coronary computed tomography angiography among patients with low-to-intermediate coronary artery disease likelihood

Seth Uretsky, Alan Rozanski, Azhar Supariwala, Surinder Khokhar, Prashanth Atluri, Salim Memon, George Dangas, Edward A. Fisher, Steven D. Wolff, M. Robert Peters

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: Coronary computed tomography angiography (CCTA) is often used to assess the extent and severity of atherosclerosis. A major limitation of CCTA are densely calcified coronary plaques that obscure the underlying lumen rendering assessment difficult. The purpose of this study was to evaluate the hemodynamic importance of densely calcified coronary lesions on CCTA in patients with low-to-intermediate likelihood of coronary artery disease. Methods: We studied 92 patients (64±10 years, 75% men) who underwent CCTA and stress perfusion cardiovascular magnetic resonance (CMR). Coronary stenoses were categorized as none, less than 50%, 50-70%, and greater than 70%, or densely calcified. Coronary arteries were considered densely calcified if the artery had a calcified lesion obscuring the underlying lumen and did not have another stenosis of greater than 50%. CMR was considered abnormal if there was reversible ischemia or myocardial scar determined by the presence of late gadolinium enhancement. Results: Among the 92 patients, 271 vessels were analyzed of which 44 (16%) were considered densely calcified. Among these 44 coronary territories, six (14%) had abnormal CMR findings. On a per-vessel analysis, a proportional increase in the number of myocardial segments with reversible ischemia or the presence of late gadolinium enhancement was associated with an increase of CCTA stenosis ranging from 2% in patients without coronary plaque to 70% in patients with a greater than 70% stenosis (P<0.0001). Conclusion: In conclusion, the vast majority (86%) of densely calcified lesions were not hemodynamically significant in our study. As our study was in patients with relatively low-to-intermediate likelihood of coronary artery disease, a prospective study is warranted to assess if our findings are generalizable to other patient populations.

Original languageEnglish (US)
Pages (from-to)463-467
Number of pages5
JournalCoronary Artery Disease
Volume22
Issue number7
DOIs
StatePublished - Nov 1 2011
Externally publishedYes

Fingerprint

Coronary Artery Disease
Pathologic Constriction
Magnetic Resonance Spectroscopy
Gadolinium
Coronary Stenosis
Computed Tomography Angiography
Cicatrix
Myocardial Ischemia
Atherosclerosis
Coronary Vessels
Ischemia
Arteries
Perfusion
Hemodynamics
Prospective Studies
Population

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Uretsky, Seth ; Rozanski, Alan ; Supariwala, Azhar ; Khokhar, Surinder ; Atluri, Prashanth ; Memon, Salim ; Dangas, George ; Fisher, Edward A. ; Wolff, Steven D. ; Robert Peters, M. / Physiological correlates of densely calcified coronary lesions on coronary computed tomography angiography among patients with low-to-intermediate coronary artery disease likelihood. In: Coronary Artery Disease. 2011 ; Vol. 22, No. 7. pp. 463-467.
@article{cfb77c38a29f444d853038d406f3ccd6,
title = "Physiological correlates of densely calcified coronary lesions on coronary computed tomography angiography among patients with low-to-intermediate coronary artery disease likelihood",
abstract = "Objectives: Coronary computed tomography angiography (CCTA) is often used to assess the extent and severity of atherosclerosis. A major limitation of CCTA are densely calcified coronary plaques that obscure the underlying lumen rendering assessment difficult. The purpose of this study was to evaluate the hemodynamic importance of densely calcified coronary lesions on CCTA in patients with low-to-intermediate likelihood of coronary artery disease. Methods: We studied 92 patients (64±10 years, 75{\%} men) who underwent CCTA and stress perfusion cardiovascular magnetic resonance (CMR). Coronary stenoses were categorized as none, less than 50{\%}, 50-70{\%}, and greater than 70{\%}, or densely calcified. Coronary arteries were considered densely calcified if the artery had a calcified lesion obscuring the underlying lumen and did not have another stenosis of greater than 50{\%}. CMR was considered abnormal if there was reversible ischemia or myocardial scar determined by the presence of late gadolinium enhancement. Results: Among the 92 patients, 271 vessels were analyzed of which 44 (16{\%}) were considered densely calcified. Among these 44 coronary territories, six (14{\%}) had abnormal CMR findings. On a per-vessel analysis, a proportional increase in the number of myocardial segments with reversible ischemia or the presence of late gadolinium enhancement was associated with an increase of CCTA stenosis ranging from 2{\%} in patients without coronary plaque to 70{\%} in patients with a greater than 70{\%} stenosis (P<0.0001). Conclusion: In conclusion, the vast majority (86{\%}) of densely calcified lesions were not hemodynamically significant in our study. As our study was in patients with relatively low-to-intermediate likelihood of coronary artery disease, a prospective study is warranted to assess if our findings are generalizable to other patient populations.",
author = "Seth Uretsky and Alan Rozanski and Azhar Supariwala and Surinder Khokhar and Prashanth Atluri and Salim Memon and George Dangas and Fisher, {Edward A.} and Wolff, {Steven D.} and {Robert Peters}, M.",
year = "2011",
month = "11",
day = "1",
doi = "10.1097/MCA.0b013e32834a37e1",
language = "English (US)",
volume = "22",
pages = "463--467",
journal = "Coronary Artery Disease",
issn = "0954-6928",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

Physiological correlates of densely calcified coronary lesions on coronary computed tomography angiography among patients with low-to-intermediate coronary artery disease likelihood. / Uretsky, Seth; Rozanski, Alan; Supariwala, Azhar; Khokhar, Surinder; Atluri, Prashanth; Memon, Salim; Dangas, George; Fisher, Edward A.; Wolff, Steven D.; Robert Peters, M.

