OBJECTIVES: Exposure to cardiovascular (CV) risk factors may result in coronary atherosclerosis and myocardial disease, which is reflected in the extent of coronary artery calcification (CAC) and resting ECG abnormalities, respectively. We studied the association of CAC with ECG abnormalities in a general population without myocardial infarction or revascularization. METHODS: The total cohort of 4814 subjects (45-75 years) were randomly selected from the general population for the Heinz Nixdorf Recall Study, an ongoing study designed to assess the prognostic value of modern risk stratification methods. In addition to measuring standard risk factors, digitized resting ECGs and the EBT-based Agatston score were obtained. Subjects were separated into those without (n=1929) and with CV disease (CVD) or treated risk factors (tRF) (n=2558). RESULTS: In both groups, a positive CAC-score was more frequent and CAC-scores were higher in men and women with ECG abnormalities as compared to those with normal ECGs (p<0.05 each). In persons without CVD/tRF, a CAC > or =75th percentile was more frequent in those with LVH (42.4%) and QTc >440 ms (34.2%) as compared to normal ECGs (23.0%, p<0.01 for both). In persons with CVD/tRF, a CAC-score > or =75th percentile was found in subjects with A-Fib (46.3%), borderline-LVH (39.1%), ECG signs of MI (40.5%) and major ECG abnormalities (40.3%) versus 31.2% in those with normal ECGs (p<0.03 for all). In multivariate analysis, LVH (p=0.025) and major ECG abnormalities (p=0.04) remained independently associated with CAC in subjects without and with CVD/tRF, respectively. CONCLUSIONS: ECG-based evidence of myocardial disease is often associated with an elevated CAC burden, suggesting a link between epicardial and myocardial manifestations of risk factor exposure. The association of CAC burden with different ECG abnormalities in different clinical groups may have implications for the interpretation of the resting ECG and CAC burden in risk stratification.
OBJECTIVES: Exposure to cardiovascular (CV) risk factors may result in coronary atherosclerosis and myocardial disease, which is reflected in the extent of coronary artery calcification (CAC) and resting ECG abnormalities, respectively. We studied the association of CAC with ECG abnormalities in a general population without myocardial infarction or revascularization. METHODS: The total cohort of 4814 subjects (45-75 years) were randomly selected from the general population for the Heinz Nixdorf Recall Study, an ongoing study designed to assess the prognostic value of modern risk stratification methods. In addition to measuring standard risk factors, digitized resting ECGs and the EBT-based Agatston score were obtained. Subjects were separated into those without (n=1929) and with CV disease (CVD) or treated risk factors (tRF) (n=2558). RESULTS: In both groups, a positive CAC-score was more frequent and CAC-scores were higher in men and women with ECG abnormalities as compared to those with normal ECGs (p<0.05 each). In persons without CVD/tRF, a CAC > or =75th percentile was more frequent in those with LVH (42.4%) and QTc >440 ms (34.2%) as compared to normal ECGs (23.0%, p<0.01 for both). In persons with CVD/tRF, a CAC-score > or =75th percentile was found in subjects with A-Fib (46.3%), borderline-LVH (39.1%), ECG signs of MI (40.5%) and major ECG abnormalities (40.3%) versus 31.2% in those with normal ECGs (p<0.03 for all). In multivariate analysis, LVH (p=0.025) and major ECG abnormalities (p=0.04) remained independently associated with CAC in subjects without and with CVD/tRF, respectively. CONCLUSIONS: ECG-based evidence of myocardial disease is often associated with an elevated CAC burden, suggesting a link between epicardial and myocardial manifestations of risk factor exposure. The association of CAC burden with different ECG abnormalities in different clinical groups may have implications for the interpretation of the resting ECG and CAC burden in risk stratification.
Authors: Quynh A Truong; Dahlia Banerji; Leon M Ptaszek; Carolyn Taylor; Joao D Fontes; Matthias Kriegel; Thomas Irlbeck; John T Nagurney; Udo Hoffmann Journal: Int J Cardiovasc Imaging Date: 2011-02-02 Impact factor: 2.357
Authors: H Kälsch; N Lehmann; S Möhlenkamp; T Neumann; U Slomiany; Axel Schmermund; Andreas Stang; S Moebus; M Bauer; K Mann; K-H Jöckel; R Erbel Journal: Clin Res Cardiol Date: 2010-03 Impact factor: 5.460
Authors: Todd T Schlegel; Walter B Kulecz; Alan H Feiveson; E Carl Greco; Jude L DePalma; Vito Starc; Bojan Vrtovec; M Atiar Rahman; Michael W Bungo; Matthew J Hayat; Terry Bauch; Reynolds Delgado; Stafford G Warren; Tulio Núñez-Medina; Rubén Medina; Diego Jugo; Håkan Arheden; Olle Pahlm Journal: BMC Cardiovasc Disord Date: 2010-06-16 Impact factor: 2.298
Authors: Stefan Möhlenkamp; Nils Lehmann; Axel Schmermund; Ulla Roggenbuck; Susanne Moebus; Nico Dragano; Marcus Bauer; Hagen Kälsch; Barbara Hoffmann; Andreas Stang; Martina Bröcker-Preuss; Michael Böhm; Klaus Mann; Karl-Heinz Jöckel; Raimund Erbel Journal: Clin Res Cardiol Date: 2009-08-20 Impact factor: 5.460
Authors: Raimund Erbel; Stefan Möhlenkamp; Karl-Heinz Jöckel; Nils Lehmann; Susanne Moebus; Barbara Hoffmann; Axel Schmermund; Andreas Stang; Johannes Siegrist; Nico Dragano; Dietrich Grönemeyer; Rainer Seibel; Klaus Mann; Martina Bröcker-Preuss; Knut Kröger; Lothar Volbracht Journal: Dtsch Arztebl Int Date: 2008-01-07 Impact factor: 5.594
Authors: Anita Kumar; Ronald J Prineas; Alice M Arnold; Bruce M Psaty; Curt D Furberg; John Robbins; Donald M Lloyd-Jones Journal: Circulation Date: 2008-12-08 Impact factor: 29.690