Test Code 87300
Test Details
CVMap
Boston Heart Diagnostic’s foundational CVMap provides a comprehensive insight into CVD risk by augmenting standard lipid assessment with advanced diagnostics.
The unique combination of biomarkers – lipids and Lp(a) levels, as well as lipid particle numbers; markers of inflammation; and BHD’s unique Cholesterol Balance reporting are informative and actionable.
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Methodology
Various methodologies are used. See individual test for more details
Patient Preparation
8 hour fast prior to collection. Patient may drink water only.
Preferred Specimen
Both Serum and Plasma are needed
Alternate Specimen
None
Transport Temperature
Refrigerated (ship on frozen cold packs)
Stability
3 days at 2-8°C.
Lab Values
CVMap
| BioMarker | Lab Values (view will take you to individual test pages) |
|---|---|
| Lipids | |
| Total cholesterol | View |
| Direct LDL-C | View |
| sdLDL-C | View |
| HDL-C | View |
| Triglycerides | View |
| NonHDL | View |
| TC/HDL-C | View |
| HDL-C/TG | View |
| apoB | View |
| Lp(a) | View |
| LDL-P | View |
| HDL-P | Optimal: >44 Borderline: 34-44 Increased Risk: <34 umol/L |
| Small LDL-P | Optimal: <450 Borderline: 450-950 Increased Risk: >950 umol/L |
| Large HDL-P | Optimal: >11.1 Borderline: 4.8-11.1 Increased Risk: <4.8 umol/L |
| Large VLDL-P | Optimal: <2.0 Borderline: 2.0-4.7 Increased Risk: >4.7 umol/L |
| Cholesterol Balance | |
| Production Markers | View |
| Absorption Markers | View |
| Inflammation | |
| hs-CRP | View |
| LpPLA2 | View |
Clinical Significance
CVMap
| BioMarker | BioMarker Description |
|---|---|
| Lipids | |
| Total cholesterol | Amount of cholesterol in all cholesterol-containing lipoproteins. |
| Direct LDL-C | Direct measurement of the amount of cholesterol in atherogenic low-density lipoproteins. |
| sdLDL-C | Amount of cholesterol in the densest and most atherogenic LDL particles. Stronger predictor of cardiovascular disease (CVD) than apoB or LDL-P. |
| HDL-C | Amount of cholesterol in high-density lipoproteins (HDL). Higher levels of HDL are associated with reduced CVD; however, very high concentrations have shown increased risk for adverse outcomes in certain populations. |
| Triglycerides | Elevated levels increase CVD risk by altering lipoprotein metabolism. |
| NonHDL | Calculation that represents the cholesterol carried by all atherogenic particles. It is an independent risk factor for ASCVD, especially in patients on statin therapy and/or with obesity, diabetes, and metabolic disorders. |
| TC/HDL-C | Lipid ratio that is a stronger risk factor than LDL-C or HDL-C. |
| HDL-C/TG | Lipid ratio associated with insulin resistance. |
| apoB | Major protein component of LDL-C and other atherogenic lipoproteins. |
| Lp(a) | Lipoprotein particle similar to LDL-C that contains an additional protein called apolipoprotein(a). Independent, predominantly genetically determined, and prevalent causal risk factor for atherosclerotic heart disease. |
| LDL-P | Total number of LDL particles in blood. High levels of LDL-P are a strong, independent predictor of CVD. |
| HDL-P | Total number of HDL particles in blood. Lower concentration of HDL particles has been independently associated with coronary artery disease (CAD) risk. |
| Small LDL-P | Total number of small low-density lipoprotein articles in blood. A higher level of small LDL-P has been seen to be elevated in individuals with Metabolic Syndrome. |
| Large HDL-P | Amount of large high-density lipoprotein particles in blood. Studies suggest a strong association between HDL-P size and risk factors characteristic of the metabolic syndrome. |
| Large VLDL-P | Amount of large low-density lipoprotein particles in blood. |
| Cholesterol Balance | |
| Production Markers | Elevated lathosterol and desmosterol indicate cholesterol over-production and can be treated with agents that reduce production. |
| Absorption Markers | Elevated beta-sitosterol or campesterol indicate cholesterol over-absorption and can be treated with agents that reduce absorption. |
| Inflammation | |
| hs-CRP | Acute phase inflammatory protein associated with atherosclerosis (after other causes excluded). |
| LpPLA2 | Enzyme produced by monocytes/macrophages that reflects an active inflammatory process in the vessel wall. |
Treatment Options
CVMap
10 Steps in CVD Prevention and Treatment
- Ensure a diet low saturated and trans fats, rich in essential fatty acids including omega-3s, high in low glycemic fruits and high in vegetable fiber.
- Include exercise greater than 150 min/week.
- Smoking cessation.
- Obtain blood pressure goals of less than 130/90 mmHg.
- Lower HbA1c to less than 7.0%.
- Optimize LDL-C to less than 70 mg/dL and sdLDL-C less than 25 mg/dL.
- Optimize hs-CRP to less than 1.0 mg/L.
- Optimize Triglycerides with a goal of less than 100 mg/dL and encourage healthy large HDL particles with diet, exercise and fish oil.
- Manage Homocysteine to a goal of less than 10 µmol/L by using methlyated B vitamins and folate.
- Manage risk factors associate with Lp(a)elevations.
