Coronary artery calcium associated with prevalence of diastolic dysfunction: BMC

A new study published in the journal of BMC Medicine showed that coronary artery calcium (CAC) and diastolic dysfunction (DD) prevalence were significantly correlated in the general population, and both subclinical measures were linked to higher mortality.

Regardless of recognized risk variables including age, sex, ethnicity, or cardiovascular comorbidities, the CAC is an independent risk factor for coronary artery disease. On the other hand, nothing is known about how DD and CAC work together to reduce mortality in the general population. Therefore, Ki Hong Choi and team carried out this study to find out how often DD is, how it progresses based on the severity of CAC, and how they work together to reduce mortality.

This study was a cohort study based on the population. Every one of the 15,193 persons who had a health screening examination that included both a CAC scan and echocardiography at the same time was recruited. Both definite or probable DD (≥2/4) and definite DD (≥3/4 aberrant values for DD [e′, E/e′, tricuspid regurgitation velocity, and left atrial volume index]) were identified. Based on the CAC and DD, all-cause mortality was calculated.

Of the individuals in the population, 7995 had CAC = 0, 4661 had 0 < CAC < 100, and 2537 had CAC > 100. Those with CAC = 0 had considerably lower prevalence ratios for definite and definite or probable DD than those with CAC = 100. The linear relationship between CAC and E/e′ was significant.

The adjusted HRs with 95% CI for mortality of CAC ≥100 without definite DD, CAC <100 with definite DD, and CAC ≥100 with definite DD were 2.56, 3.08, and 3.91, respectively, in comparison to CAC <100 without definite DD. Significant CAC was substantially linked to quicker development in definite DD over time, with a faster elevation of E/e′ during follow-up among subjects with at least two echocardiographic measures who did not have DD at the time of CAC assessment.

Overall, there was a significant correlation between CAC and DD in a general population that had a thorough health screening examination that included both a CAC scan and echocardiography at the same time. The risk of mortality was higher for patients with both subclinical measures than for those with only one.

Source:

Choi, K. H., Kang, D., Lee, S. H., Kim, D., Cho, S. W., Choi, S.-H., Park, T. K., Lee, J. M., Song, Y. B., Hahn, J.-Y., Choi, S.-H., Gwon, H.-C., Cho, S. J., & Yang, J. H. (2025). Impact of coronary artery calcium on progression of diastolic dysfunction: a cohort study. BMC Medicine, 23(1). https://doi.org/10.1186/s12916-025-03956-9