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Calcium builds up in the vessels and stiffen
them, laying the foundation for heart disease. Getting one's
calcium score is simple, either by electron
beam computed tomography (EBCT) or by multidetector CT. Studies
show that in every age group people with higher vascular
calcium levels have a greater risk of heart attack
than do people of the same age with lower scores. |
Atherosclerosis is the major cause of mortality in the Western
world. It is characterized by the presence of atherosclerotic
lesions in the arterial intima. Atherosclerosis is thought to
progress from fatty streak to fibrous plaques, and finally to
calcified atheromata.
Vascular calcification does not remain restricted to the intima,
but also occurs in the media were it is known as Mönckeberg
sclerosis. In contrast to intimal calcification, medial calcification
occurs in the absence of inflammatory cell infiltration and lipid
deposition. Although both processes are different in many ways,
it is generally accepted that vascular calcification is an active
process rather than a passive process resulting from the accumulation
of calcium released from dying cells.
| Arterial calcification
is now generally accepted as an important independent risk
factor for the development of atherosclerosis, myocardial
infarction, stroke, and renal disease. Patients with manifest
arterial calcification have an unfavorable prognosis compared
to patients with no or mild calcification. Therefore, the
prevention or reversal of arterial calcification may lead
to improved patient outcomes. |
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For a long time it has been thought that calcification was a
passive process and the end stage of cardiovascular disease. During
the last decades, however, it has become clear that several osteoregulatory
proteins, both stimulatory and inhibitory, are involved in the
calcification of vascular tissue with a major role for the vitamin
K-dependent matrix Gla-protein.
Recommended literature:
-
"Ross R. The pathogenesis of atherosclerosis:
a perspective for the 1990s. Nature. 1993;362:801-809.
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Wexler L, Brundage B, Crouse J, Detrano
R, Fuster V, Maddahi J, Rumberger J, Stanford W, White R, Taubert
K. Coronary artery calcification: pathophysiology, epidemiology,
imaging methods, and clinical implications. A statement for
health professionals from the American Heart Association. Writing
Group. Circulation. 1996;94:1175-1192.
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Mönckeberg JG. Uber die reine mediaverkalkung
der extremitätenarterien und ihr verhalten zur arteriosklerose.
Virchows Arch Pathol Anat. 1902;171:141-167.
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Shanahan CM, Cary NR, Salisbury JR,
Proudfoot D, Weissberg PL, Edmonds ME. Medial Localization of
Mineralization-Regulating Proteins in Association With Mönckeberg's
Sclerosis: Evidence for Smooth Muscle Cell-Mediated Vascular
Calcification. Circulation. 1999;100:2168-2176.
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Doherty, T. M. Fitzpatrick, L. A. Inoue,
D. Qiao, J. H. Fishbein, M. C. Detrano, R. C. Shah, P. K. Rajavashisth,
T. B. Molecular, endocrine, and genetic mechanisms of arterial
calcification. 2004; 25: 629-72
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Lehto S, Niskanen L, Suhonen M, et al.
Medial artery calcification: a neglected harbinger of cardiovascular
complications in non-insulin-dependent diabetes mellitus. Arterioscler
Thromb Vasc Biol 1996; 16:978-983.
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Zieman SJ, Melenovsky V, Kass DA. Mechanisms,
pathophysiology, and therapy of arterial stiffness. Arterioscler
Thromb Vasc Biol. 2005 May;25(5):932-43
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