Relationship Between the Coronary Artery Calcium (CAC) Score and the Angle Between the Aortic Valve and the Left Ventricular Inflow Long Axis (AV-LV) as Cardiovascular Risk Factors

Abstract

Background: Cardiovascular disease (CVD) is one of the leading causes of mortality in both developed and developing countries. Therefore, identification of CVD risk factors is one of the most important steps in preventing this disease. Evidence suggests that imaging of the cardiac anatomy can be helpful for risk assessment. Objectives: This study aimed to assess two cardiac anatomy features, namely, the angle between the aortic valve and the left ventricular inflow long axis (AV-LV angle) and the coronary artery calcium (CAC) score. Patients and Methods: This cross-sectional study was conducted on 74 patients with indications for computed tomography angiography (CTA) according to the American Heart Association (AHA) guidelines from July 2019 to January 2020 in Iran. The Agatston method was applied to measure the CAC score. Besides, to determine the AV-LV angle, the angle between a line tangent to the aortic valve leaflets and a line through the center of the aorta toward the left ventricular apex was measured. The patients’ baseline characteristics were also documented by conducting interviews. Results: Of 74 patients, 56% were male. The mean age of the patients was 54.41 ± 12.31 years, and their mean body mass index (BMI) was 26.71 ± 3.89 kg/m2. The frequency of smoking was 28% among the participants. A history of hypertension was reported in 38.7% of the patients, and a history of dyslipidemia was reported in 36%. Besides, the history of myocardial infarction was reported in 4% of the patients, diabetes mellitus in 9.3% of the patients, and angioplasty in 6% of the patients. The CAC score only had significant relationships with hypertension and age (correlation coefficients = 0.51). On the other hand, the AV-LV angle had no significant relationship with the patients’ baseline characteristics. The statistical analysis of the AV-LV angle and CAC score showed no significant relationship between these parameters (P = 0.756). Conclusion: The AV-LV angle and the CAC score were not significantly associated. Further research is recommended to fill the knowledge gap regarding the cardiac anatomy features for cardiovascular risk assessment.