Relationship of visceral obesity and coronary calcinosis in ischemic heart disease

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Abstract

Aim. To assess the relationship between the prevalence of visceral obesity (VO) and the severity of coronary calcification (CC) in patients with verified coronary artery disease (CAD).

Materials and methods. 125 patients with CAD were examined. Assessment of the morphometric characteristics of visceral adipose tissue (VAT) and CC was perform using multislice computed tomography (MSCT). The calcium index (CI) of the coronary arteries (CA) was determine by the Agatston method. Statistical analysis was perform using Statistica 10.0.

Results. VO was detect in 82 (65.6%) patients with CAD. In the presence of VO, higher CC values were observed in the projection of the envelope (p=0.00014), right coronary (p=0.00002) arteries, total CI (p=0.0003), and the prevalence of massive CC. Correlation analysis showed the relationship between the area of VAT and the CC of all the studied localizations. According to the ROC analysis, VO is a significant predictor of massive CC (area under the ROC curve – AUC 0.72, 95% CI 0.56–0.89), in contrast to body mass index – BMI (AUC 0.56, 95% CI 0.31–0.82).

Conclusion. The index of the ratio of VAT to subcutaneous adipose tissue (VAT/SAT), but not BMI, had a direct correlation with CC. Morphology of VAT may be a significant diagnostic sign of massive CC in patients with CAD, as a factor affecting treatment and prognosis.

About the authors

Natalia K. Brel

Research Institute for Complex Issues of Cardiovascular Diseases

Email: brel.n.k@mail.ru
ORCID iD: 0000-0002-5643-4022
SPIN-code: 3401-4062

мл. науч. сотр. лаб. лучевых методов диагностики

Russian Federation, Kemerovo

Olga V. Gruzdeva

Research Institute for Complex Issues of Cardiovascular Diseases; Kemerovo State Medical University

Author for correspondence.
Email: o_gruzdeva@mail.ru
ORCID iD: 0000-0002-7780-829X

д-р мед. наук, зав. лаб. исследований гомеостаза, проф. каф. патологической физиологии

Russian Federation, Kemerovo; Kemerovo

Alexander N. Kokov

Research Institute for Complex Issues of Cardiovascular Diseases

Email: dr.kokov@gmail.com
ORCID iD: 0000-0002-7573-0636

канд. мед. наук, зав. лаб. лучевых методов диагностики

Russian Federation, Kemerovo

Vladislava L. Masenko

Research Institute for Complex Issues of Cardiovascular Diseases

Email: radiology@bk.ru
ORCID iD: 0000-0003-3970-4294
SPIN-code: 5437-0710
Scopus Author ID: 56188576400

канд. мед. наук, науч. сотр. лаб. лучевых методов диагностики

Russian Federation, Kemerovo

Yulia A. Dyleva

Research Institute for Complex Issues of Cardiovascular Diseases

Email: sionina.ev@mail.ru
ORCID iD: 0000-0002-6890-3287

канд. мед. наук, ст. науч. сотр. лаб. исследований гомеостаза

Russian Federation, Kemerovo

Ekaterina V. Belik

Research Institute for Complex Issues of Cardiovascular Diseases

Email: sionina.ev@mail.ru
ORCID iD: 0000-0003-3996-3325

канд. мед. наук, мл. науч. сотр. лаб. исследований гомеостаза

Russian Federation, Kemerovo

Olga L. Barbarash

Research Institute for Complex Issues of Cardiovascular Diseases; Kemerovo State Medical University

Email: mein11@mail.ru
ORCID iD: 0000-0002-4642-3610
SPIN-code: 5373-7620
ResearcherId: A-4834-2017

чл.-кор. РАН, д-р мед. наук, проф., дир., зав. каф. кардиологии и сердечно-сосудистой хирургии

Russian Federation, Kemerovo; Kemerovo

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2. Fig. 1. Indicators of CC according to the Agatston scale.

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3. Fig. 2. ROC-curves. Influence of VАT/SAТ and BMI on the risk of detecting massive calcification of the CA: a – ROC-curve of the indexes of the VAT/SAT, which acts as a diagnostic sign of the presence of massive CC; b – ROС-curve of BMI indices, which acts as a diagnostic sign of the presence of massive CC.

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4. Fig. 3. Patient A (without signs of VO): BMI 31.1 kg/cm2, SVAT 126 cm2, VAT/SAT 0.37, total CC 24 AU (a). Patient B (with signs of VO): BMI 32.1 kg/cm2, SVAT 250.5 cm2, VAT/SAT 0.68, total CC 934 AU (b).

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