BackgroundThe relationship of coronary artery calcium (CAC) with adverse cardiac remodeling is not well established. We aimed to study the association of CAC in middle age and change in CAC from early adulthood to middle age with left ventricular (LV) function.MethodsCAC score was measured by computed tomography at CARDIA study (Coronary Artery Risk Development in Young Adults) year-15 examination and at year-25 examination (Y25) in 3043 and 3189 participants, respectively. CAC score was assessed as a continuous variable and log-transformed to account for nonlinearity. Change in CAC from year-15 examination to Y25 was evaluated as the absolute difference of log-transformed CAC from year-15 examination to Y25. LV structure and function were evaluated by echocardiography at Y25.ResultsAt Y25, mean age was 50.1±3.6 years, 56.6% women, 52.4% black. In the multivariable analysis at Y25, higher CAC was related to higher LV mass (β=1.218; adjusted P=0.007), higher LV end-diastolic volume (β=0.811; adjusted P=0.007), higher LV end-systolic volume (β=0.350; adjusted P=0.048), higher left atrial volume (β=0.214; adjusted P=0.009), and higher E/e′ ratio (β=0.059; adjusted P=0.014). CAC was measured at both year-15 examination and Y25 in 2449 individuals. Higher change in CAC score during follow-up was independently related to higher LV mass index in blacks (β=4.789; adjusted P<0.001), but not in whites (β=1.051; adjusted P=0.283).ConclusionsHigher CAC in middle age is associated with higher LV mass and volumes and worse LV diastolic function. Being free of CAC from young adulthood to middle age correlates to better LV function at middle age. Higher change in CAC score during follow-up is independently related to higher LV mass index in blacks.

中文翻译：

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从成年早期到中年的冠状动脉钙和左心室的结构和功能。

背景冠状动脉钙（CAC）与不良心脏重构的关系尚未明确。我们的目的是研究中年 CAC 以及从成年早期到中年 CAC 的变化与左心室 (LV) 功能的关系。方法 CAC 评分是在 CARDIA 研究（年轻人冠状动脉风险发展）中通过计算机断层扫描测量的15 年级考试和 25 年级考试（Y25）分别有 3043 名和 3189 名参与者。CAC 分数被评估为连续变量并进行对数转换以解释非线性。从 15 年级考试到 Y25 的 CAC 变化被评估为从 15 年级考试到 Y25 的对数转换 CAC 的绝对差异。在 25 岁时通过超声心动图评估 LV 结构和功能。结果 25 岁时，平均年龄为 50.1±3.6 岁，其中 56.6% 为女性，52.4% 为黑人。在 Y25 的多变量分析中，较高的 CAC 与较高的 LV 质量（β=1.218；调整后的P =0.007）、较高的 LV 舒张末期容积（β=0.811；调整后的P =0.007）、较高的 LV 收缩末期容积（ β=0.350；调整后的P =0.048），左心房容积较高（β=0.214；调整后的P =0.009），以及较高的E/e'比（β=0.059；调整后的P =0.014）。CAC 在 2449 名个体的 15 年级考试和 25 年级考试中进行了测量。随访期间 CAC 评分的较高变化与黑人较高的 LV 质量指数独立相关（β=4.789；调整后的P <0.001），但在白人中则不然（β=1.051；调整后的P =0.283）。 结论 中年人 CAC 较高与较高的 LV 质量和容量以及较差的 LV 舒张功能相关。从青年期到中年期间没有 CAC 与中年时更好的左心室功能相关。随访期间 CAC 评分的较高变化与黑人较高的 LV 质量指数独立相关。