Chest Radiography and Cardiac Fluoroscopy in Coronary Artery Disease

Digital radiography with dual-energy subtraction: improved evaluation of cardiac calcification

OBJECTIVE

The objective of our study was to describe cardiac applications for digital radiography with dual-energy subtraction.

CONCLUSION

Dual-energy subtraction digital radiography offers potentially important new information in the assessment of coronary artery disease.

Cardiovascular calcification in patients with chronic renal failure: Are we on target with this risk factor?

End-stage renal disease (ESRD) is comprised of conditions associated with metabolic disorders associated with soft tissue and coronary artery calcification (CAC). The most consistent determinants of CAC in these patients are extent and duration of renal dysfunction and older age. The majority of published studies have not found a causal relationship between measures of calcium-phosphorus balance and CAC. When taken into consideration, the lipid profile [primarily low high-density lipoprotein cholesterol, elevated triglycerides, elevated low-density lipoprotein (LDL-C), and elevated total cholesterol] are important factors in the calcification process. Recent data seems to indicate that CAC is regulated both positively and negatively by a wide variety of mechanisms affecting patients with renal disease. The progression of CAC can be reduced from a 25% to 30% to 0% to 6% annual increase with LDL-C reduction caused by statins or possibly sevelamer. It is currently unclear whether the calcium-phosphorus balance and its related treatments are involved in CAC progression in ESRD patients. Further research into the determinants and potential treatments for CAC in association with ESRD is warranted.

Imaging of coronary artery calcification. Its importance in assessing atherosclerotic disease

Coronary artery calcification is a marker for atherosclerotic disease. The calcifications frequently occur early in the disease process and often before the development of luminal narrowing or cardiac events. Electron beam CT has a high accuracy in detecting calcifications, and thus has prognostic value in predicting luminal narrowing and future cardiac events.