Test Code 87301
Test Details
CVMap + Metabolics
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 markers of inflammation and metabolics; and BHD’s unique Cholesterol Balance reporting are informative and readily 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
Two Tubes Required:
- Green Top Tube
(Lithium Heparin plasma separator tube with gel) - Red & Yellow Top Tube
(CAT serum separator clot activator with gel)
Alternate Specimen
None
Transport Temperature
Refrigerated (ship on frozen cold packs)
Stability
3 days at 2-8°C.
Lab Values
CVMap + Metabolics
| 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 |
| apoA-I | View |
| ApoB/ApoA-I | View |
| Lp(a) | View |
| Cholesterol Balance | |
| Production Markers | View |
| Absorption Markers | View |
| Inflammation | |
| hs-CRP | View |
| LpPLA2 | View |
| Metabolics | |
| HbA1C | View |
| Glucose | View |
| Insulin | View |
| C-Peptide | View |
| Beta Cell Function | View |
Clinical Significance
CVMap + Metabolics
| 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. |
| apoA-I | Provides structure to HDL particles as well as activates enzymes that add a fatty acid to cholesterol (esterifies cholesterol) and allows it to enter the core of HDL. |
| ApoB/ApoA-I | Strong predictor of heart disease risk. A higher ratio indicates more LDL/VLDL particles relative to HDL, suggesting greater cardiovascular risk. |
| 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. |
| 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. |
| Metabolics | |
| HbA1C | Concentration of glucose attached to the hemoglobin in red blood cells. It assesses the average amount of glucose in the blood over the last two to three months. |
| Glucose | Fasting glucose level ≥ 125 mg/dL indicates the presence of diabetes mellitus, associated with a significantly increased risk of developing CVD, stroke, peripheral vascular disease, kidney failure, neuropathy, and retinopathy |
| Insulin | Insulin is a hormone responsible for the transportation and storage of glucose in cells. It regulates glucose levels in blood. |
| C-Peptide | Produced by β-cells of the pancreas along with insulin. It serves as an accurate measure of insulin production, even in patients receiving insulin treatment. |
| Beta Cell Function | Calculation based on fasting glucose and insulin designed to give insights into beta cell function. It allows clinicians to assess baseline beta cell function, consider treatment options, and follow changes over time. Includes HOMA-R, HOMA-B and HOMA-S |
Treatment Options
CVMap + Metabolics
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.
