Right coronary wall CMR in the older asymptomatic advance cohort: positive remodeling and associations with type 2 diabetes and coronary calcium.
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BACKGROUND: 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. RESULTS: 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). CONCLUSIONS: 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.
Coronary Artery Disease
Diabetes Mellitus, Type 2
Magnetic Resonance Imaging
Predictive Value of Tests
Reproducibility of Results
Published Version (Please cite this version)10.1186/1532-429X-12-75
Publication InfoTerashima, M; Nguyen, PK; Rubin, Geoffrey D; Meyer, CH; Shimakawa, A; Nishimura, DG; ... McConnell, MV (2010). Right coronary wall CMR in the older asymptomatic advance cohort: positive remodeling and associations with type 2 diabetes and coronary calcium. J Cardiovasc Magn Reson, 12. pp. 75. 10.1186/1532-429X-12-75. Retrieved from http://hdl.handle.net/10161/14975.
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George Barth Geller Professorship for Research in Cardiovascular Diseases
Geoffrey D. Rubin, MD, MBA, FACR, FSCBTMR, FNASCI is the George B. Geller Distinguished Professor for Research in Cardiovascular Diseases and Professor of Radiology at Duke University. Born in Los Angeles, California, he earned Bachelor of Science degrees with Honor in Chemistry and Biology from the California Institute of Technology in 1982 and MD degree from the University of California, San Diego in 1987. He spent the next 22 years at Stanford University where