Echocardiographic Calcium Score of Aortic Valve Correlates with Coronary Artery Calcium Score in Heterozygous Familial Hypercholesterolemia
Abstract
1. Introduction
2. Materials and Methods
2.1. ACS Measurement by Coronary Calcium CT Scan
2.2. Echocardiographic Calcium Score (ECS)
2.3. Statistics
3. Results
4. Discussion and Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
HeFH | Heterozygous familial hypercholesterolemia |
HoFH | Homozygous familial hypercholesterolemia |
ASCVD | Atherosclerotic cardiovascular disease |
AVC | Aortic valve calcifications |
CV | Cardiovascular |
CAC score | Coronary artery calcium score |
CT | Computed tomography |
MACE | Major adverse cardiovascular event |
ACS | Agatston calcium score |
ECS | Echocardiographic calcium score |
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Parameters | ACS ≤ 100 | ACS > 100 | p-Value 1 |
---|---|---|---|
Cardiovascular risk based on CAC score | Low | High | - |
Number of subjects | 52 | 29 | - |
Age (yrs) | 45.77 ± 12.29 | 62.69 ± 8.55 | <0.001 |
Gender (M/F) | (24/28) | (11/18) | 0.475 |
Smoking (No/Former/Active) | (9/3/17) | (14/10/28) | 0.576 |
Age of FH diagnosis (yrs) | 22.08 ± 13.62 | 33.57 ± 14.06 | <0.001 |
Family history of CVD (Y/N) | (25/27) | (14/15) | 0.927 |
Hypertension (Y/N) | (6/46) | (13/16) | 0.297 |
Diabetes (Y/N) | (2/50) | (3/26) | 0.729 |
Age at start of LLT (yrs) | 26.21 ± 12.63 | 37.52 ± 14.66 | <0.001 |
Clinical examination | |||
BMI (kg/m2) | 26.36 ± 5.27 | 29.16 ± 4.73 | 0.007 |
Waist circumference (cm) | 92.84 ± 15.9 | 99.24 ± 11.1 | 0.024 |
S.B.P. (mm/Hg) | 121.81 ± 14.26 | 137.86 ± 23.97 | <0.001 |
D.B.P. (mm/Hg) | 73.38 ± 10.47 | 77.21 ± 13.11 | 0.083 |
Tendon xanthoma (Y/N) | (4/48) | (8/21) | 0.260 |
Corneal arcus (Y/N) | (4/48) | (15/14) | 0.128 |
Biochemical parameters | |||
Total cholesterol (mmol/L) | 6.06 ± 1.83 | 5.69 ± 1.77 | 0.292 |
Triglyceride (mmol/L) | 1.20 ± 0.57 | 1.22 ± 0.58 | 0.821 |
HDL cholesterol (mmol/L) | 1.41 ± 0.36 | 1.49 ± 0.35 | 0.267 |
LDL cholesterol (mmol/L) | 4.11 ± 1.65 | 3.65 ± 1.62 | 0.153 |
Lipid-lowering therapy | |||
Statins (Y/N) | (41/10) | (27/2) | 0.407 |
Statins + Ezetimibe (Y/N) | (41/10) | (27/2) | 0.407 |
PCSK9i Mab (Y/N) | (4/48) | (9/20) | 0.493 |
Instrumental measures | |||
Coronary calcium CT scan | |||
ACS (range) | 0 (0–80) | 384 (101–15 k) | <0.001 2 |
Echocardiography | |||
ECS > 0 (Y/N) | (8/44) | (26/3) | <0.001 |
V_max 3 | 1.38 ± 0.05 | 1.61 ± 0.07 | 0.022 |
Specificity | 0.846 |
Sensitivity | 0.897 |
Accuracy | 0.864 |
Precision | 0.765 |
False positive rate | 0.154 |
True positive rate | 0.897 |
False negative rate | 0.103 |
True negative rate | 0.846 |
Parameters | ECS = 0 and ACS ≤ 100 | ECS = 0 and ACS > 100 | ECS > 0 and ACS ≤ 100 | ECS > 0 and ACS > 100 | p-Value 1 |
---|---|---|---|---|---|
Risk according to ACS | Low | High | Low | High | - |
Risk according to ECS | Low | Low | High | High | - |
N of subjects | 44 | 8 | 3 | 26 | - |
