CAC, coronary artery calcification

  • 文章类型: Journal Article
    未经证实:由于血管和非血管危险因素,80岁(晚年)后的痴呆症越来越普遍。识别晚期痴呆症风险较高的个体仍然是全球优先事项。
    UNASISIGNED:在958名流动社区居住的老年妇女(≥70岁)的前瞻性研究中,1998年从骨密度仪(基线)获取的脊柱侧位图像(LSI)用于评估腹主动脉钙化(AAC).AAC被分为既定类别(低,适度和广泛)。评估心血管危险因素和载脂蛋白E(APOE)基因分型。从相关的医院和死亡率记录中发现了14.5年晚期痴呆症。
    未经评估:基线时,女性为75.0±2.6岁,44.7%的AAC较低,36.4%有中度AAC,18.9%有广泛的AAC。超过14.5年,150名(15.7%)女性晚期痴呆症住院(n=132)和/或死亡(n=58)。与低AAC相比,患有中度和广泛性AAC的女性更有可能患晚期痴呆症住院(9.3%,15.5%,18.3%,分别)和死亡(2.8%,8.3%,9.4%,分别)。在调整心血管危险因素和APOE后,患有中度和广泛性AAC的女性患晚期痴呆的相对危害是其两倍(中度,aHR2.0395CI1.38-2.97;广泛,aHR2.1095CI1.33-3.32),与低AAC的女性相比。
    未经授权:在社区居住的老年妇女中,那些AAC更晚期的人患晚期痴呆症的风险更高,独立于心血管危险因素和APOE基因型。鉴于骨密度测试的广泛使用,同时捕获AAC信息可能是一种新颖的,非侵入性,可扩展的方法来识别有晚年痴呆风险的老年女性。
    未经批准:澳大利亚肾脏健康,西澳大利亚州健康促进基金会,查尔斯·盖尔德纳爵士医院研究咨询委员会格兰特,澳大利亚国家卫生和医学研究委员会。
    UNASSIGNED: Dementia after the age of 80 years (late-life) is increasingly common due to vascular and non-vascular risk factors. Identifying individuals at higher risk of late-life dementia remains a global priority.
    UNASSIGNED: In prospective study of 958 ambulant community-dwelling older women (≥70 years), lateral spine images (LSI) captured in 1998 (baseline) from a bone density machine were used to assess abdominal aortic calcification (AAC). AAC was classified into established categories (low, moderate and extensive). Cardiovascular risk factors and apolipoprotein E (APOE) genotyping were evaluated. Incident 14.5-year late-life dementia was identified from linked hospital and mortality records.
    UNASSIGNED: At baseline women were 75.0 ± 2.6 years, 44.7% had low AAC, 36.4% had moderate AAC and 18.9% had extensive AAC. Over 14.5- years, 150 (15.7%) women had a late-life dementia hospitalisation (n = 132) and/or death (n = 58). Compared to those with low AAC, women with moderate and extensive AAC were more likely to suffer late-life dementia hospitalisations (9.3%, 15.5%, 18.3%, respectively) and deaths (2.8%, 8.3%, 9.4%, respectively). After adjustment for cardiovascular risk factors and APOE, women with moderate and extensive AAC had twice the relative hazards of late-life dementia (moderate, aHR 2.03 95%CI 1.38-2.97; extensive, aHR 2.10 95%CI 1.33-3.32), compared to women with low AAC.
    UNASSIGNED: In community-dwelling older women, those with more advanced AAC had higher risk of late-life dementia, independent of cardiovascular risk factors and APOE genotype. Given the widespread use of bone density testing, simultaneously capturing AAC information may be a novel, non-invasive, scalable approach to identify older women at risk of late-life dementia.
    UNASSIGNED: Kidney Health Australia, Healthway Health Promotion Foundation of Western Australia, Sir Charles Gairdner Hospital Research Advisory Committee Grant, National Health and Medical Research Council of Australia.
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  • 文章类型: Journal Article
    阐明异位矿化介质作为动脉钙化生物标志物的作用。
    搜索MEDLINE和Embase的相关文献,直到2022年1月4日。研究的生物标志物是:钙,磷酸盐,甲状旁腺激素,维生素D,焦磷酸盐,骨保护素,核因子-κB受体活化因子配体(RANKL),成纤维细胞生长因子-23(FGF-23),Klotho,骨桥蛋白,骨钙蛋白,基质Gla蛋白(MGP)及其非活性形式和维生素K。排除仅在肾功能不全或糖尿病患者中进行的研究。
    在筛选了8985篇文章后,本系统综述共纳入129篇文章.对于本综述中包含的所有生物标志物,结果是可变的,超过一半的研究中每种特定生物标志物的结果均不显著.此外,纳入研究的总体质量较低,部分原因是主要是横断面研究设计。最大的证据是磷酸盐,骨桥蛋白和FGF-23,一半以上的研究表明,正关联。无法得出这些生物标志物的确切陈述,由于研究数量有限,并受到残留混杂因素的阻碍,或者结果不显著.其他异位矿化介质与动脉钙化的关联尚不清楚。
    异位矿化和动脉钙化的生物标志物之间的关联在已发表的文献中是可变的。未来区分内侧和内膜钙化的纵向研究可以增加对生物标志物和动脉钙化机制的认识。
    UNASSIGNED: To clarify the role of mediators of ectopic mineralization as biomarkers for arterial calcifications.
