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Abstract:

Background: The presence of calcified atherosclerosis in different vascular beds has been associated with a higher risk of mortality. Thoracic aorta calcium (TAC) can be assessed from computed tomography (CT) scans, originally aimed at coronary artery calcium (CAC) assessment. CAC screening improves cardiovascular risk prediction, beyond standard risk assessment, whereas TAC performance remains controversial. However, the curvilinear portion of the thoracic aorta (TA), that includes the aortic arch, is systematically excluded from TAC analysis. We investigated the prevalence and spatial distribution of TAC all along the TA, to see how those segments that remain invisible in standard TA evaluation were affected. Methods and Results: A total of 970 patients (77% men) underwent extended non-contrast cardiac CT scans including the aortic arch. An automated algorithm was designed to extract the vessel centerline and to estimate the vessel diameter in perpendicular planes. Then, calcifications were quantified using the Agatston score and associated with the corresponding thoracic aorta segment. The aortic arch and the proximal descending aorta, "invisible" in routine CAC screening, appeared as two vulnerable sites concentrating 60% of almost 11000 calcifications. The aortic arch was the most affected segment per cm length. Using the extended measurement method, TAC prevalence doubled from 31% to 64%, meaning that 52% of patients would escape detection with a standard scan. In a stratified analysis for CAC and/or TAC assessment, 111 subjects (46% women) were exclusively identified with the enlarged scan. Conclusions: Calcium screening in the TA revealed that the aortic arch and the proximal descending aorta, hidden in standard TA evaluations, concentrated most of the calcifications. Middle-aged women were more prone to have calcifications in those hidden portions and became candidates for reclassification. © 2014 Craiem et al.

Registro:

Documento: Artículo
Título:Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT
Autor:Craiem, D.; Chironi, G.; Casciaro, M.E.; Graf, S.; Simon, A.
Filiación:Favaloro University, Facultad de Ingeniería, Ciencias Exactas y Naturales, Buenos Aires, Argentina
APHP, Hôpital Européen Georges Pompidou, Université Paris-Descartes, Paris, France
Palabras clave:calcium; adult; Agatston score; algorithm; aorta arch; artery calcification; Article; blood vessel diameter; cardiac imaging; cardiovascular risk; computed tomography scanner; controlled study; descending aorta; female; human; major clinical study; male; middle aged; multidetector computed tomography; patient coding; risk assessment; thoracic aorta; age; aged; angiocardiography; aorta disease; atherosclerosis; calcinosis; radiography; risk factor; sex difference; thoracic aorta; Adult; Age Factors; Aged; Aorta, Thoracic; Aortic Diseases; Atherosclerosis; Calcinosis; Coronary Angiography; Female; Humans; Male; Middle Aged; Risk Assessment; Risk Factors; Sex Factors
Año:2014
Volumen:9
Número:10
DOI: http://dx.doi.org/10.1371/journal.pone.0109584
Título revista:PLoS ONE
Título revista abreviado:PLoS ONE
ISSN:19326203
CODEN:POLNC
CAS:calcium, 7440-70-2, 14092-94-5
Registro:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_19326203_v9_n10_p_Craiem

Referencias:

