Echocardiography Calcium Score And Aortic Stiffness As Predictive Tools Of Severity Of Coronary Artery Disease. A Single Center Egyptian Experience

Abstract Background: Coronary artery disease (CAD) represents a leading cause of death worldwide. Coronary angiography represents the gold standard for diagnosis and selection of the best treatment for patients with CAD. However some efforts have been made to predict CAD severity and complexity using non-invasive methods to identify the patients at high risk for cardiovascular events with less risk to the patients and before doing coronary angiography. Characterization of coronary-artery calcification by computed tomography known as Coronary artery calcium score (CACS) is proven to be equivalent to the total coronary atherosclerosis load and the angiographically significant lesions. Echocardiographic calcium score is now validated against non-coronary calcium by computed tomography with lower cost and no irradiation safety issues for reclassification of cardiac risk. Aim and Objectives: to determine the correlation of echocardiography calcium score and Aortic stiffness to severity of coronary artery disease. Patients and Methods: Patients coming to Ain Shams University Hospitals for elective coronary angiography were subjected to history taking, examination, blood samples and echocardiographic examination. The calculated echocardiographic calcium score and calculated Aortic stiffness were correlated with their coronary angiography films. Results: The study included 45 patients. The mean final calcium score of the whole study group was 4.95±1.29. The mean Aortic distensibility was 0.0044±0.0029. The mean syntax score of the whole study group was 22.88±12.3. There was highly significant difference between the numerical values of syntax score and final calcium score. There was weak negative but significant correlation between the syntax score numerical value and aortic distensibility. Conclusion: Echocardiographic calcium score is associated with the severity of CAD. The relationship between Aortic stiffness by echocardiography and severity of CAD still needs further evaluation. The low cost, availability and the radiation free nature of echocardiography make it an attractive candidate regarding the non-invasive tools for prediction of CAD.