Abstract
Purpose of this study was the evaluation of the thoracic aortic wall thickness as a potential identifier of patients at increased risk for future cardiac events. Thoracic aortic wall thickness was measured with MDCT in 160 patients. The CT-scans were implemented as non-invasive coronary angiography studies. Relationships between aortic wall thickness, sex, age, major risk factors and atherosclerotic plaque burden of the coronary arteries were explored. Higher values of maximum aortic wall thickness of the descending aorta (women P = 0.02, men P = 0.01) were found in patients with coronary atherosclerosis, compared to patients with same gender but excluded atherosclerosis. Aortic wall thickness of the mid-portion of the descending aorta of 3.0 mm is associated with coronary artery disease (CAD) with a specificity of 96.6% (sensitivity 27.5%) and a positive predictive value (PPV) of 93.3%. For patients with two or more major risk factors and a maximum wall thickness of equal or more than 2.6 mm we found a PPV of 100%. We conclude that measurements of maximum wall thickness of the descending aorta are a potential tool for detecting patients with coronary atherosclerosis. The potential effect of combining measurements of aortic wall thickness at routine chest CT studies with a possible cardiovascular screening is substantial and merits further study.
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References
Budoff MJ (2003) Atherosclerosis imaging and calcified plaque: coronary artery disease risk assessment. Prog Cardiovasc Dis 46(2):135–148. doi:10.1016/S0033-0620(03)00083-5
Fuster V, Fayad ZA, Moreno PR, Poon M, Corti R, Badimon JJ (2005) Atherothrombosis and high-risk plaque: part II: approaches by noninvasive computed tomographic/magnetic resonance imaging. J Am Coll Cardiol 46(7):1209–1218. doi:10.1016/j.jacc.2005.03.075
Aronow WS, Ahn C (1994) Prevalence of coexistence of coronary artery disease, peripheral arterial disease, and atherothrombotic brain infarction in men and women > or = 62 years of age. Am J Cardiol 74(1):64–65. doi:10.1016/0002-9149(94)90493-6
(1996) A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet 348(9038):1329–1339. doi:10.1016/S0140-6736(96)09457-3
Chambless LE, Heiss G, Folsom AR et al (1997) Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987–1993. Am J Epidemiol 146(6):483–494
Hodis HN, Mack WJ, LaBree L et al (1998) The role of carotid arterial intima-media thickness in predicting clinical coronary events. Ann Intern Med 128(4):262–269
Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE (1997) Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation 96(5):1432–1437
O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr (1999) Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 340(1):14–22. doi:10.1056/NEJM199901073400103
Salonen JT, Salonen R (1991) Ultrasonographically assessed carotid morphology and the risk of coronary heart disease. Arterioscler Thromb 11(5):1245–1249
Rohani M, Jogestrand T, Ekberg M et al (2005) Interrelation between the extent of atherosclerosis in the thoracic aorta, carotid intima-media thickness and the extent of coronary artery disease. Atherosclerosis 179(2):311–316. doi:10.1016/j.atherosclerosis.2004.10.012
Couturier G, Voustaniouk A, Weinberger J, Fuster V (2006) Correlation between coronary artery disease and aortic arch plaque thickness measured by non-invasive B-mode ultrasonography. Atherosclerosis 185(1):159–164. doi:10.1016/j.atherosclerosis.2005.05.035
Takasu J, Mao S, Budoff MJ (2003) Aortic atherosclerosis detected with electron-beam CT as a predictor of obstructive coronary artery disease. Acad Radiol 10(6):631–637. doi:10.1016/S1076-6332(03)80081-8
Stary HC, Chandler AB, Dinsmore RE et al (1995) A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the committee on vascular lesions of the council on arteriosclerosis, American Heart Association. Arterioscler Thromb Vasc Biol 15(9):1512–1531
Jaffer FA, O’Donnell CJ, Larson MG et al (2002) Age and sex distribution of subclinical aortic atherosclerosis: a magnetic resonance imaging examination of the Framingham Heart Study. Arterioscler Thromb Vasc Biol 22(5):849–854. doi:10.1161/01.ATV.0000012662.29622.00
(1996) Atherosclerotic disease of the aortic arch as a risk factor for recurrent ischemic stroke. The French Study of aortic plaques in Stroke Group. N Engl J Med 334(19):1216–1221. doi:10.1056/NEJM199605093341902
Haberl R, Becker A, Leber A et al (2001) Correlation of coronary calcification and angiographically documented stenoses in patients with suspected coronary artery disease: results of 1,764 patients. J Am Coll Cardiol 37(2):451–457. doi:10.1016/S0735-1097(00)01119-0
Takasu J, Takanashi K, Naito S et al (1992) Evaluation of morphological changes of the atherosclerotic aorta by enhanced computed tomography. Atherosclerosis 97(2–3):107–121. doi:10.1016/0021-9150(92)90124-Y
Agmon Y, Khandheria BK, Meissner I et al (2002) Relation of coronary artery disease and cerebrovascular disease with atherosclerosis of the thoracic aorta in the general population. Am J Cardiol 89(3):262–267. doi:10.1016/S0002-9149(01)02225-1
Belhassen L, Carville C, Pelle G et al (2002) Evaluation of carotid artery and aortic intima-media thickness measurements for exclusion of significant coronary atherosclerosis in patients scheduled for heart valve surgery. J Am Coll Cardiol 39(7):1139–1144. doi:10.1016/S0735-1097(02)01748-5
Fazio GP, Redberg RF, Winslow T, Schiller NB (1993) Transesophageal echocardiographically detected atherosclerotic aortic plaque is a marker for coronary artery disease. J Am Coll Cardiol 21(1):144–150
Tribouilloy C, Shen WF, Peltier M, Lesbre JP (1994) Noninvasive prediction of coronary artery disease by transesophageal echocardiographic detection of thoracic aortic plaque in valvular heart disease. Am J Cardiol 74(3):258–260. doi:10.1016/0002-9149(94)90367-0
Ko SF, Hsieh MJ, Chen MC et al (2005) Effects of heart rate on motion artifacts of the aorta on non-ECG-assisted 0.5-sec thoracic MDCT. Am J Roentgenol 184(4):1225–1230
Hoffmann MH, Shi H, Schmitz BL et al (2005) Noninvasive coronary angiography with multislice computed tomography. JAMA 293(20):2471–2478. doi:10.1001/jama.293.20.2471
Achenbach S, Moselewski F, Ropers D et al (2004) Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral computed tomography: a segment-based comparison with intravascular ultrasound. Circulation 109(1):14–17. doi:10.1161/01.CIR.0000111517.69230.0F
Leber AW, Knez A, von Ziegler F et al (2005) Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound. J Am Coll Cardiol 46(1):147–154. doi:10.1016/j.jacc.2005.03.071
Leber AW, Knez A, Becker A et al (2005) Visualising noncalcified coronary plaques by CT. Int J Cardiovasc Imaging 21(1):55–61. doi:10.1007/s10554-004-5337-7
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Jeltsch, M., Klass, O., Klein, S. et al. Aortic wall thickness assessed by multidetector computed tomography as a predictor of coronary atherosclerosis. Int J Cardiovasc Imaging 25, 209–217 (2009). https://doi.org/10.1007/s10554-008-9373-6
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DOI: https://doi.org/10.1007/s10554-008-9373-6