Impact of altitude environment on coronary artery calcification: comparative analysis in ecuadorian populations using coronary calcium score
Notice bibliographique
Résumé
Abstract Background Coronary artery calcification is a marker of atherosclerosis and a predictor of cardiovascular events. In recent years, the influence of non-traditional cardiovascular risk factors, called exposome, has gained relevance in the pathogenesis of cardiovascular disease. Moreover, chronic exposure to hypoxia at high altitudes generates cardiovascular adaptations, including systemic hypertension, pulmonary hypertension, and cardiac remodeling. However, its impact on coronary atherosclerosis has not been clearly established. This study aimed to compare coronary atherosclerotic plaque burden measured by coronary calcium scoring (CCS) by computed tomography (CT), between populations that permanently reside at sea level and at high altitudes in Ecuador. Methods Patients from three cities were included in the analysis: Guayaquil (sea level), Cuenca (2550m), and Quito (2850m above sea level). CCS was performed in three institutions of these cities and was acquired with the recommended protocols, quantifyin in Agatston units (AU). Results A total of 327 patients were included; the mean age was 62.9 years, and 40.3% were women. The main cardiovascular risk factors were arterial hypertension (58%), overweight/obesity, type 2 diabetes (17.4%), and dyslipidemia. 36.3% of the participants were under treatment with statins. Table 1 summarizes the baseline characteristics of the population, according to their city of origin. Populations at sea level had significantly lower values of total cholesterol, HDL-c, and LDL-c compared to higher altitude regions (Table 1). However, residents living at sea level had significantly more calcification in all coronary areas except the left main coronary artery territory (Table 2). The greatest variation was observed at the circumflex artery level among residents of Guayaquil, Cuenca, and Quito (SCC 69.1 ±223 versus 20.5 ±103.7 and 15.6 ±62; p=0.008 respectively) (Table 2). A zero coronary artery calcium score was found more frequently in patients living in high-altitude environments compared to sea level. Nevertheless, there were no significant differences between groups (SLR: 47.5% vs 2550mts: 58.9% vs 2850mts: 50%, p:0.3) Conclusions Our data suggest that living at high altitudes was not associated with a higher coronary atherosclerotic plaque burden, as measured by CCS. The higher coronary calcification in individuals at sea level, despite similar clinical characteristics, and even lower lipid levels, suggests the influence of other environmental and/or genetic factors. Therefore, further studies are needed to clarify the influence of altitude on the development of coronary atherosclerosis.Characteristics of total population SCC in different coronary arteries
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».