Hubungan antara Skor Kalsium Arteri Koroner dengan Aortic Strain, Distensibility dan Elastic Modulus pada Pasien dengan Penyakit Jantung Koroner Stabil di RS H. Adam Malik Medan

Abstract

Introduction: Aortic stiffness parameters such as aortic strain, distensibility, and elastic modulus are increasingly used in clinical applications, but their correlation with coronary artery calcium score in patients with stable coronary heart disease remains very limited. This study aimed to investigate whether there is a relationship between coronary artery calcium score and aortic stiffness parameters such as aortic strain, distensibility, and elastic modulus in patients with stable coronary heart disease. Methods: This was an observational analytic study with a cross-sectional approach. The study was conducted at H. Adam Malik Hospital, Medan, from January 2025 until August 2025. Patients with stable coronary heart disease who underwent cardiac CCTA for calcium scoring were collected. Aortic strain, distensibility, and elastic modulus parameters were obtained from transthoracic echocardiography. Data analysis was performed using bivariate analysis, and predictive ability was assessed through ROC/AUC curve analysis, with sensitivity and specificity values also obtained. Results: A total of 110 samples were collected. There was an inverse correlation between aortic strain (P = 0.0001; r = -0.447), aortic distensibility (P = 0.0001; r = - 0.473), and a positive correlation between aortic elastic modulus (P = 0.001; r = 0.338) with calcium score. Aortic Strain (P = 0.0001, AUC 0.868, 95% CI 0.799– 0.937, Sensitivity 92.9%, Specificity 74.1%), Aortic Distensibility (P = 0.0001, AUC 0.781, 95% CI 0.693–0.868, Sensitivity 73.2%, Specificity 72.2%), and Aortic Elastic Modulus (P = 0.0001, AUC 0.781, 95% CI 0.693–0.868, Sensitivity 71.4%, Specificity 74.5%) showed fair until good predictive ability for calcium scores above 100. Conclusion: Aortic stiffness parameters such as aortic strain, distensibility, and elastic modulus have a significant correlation with calcium score and demonstrate fair until good predictive ability for calcium scores above 100.