In: Coronary Artery Disease, Vol. 22, No. 7, 01.11.2011, p. 463-467.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Physiological correlates of densely calcified coronary lesions on coronary computed tomography angiography among patients with low-to-intermediate coronary artery disease likelihood

AU - Uretsky, Seth

AU - Rozanski, Alan

AU - Supariwala, Azhar

AU - Khokhar, Surinder

AU - Atluri, Prashanth

AU - Memon, Salim

AU - Dangas, George

AU - Fisher, Edward A.

AU - Wolff, Steven D.

AU - Robert Peters, M.

PY - 2011/11/1

Y1 - 2011/11/1

N2 - Objectives: Coronary computed tomography angiography (CCTA) is often used to assess the extent and severity of atherosclerosis. A major limitation of CCTA are densely calcified coronary plaques that obscure the underlying lumen rendering assessment difficult. The purpose of this study was to evaluate the hemodynamic importance of densely calcified coronary lesions on CCTA in patients with low-to-intermediate likelihood of coronary artery disease. Methods: We studied 92 patients (64±10 years, 75% men) who underwent CCTA and stress perfusion cardiovascular magnetic resonance (CMR). Coronary stenoses were categorized as none, less than 50%, 50-70%, and greater than 70%, or densely calcified. Coronary arteries were considered densely calcified if the artery had a calcified lesion obscuring the underlying lumen and did not have another stenosis of greater than 50%. CMR was considered abnormal if there was reversible ischemia or myocardial scar determined by the presence of late gadolinium enhancement. Results: Among the 92 patients, 271 vessels were analyzed of which 44 (16%) were considered densely calcified. Among these 44 coronary territories, six (14%) had abnormal CMR findings. On a per-vessel analysis, a proportional increase in the number of myocardial segments with reversible ischemia or the presence of late gadolinium enhancement was associated with an increase of CCTA stenosis ranging from 2% in patients without coronary plaque to 70% in patients with a greater than 70% stenosis (P<0.0001). Conclusion: In conclusion, the vast majority (86%) of densely calcified lesions were not hemodynamically significant in our study. As our study was in patients with relatively low-to-intermediate likelihood of coronary artery disease, a prospective study is warranted to assess if our findings are generalizable to other patient populations.

AB - Objectives: Coronary computed tomography angiography (CCTA) is often used to assess the extent and severity of atherosclerosis. A major limitation of CCTA are densely calcified coronary plaques that obscure the underlying lumen rendering assessment difficult. The purpose of this study was to evaluate the hemodynamic importance of densely calcified coronary lesions on CCTA in patients with low-to-intermediate likelihood of coronary artery disease. Methods: We studied 92 patients (64±10 years, 75% men) who underwent CCTA and stress perfusion cardiovascular magnetic resonance (CMR). Coronary stenoses were categorized as none, less than 50%, 50-70%, and greater than 70%, or densely calcified. Coronary arteries were considered densely calcified if the artery had a calcified lesion obscuring the underlying lumen and did not have another stenosis of greater than 50%. CMR was considered abnormal if there was reversible ischemia or myocardial scar determined by the presence of late gadolinium enhancement. Results: Among the 92 patients, 271 vessels were analyzed of which 44 (16%) were considered densely calcified. Among these 44 coronary territories, six (14%) had abnormal CMR findings. On a per-vessel analysis, a proportional increase in the number of myocardial segments with reversible ischemia or the presence of late gadolinium enhancement was associated with an increase of CCTA stenosis ranging from 2% in patients without coronary plaque to 70% in patients with a greater than 70% stenosis (P<0.0001). Conclusion: In conclusion, the vast majority (86%) of densely calcified lesions were not hemodynamically significant in our study. As our study was in patients with relatively low-to-intermediate likelihood of coronary artery disease, a prospective study is warranted to assess if our findings are generalizable to other patient populations.

UR - http://www.scopus.com/inward/record.url?scp=80053636765&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053636765&partnerID=8YFLogxK

U2 - 10.1097/MCA.0b013e32834a37e1

DO - 10.1097/MCA.0b013e32834a37e1

M3 - Article

C2 - 21857509

AN - SCOPUS:80053636765

VL - 22

SP - 463

EP - 467

JO - Coronary Artery Disease

JF - Coronary Artery Disease

SN - 0954-6928

IS - 7

ER -