    UNASSIGNED: MEDLINE and Embase were searched for relevant literature, until January 4th 2022. The investigated biomarkers were: calcium, phosphate, parathyroid hormone, vitamin D, pyrophosphate, osteoprotegerin, receptor activator of nuclear factor-kappa B ligand (RANKL), fibroblast growth factor-23 (FGF-23), Klotho, osteopontin, osteocalcin, Matrix Gla protein (MGP) and its inactive forms and vitamin K. Studies solely performed in patients with kidney insufficiency or diabetes mellitus were excluded.
    UNASSIGNED: After screening of 8985 articles, a total of 129 articles were included in this systematic review. For all biomarkers included in this review, the results were variable and more than half of the studies for each specific biomarker had a non-significant result. Also, the overall quality of the included studies was low, partly as a result of the mostly cross-sectional study designs. The largest body of evidence is available for phosphate, osteopontin and FGF-23, as a little over half of the studies showed a significant, positive association. Firm statements for these biomarkers cannot be drawn, as the number of studies was limited and hampered by residual confounding or had non-significant results. The associations of the other mediators of ectopic mineralization with arterial calcifications were not clear.
    UNASSIGNED: Associations between biomarkers of ectopic mineralization and arterial calcification are variable in the published literature. Future longitudinal studies differentiating medial and intimal calcification could add to the knowledge of biomarkers and mechanisms of arterial calcifications.
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  • 文章类型: Journal Article
    目的:胸部计算机断层扫描(胸部CT)通常用于评估COVID-19的疾病严重程度。虽然COVID-19对肺部发现有很好的描述,但对心血管发现的影响却知之甚少。我们评估了胸部CT上的心血管发现对住院COVID-19患者的不良复合结局(ACO)的影响。
    方法:纳入了在拉什大学卫生系统接受胸部CT检查的245例COVID-19患者。
    方法:心血管检查结果,包括冠状动脉钙化(CAC),主动脉钙化,右心室应变的迹象[右心室与左心室直径比,肺动脉与主动脉直径之比,室间隔位置,和下腔静脉(IVC)反流],由训练有素的医生测量。
    方法:这些发现,随着肺部的发现,使用单变量逻辑分析进行分析,以确定定义为重症监护入院的ACO风险,需要无创正压通气,插管,住院和60天死亡率。次要终点包括ACO的单个组分。
    结果:主动脉钙化与ACO风险增加独立相关(比值比1.86,95%置信区间(1.11-3.17)p<0.05)。主动脉钙化,CAC,隔位异常,对比剂或IVC反流均与60天死亡率和主要不良心血管事件显著相关.IVC反流与住院死亡率相关(p=0.005)。
    结论:胸部CT偶然发现的心血管是COVID-19临床上重要的影像学标志物。确定并常规报告COVID-19患者CT成像的心血管发现非常重要,因为它们有可能识别高风险患者。
    OBJECTIVE: Chest computed tomography (chest CT) is routinely obtained to assess disease severity in COVID-19. While pulmonary findings are well-described in COVID-19, the implications of cardiovascular findings are less well understood. We evaluated the impact of cardiovascular findings on chest CT on the adverse composite outcome (ACO) of hospitalized COVID-19 patients.
    METHODS: 245 COVID-19 patients who underwent chest CT at Rush University Health System were included.
    METHODS: Cardiovascular findings, including coronary artery calcification (CAC), aortic calcification, signs of right ventricular strain [right ventricular to left ventricular diameter ratio, pulmonary artery to aorta diameter ratio, interventricular septal position, and inferior vena cava (IVC) reflux], were measured by trained physicians.
    METHODS: These findings, along with pulmonary findings, were analyzed using univariable logistic analysis to determine the risk of ACO defined as intensive care admission, need for non-invasive positive pressure ventilation, intubation, in-hospital and 60-day mortality. Secondary endpoints included individual components of the ACO.
    RESULTS: Aortic calcification was independently associated with an increased risk of the ACO (odds ratio 1.86, 95% confidence interval (1.11-3.17) p < 0.05). Aortic calcification, CAC, abnormal septal position, or IVC reflux of contrast were all significantly associated with 60-day mortality and major adverse cardiovascular events. IVC reflux was associated with in-hospital mortality (p = 0.005).
