TITLE:
Imaging the Atherosclerosis with 64-Detector Row Computed Tomography in Homozygous Familial Hypercholesterolemia
AUTHORS:
Cihan Akgul Ozmen, Deniz Gokalp, Hasan Nazaroglu, Ayfer Gozu Pirinccioglu
KEYWORDS:
Familial Hyperlipidemia; Cardiovascular Disease; Computed Tomography Angiography
JOURNAL NAME:
Advances in Computed Tomography,
Vol.2 No.3,
September
26,
2013
ABSTRACT: Objective: The higher risk and fatality of cardiovascular disease in subjects
with homozygous familial hypercholesterolemia warrants early screening.
Computed tomography angiography is the most promising method at present as a
reliable and reproducible noninvasive diagnostic test of cardiovascular
disease. We aimed to describe the 64-slice multidetector computed tomography
coronary angiography findings of new cases with homozygous familial hypercholesterolemia. Methods: Four patients with
homozygous familial hypercholesterolemia (2 female and 2 male) with mean age of
23 ± 9 years were included. Mean plasma total and LDL cholesterol were
654 ± 75 mg/dl and 609 ± 76 mg/dl. Tomography examinations were
performed using a 64-row MDCT-CA system (Brilliance Computed Tomography
scanner, Philips Healthcare). Results: All
patients presented calcified and mixed atherosclerotic plaques in the ascending
aorta near the origin of the coronary arteries. More extensive atherosclerosis
was found in Case 1 and Case 2 than in other cases. Case 3 has mild
atherosclerosis and Case 4 had normal coronaries but plaques in aorta. In
addition, we detected myocardial bridging in left anterior descending artery
of 2 cases, calcified plaques in postero-lateral branch artery, and
calcification in non-coronary sinus in others. Conclusion: Multidetector computed tomography coronary angiography
is a useful, non-invasive tool for detecting early aortic and coronary
atherosclerosis in homozygous familial hypercholesterolemia subjects and may be
the choice of imaging for most of such subjects.