Right coronary wall cmr in the older asymptomatic advance cohort: positive remodeling and associations with type 2 diabetes and coronary calcium
1 Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
2 Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
3 Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
4 Applied Science Laboratory-West, GE Healthcare, Menlo Park, CA, USA
5 Magnetic Resonance Systems Research Laboratory, Department of Electrical Engineering, Stanford University School of Medicine, Stanford, CA, USA
6 Division of Research, Kaiser Permanente of Northern California, Oakland, CA, USA
7 Departments of Epidemiology, Biostatistics, and Medicine, University of California, San Francisco, San Francisco, CA, USA
8 Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
9 Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
Journal of Cardiovascular Magnetic Resonance 2010, 12:75 doi:10.1186/1532-429X-12-75Published: 30 December 2010
Coronary wall cardiovascular magnetic resonance (CMR) is a promising noninvasive approach to assess subclinical atherosclerosis, but data are limited in subjects over 60 years old, who are at increased risk. The purpose of the study was to evaluate coronary wall CMR in an asymptomatic older cohort.
Cross-sectional images of the proximal right coronary artery (RCA) were acquired using spiral black-blood coronary CMR (0.7 mm resolution) in 223 older, community-based patients without a history of cardiovascular disease (age 60-72 years old, 38% female). Coronary measurements (total vessel area, lumen area, wall area, and wall thickness) had small intra- and inter-observer variabilities (r = 0.93~0.99, all p < 0.0001), though one-third of these older subjects had suboptimal image quality. Increased coronary wall thickness correlated with increased coronary vessel area (p < 0.0001), consistent with positive remodeling. On multivariate analysis, type 2 diabetes was the only risk factor associated with increased coronary wall area and thickness (p = 0.03 and p = 0.007, respectively). Coronary wall CMR measures were also associated with coronary calcification (p = 0.01-0.03).
Right coronary wall CMR in asymptomatic older subjects showed increased coronary atherosclerosis in subjects with type 2 diabetes as well as coronary calcification. Coronary wall CMR may contribute to the noninvasive assessment of subclinical coronary atherosclerosis in older, at-risk patient groups.