Imaging the Atherosclerosis with 64-Detector Row Computed Tomography in Homozygous Familial Hypercholesterolemia

Cihan Akgul Ozmen, Deniz Gokalp, Hasan Nazaroglu, Ayfer Gozu Pirinccioglu

Department of Endocrinology, Dicle University School of Medicine, Diyarbakir, Turkey.
Department of Pediatrics, Dicle University School of Medicine, Diyarbakir, Turkey.
Department of Radiology, Dicle University School of Medicine, Diyarbakir, Turkey.

DOI: 10.4236/act.2013.23017                

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.

Keywords

Familial Hyperlipidemia; Cardiovascular Disease; Computed Tomography Angiography

Conflicts of Interest

The authors declare no conflicts of interest.

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