    CONCLUSIONS: Incidental cardiovascular findings on chest CT are clinically important imaging markers in COVID-19. It is important to ascertain and routinely report cardiovascular findings on CT imaging of COVID-19 patients as they have potential to identify high risk patients.
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  • 文章类型: Journal Article
    心血管疾病(CV)仍然是慢性肾脏病(CKD)患者发病和死亡的重要原因。虽然传统的危险因素与CKD的聚集是公认的,肾脏特异性机制被认为驱动了CV疾病不成比例的负担.在CKD患者中,经常观察到的一个扰动是血管钙化,它可能是一系列CV后遗症的中心介质。本文综述了CKD内膜和内侧血管钙化的病理生理基础。当前的诊断和管理策略,并将血管钙化作为风险标志物和治疗靶点。
    Cardiovascular (CV) disease remains an important cause of morbidity and mortality for patients with chronic kidney disease (CKD). Although clustering of traditional risk factors with CKD is well recognized, kidney-specific mechanisms are believed to drive the disproportionate burden of CV disease. One perturbation that is frequently observed at high rates in patients with CKD is vascular calcification, which may be a central mediator for an array of CV sequelae. This review summarizes the pathophysiological bases of intimal and medial vascular calcification in CKD, current strategies for diagnosis and management, and posits vascular calcification as a risk marker and therapeutic target.
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  • 文章类型: Journal Article
    单磷酸腺苷活化蛋白激酶(AMPK)乙酰辅酶A羧化酶(ACC)信号在血小板中被动脉粥样硬化脂质激活,特别是氧化的低密度脂蛋白,通过CD36依赖性途径。更有趣的是,血小板AMPK诱导的ACC磷酸化增加与冠心病患者冠状动脉钙化的严重程度以及急性冠状动脉事件相关。因此,AMPK诱导的ACC磷酸化是可疑冠状动脉疾病患者危险分层的潜在标志物。由其磷酸化引起的ACC的抑制通过下调甘油三酯影响血小板脂质含量,这反过来可能会影响血小板功能。
    Adenosine monophosphate-activated protein kinase (AMPK) acetyl-CoA carboxylase (ACC) signaling is activated in platelets by atherogenic lipids, particularly by oxidized low-density lipoproteins, through a CD36-dependent pathway. More interestingly, increased platelet AMPK-induced ACC phosphorylation is associated with the severity of coronary artery calcification as well as acute coronary events in coronary artery disease patients. Therefore, AMPK-induced ACC phosphorylation is a potential marker for risk stratification in suspected coronary artery disease patients. The inhibition of ACC resulting from its phosphorylation impacts platelet lipid content by down-regulating triglycerides, which in turn may affect platelet function.
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  • 文章类型: Journal Article
    Data presented in this article are supplementary data to our primary article \'Association of Alcohol Consumption and Aortic Calcification in Healthy Men Aged 40-49 Years for the ERA JUMP Study\' [1]. In this article, we have presented supplementary tables showing the independent association of alcohol consumption with coronary artery calcification using Tobit conditional regression and ordinal logistic regression.
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  • 文章类型: Journal Article
    Vitamin K is considered to be involved in the pathological mechanisms of coronary artery calcification (CAC). Correlation between CAC and plasma vitamin K levels was studied. A total of 103 patients, with at least one coronary risk factor, were studied. CAC was measured using 64-slice multislice computed tomography (MSCT) and divided into three groups: none (CAC score = 0; n 25), mild to moderate (0 < CAC score < 400; n 52) and severe (CAC score > 400; n 26). Phylloquinone (PK) and menaquinone (MK)-4 and MK-7 were measured by HPLC-tandem MS. Mean age of patients was 64 (sd 13) years, of which 57 % were male. Median CAC score was 57·2. Median levels of PK, MK-4 and MK-7 were 1·33, 0 and 6·99 ng/ml, showing that MK-7 was the dominant vitamin K in this population. MK-7 showed a significant inverse correlation with uncarboxylated osteocalcin (ucOC, P = 0·014), protein induced by vitamin K absence of antagonist-2 (PIVKA-2, P = 0·013), intact parathyroid hormone (P = 0·007) and bone-specific alkaline phosphatase (P = 0·018). CAC showed an inverse correlation with total circulating uncarboxylated matrix Gla protein (t-ucMGP, P = 0·018) and Hb (P = 0·05), and a positive correlation with age (P < 0·001), creatinine, collagen type 1 cross-linked N-terminal telopeptide (NTX, P = 0·03), pulse wave velocity (P < 0·001) and osteoprotegerin (P < 0·001). However, CAC did not have a significant correlation with plasma levels of PK, MK-4 or MK-7. In conclusion, plasma MK-7, MK-4 or PK level did not show significant correlation with CAC despite the association between plasma vitamin K levels and vitamin K-dependent proteins such as ucOC or PIVKA-2.
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