Age (years) | 43.52 ± 11.80 | 58.12 ± 6.40 | 58.33 ± 3.05 | 63.12 ± 8.86 * | 0.005 |
Male gender | 0.45 | 0.50 | 1.00 | 0.30 | 0.995 |
BMI (kg/m2) | 26.16 ± 5.09 | 28.87 ± 2.02 | 27.61 ± 6.6 | 29.19 ± 4.98 ** | 0.005 |
WC (cm) | 102.73 ± 10.68 | 106.33 ± 7.37 | 101.57 ± 9.61 | 107.19 ± 12.35 * | 0.033 |
S.B.P. (mm/Hg) | 119.86 ± 13.62 | 135.33 ± 17.47 * | 132.5 ± 13.68 | 138.15 ± 24.87 ** | <0.001 |
D.B.P. (mm/Hg) | 72.25 ± 10.16 | 88 ± 24.25 * | 79.63 ± 10.54 * | 75.96 ± 11.4 | 0.071 |
Hypertension | 0.068 | 0.333 * | 0.375 | 0.462 * | 0.002 |
Diabetes mellitus | 0.045 | 0 | 0 | 0.115 | 0.529 |
Tendon xanthoma | 0.045 | 0 | 0.25 | 0.308 * | 0.018 |
Corneal arcus | 0.091 | 0 | 0 | 0.577 | <0.001 |
CVD Family history | 0.545 | 0.333 | 0.125 | 0.5 | 0.165 |
Age of FH diagnosis (yrs) | 19.59 ± 12.72 | 23 ± 3.46 * | 35.75 ± 10.25 | 34.84 ± 14.35 * | <0.001 |
TC (mmol/L) | 236.68 ± 74.47 | 249.67 ± 84.71 | 231 ± 52.21 | 218.12 ± 67.95 | 0.264 |
TG (mmol/L) | 102.64 ± 46.53 | 104.67 ± 33.53 | 119.25 ± 66.78 | 107.68 ± 52.99 | 0.768 |
HDL- C (mmol/L) | 55.2 ± 14.24 | 59.33 ± 8.02 | 53.63 ± 13.33 | 57.76 ± 14.13 | 0.271 |
LDL- C (mmol/L) | 160.95 ± 66.61 | 169.4 ± 73.88 | 153.53 ± 51.42 | 138.82 ± 62.46 | 0.132 |
Parameters | Odd Ratio (95% CI Interval) | p-Value 1 |
---|---|---|
Age (×10 years) 2 | 14.48 (3.78–86.8) | 0.003 |
Echocardiographic calcium score > 0 | 0.8 (1–4.42) | <0.001 |
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Cefalù, A.B.; Nardi, E.; Giammanco, A.; Gagliardo, C.M.; Barbagallo, C.M.; La Grutta, L.; Toia, P.; Brucato, F.; Scrimali, C.; Fasciana, T.M.G.; et al. Echocardiographic Calcium Score of Aortic Valve Correlates with Coronary Artery Calcium Score in Heterozygous Familial Hypercholesterolemia. Life 2025, 15, 506. https://doi.org/10.3390/life15030506
Cefalù AB, Nardi E, Giammanco A, Gagliardo CM, Barbagallo CM, La Grutta L, Toia P, Brucato F, Scrimali C, Fasciana TMG, et al. Echocardiographic Calcium Score of Aortic Valve Correlates with Coronary Artery Calcium Score in Heterozygous Familial Hypercholesterolemia. Life. 2025; 15(3):506. https://doi.org/10.3390/life15030506
Chicago/Turabian StyleCefalù, Angelo Baldassare, Emilio Nardi, Antonina Giammanco, Carola Maria Gagliardo, Carlo Maria Barbagallo, Ludovico La Grutta, Patrizia Toia, Federica Brucato, Chiara Scrimali, Teresa Maria Grazia Fasciana, and et al. 2025. "Echocardiographic Calcium Score of Aortic Valve Correlates with Coronary Artery Calcium Score in Heterozygous Familial Hypercholesterolemia" Life 15, no. 3: 506. https://doi.org/10.3390/life15030506
APA StyleCefalù, A. B., Nardi, E., Giammanco, A., Gagliardo, C. M., Barbagallo, C. M., La Grutta, L., Toia, P., Brucato, F., Scrimali, C., Fasciana, T. M. G., Spina, R., Lanza, M., Vitale, F., Noto, D., & Averna, M. (2025). Echocardiographic Calcium Score of Aortic Valve Correlates with Coronary Artery Calcium Score in Heterozygous Familial Hypercholesterolemia. Life, 15(3), 506. https://doi.org/10.3390/life15030506