Calcium and heart problems: An excess of this mineral can increase the risk of heart attack by 20% and promote aortic stenosis
It is not only a football match that makes the hearts of Italians ‘blow’, but also the soccer which is found as a mineral in the body, if it is too much and in the wrong place: this fundamental element, when it is deposited in excess in the coronary or around heart valvescan become the number one danger to the heart. If too much calcium is deposited on the walls of the arteries or on the valve flaps, the tissues become rigid and no longer work well, increasing the risk of heart attack within 10 years and favoring the aortic stenosisa hardening of the valve that becomes more likely with aging and that can lead to heart failure. Italian Society of Invasive Cardiology (GISE) during the congress EuroPCR 2022in Paris from 17 to 20 May, underlining however that today there is the possibility of intervening to ‘pulverize’ the accumulations of excess calcium.
Calcium and heart problems: the solution could be intravascular lithotripsy
In fact, the possible results with the litotrissia intravascolarea technique that uses the shock waves of ultrasound to break up calcium accumulations as if they were an egg shell, in an effective but safe way at the same time, so much so that it can also be used in frail elderly people and in patients who are candidates for replacement of the aortic valve to improve the outcome of the surgery.
“Calcification of the coronary arteries and heart valves is a common finding with increasing age,” he explains Giovanni Espositopresident GISE – Over time, calcium tends to settle in these tissues and severe calcifications can also be observed in up to 30% of patients undergoing coronary angiography, while valve stenosis is the result of valve calcification associated with aging. The stiffening induced by calcium is very dangerous, because it compromises the correct function of vessels and valves; if, however, large coronary calcifications are found with angiography, coronary CT, intravascular ultrasound or optical computed tomography, these can now be treated in an increasing number of patients with intravascular lithotripsy, restoring elasticity to the vessels and reducing the risk of heart attacks and heart failure “.
Calcium and heart problems, intravascular littoral: how it works
The litotrissia intravascolare, approved in our country since 2017, is the application on arterial vessels of the strategy used to pulverize calcium-based kidney stones: a special catheter is inserted into the coronary artery to be treated, equipped with ultrasonic shock wave micro-emitters in a stent-like balloon. “The pressure created by the shock waves has no effect on the tissues but selectively fragments the calcium, which however does not ‘crumble’ going into a circulation and thus risking occluding small vessels – continues Esposito – The pieces remain between two layers of fibrous tissue , as if they were in a sandwich: they do no damage elsewhere but being ‘crumbled’ they no longer offer resistance, the stiffness of the coronary artery is less than 50% and it is possible to insert a stent that keeps it open. Place a stent without reducing the calcification of the vessel can be dangerous, because coronary stiffness requires using very high pressure to inflate the balloon and this can lead to vessel dissections. “
The intervention of litotrissia intravascolare for some time it has also been performed in elderly patients who must be replaced by a calcified heart valve through the TAVI, the minimally invasive percutaneous procedure increasingly used for its efficacy and safety: shock waves are not used on the valve, but for ‘ clearing the arteries through which the catheters carrying the replacement valve must pass and which therefore have a large diameter. “If the peripheral arteries through which it must pass are calcified, as often happens in very elderly patients such as those who have to replace stiff heart valves, the passage of the wide catheter with the valve can become impossible: lithotripsy can solve these cases , eliminating the rigidity and obstacles to the insertion of the catheter and thus allowing to perform the valve replacement surgery percutaneously “, concludes Esposito.