  • Allison, M.A., Hsi, S., Wassel, C.L., Morgan, C., Ix, J.H., Calcified Atherosclerosis in Different Vascular Beds and the Risk of Mortality (2012) Arteriosclerosis, Thrombosis, and Vascular Biology, 32, pp. 140-146
  • Santos, R.D., Rumberger, J.A., Budoff, M.J., Shaw, L.J., Orakzai, S.H., Thoracic aorta calcification detected by electron beam tomography predicts all-cause mortality (2010) Atherosclerosis, 209, pp. 131-135
  • Wong, N.D., Gransar, H., Shaw, L., Polk, D., Moon, J.H., Thoracic aortic calcium versus coronary artery calcium for the prediction of coronary heart disease and cardiovascular disease events (2009) JACC Cardiovasc Imaging, 2, pp. 319-326
  • Kalsch, H., Lehmann, N., Mohlenkamp, S., Hammer, C., Mahabadi, A.A., Prevalence of thoracic aortic calcification and its relationship to cardiovascular risk factors and coronary calcification in an unselected population-based cohort: The Heinz Nixdorf Recall Study (2013) Int J Cardiovasc Imaging, 29, pp. 207-216
  • Yeboah, J., Carr, J.J., Terry, J.G., Ding, J., Zeb, I., Computed tomography-derived cardiovascular risk markers, incident cardiovascular events, and all-cause mortality in nondiabetics: The Multi-Ethnic Study of Atherosclerosis (2013) Eur J Prev Cardiol
  • Budoff, M.J., Nasir, K., Katz, R., Takasu, J., Carr, J.J., Thoracic aortic calcification and coronary heart disease events: The multi-ethnic study of atherosclerosis (MESA) (2011) Atherosclerosis, 215, pp. 196-202
  • Jacobs, P.C., Prokop, M., Van Der Graaf, Y., Gondrie, M.J., Janssen, K.J., Comparing coronary artery calcium and thoracic aorta calcium for prediction of all-cause mortality and cardiovascular events on low-dose non-gated computed tomography in a high-risk population of heavy smokers (2010) Atherosclerosis, 209, pp. 455-462
  • Craiem, D., Chironi, G., Redheuil, A., Casciaro, M., Mousseaux, E., Aging Impact on Thoracic Aorta 3D Morphometry in Intermediate-Risk Subjects: Looking Beyond Coronary Arteries with Non-Contrast Cardiac CT (2012) Ann Biomed Eng, 40, pp. 1028-1038
  • Demertzis, S., Hurni, S., Stalder, M., Gahl, B., Herrmann, G., Aortic arch morphometry in living humans (2010) J Anat, 217, pp. 588-596
  • Cohen, A., Tzourio, C., Bertrand, B., Chauvel, C., Bousser, M.G., Aortic plaque morphology and vascular events: A follow-up study in patients with ischemic stroke (1997) Circulation, 96, pp. 3838-3841. , FAPS Investigators. French Study of Aortic Plaques in Stroke
  • Hartnell, G.G., Imaging of aortic aneurysms and dissection: CT and MRI (2001) J Thorac Imaging, 16, pp. 35-46
  • Craiem, D., Chironi, G., Casciaro, M.E., Redheuil, A., Mousseaux, E., Three-dimensional evaluation of thoracic aorta enlargement and unfolding in hypertensive men using non-contrast computed tomography (2013) J Hum Hypertens, 27, pp. 504-509
  • Agatston, A.S., Janowitz, W.R., Hildner, F.J., Zusmer, N.R., Viamonte, M., Jr., Quantification of coronary artery calcium using ultrafast computed tomography (1990) J Am Coll Cardiol, 15, pp. 827-832
  • Wilson, P.W., D'Agostino, R.B., Levy, D., Belanger, A.M., Silbershatz, H., Prediction of coronary heart disease using risk factor categories (1998) Circulation, 97, pp. 1837-1847
  • Nasir, K., Roguin, A., Sarwar, A., Rumberger, J.A., Blumenthal, R.S., Gender differences in coronary arteries and thoracic aorta calcification (2007) Arterioscler Thromb Vasc Biol, 27, pp. 1220-1222
  • Rivera, J.J., Nasir, K., Katz, R., Takasu, J., Allison, M., Relationship of thoracic aortic calcium to coronary calcium and its progression (from the Multi-Ethnic Study of Atherosclerosis [MESA]) (2009) Am J Cardiol, 103, pp. 1562-1567
  • Erbel, R., Delaney, J.A.C., Lehmann, N., McClelland, R.L., Möhlenkamp, S., Signs of subclinical coronary atherosclerosis in relation to risk factor distribution in the Multi-Ethnic Study of Atherosclerosis (MESA) and the Heinz Nixdorf Recall Study (HNR) (2008) European Heart Journal, 29, pp. 2782-2791
  • Takasu, J., Takanashi, K., Naito, S., Onishi, M., Miyazaki, A., Evaluation of morphological changes of the atherosclerotic aorta by enhanced computed tomography (1992) Atherosclerosis, 97, pp. 107-121
  • Itani, Y., Watanabe, S., Masuda, Y., Aortic Calcification Detected in a Mass Chest Screening Program Using a Mobile Helical Computed Tomography Unit Relationship to Risk Factors and Coronary Artery Disease (2004) Circulation Journal, 68, pp. 538-541
  • Agmon, Y., Khandheria, B.K., Meissner, I., Schwartz, G.L., Petterson, T.M., Independent Association of High Blood Pressure and Aortic Atherosclerosis: A Population-Based Study (2000) Circulation, 102, pp. 2087-2093
  • Shahcheraghi, N., Dwyer, H.A., Cheer, A.Y., Barakat, A.I., Rutaganira, T., Unsteady and three-dimensional simulation of blood flow in the human aortic arch (2002) J Biomech Eng, 124, pp. 378-387
  • Suo, J., Ferrara, D.E., Sorescu, D., Guldberg, R.E., Taylor, W.R., Hemodynamic shear stresses in mouse aortas: Implications for atherogenesis (2007) Arterioscler Thromb Vasc Biol, 27, pp. 346-351
  • Vincent, P.E., Plata, A.M., Hunt, A.A., Weinberg, P.D., Sherwin, S.J., Blood flow in the rabbit aortic arch and descending thoracic aorta (2011) J R Soc Interface, 8, pp. 1708-1719
  • Giddens, D.P., Zarins, C.K., Glagov, S., The role of fluid mechanics in the localization and detection of atherosclerosis (1993) J Biomech Eng, 115, pp. 588-594
  • Liu, X., Pu, F., Fan, Y., Deng, X., Li, D., A numerical study on the flow of blood and the transport of LDL in the human aorta: The physiological significance of the helical flow in the aortic arch (2009) Am J Physiol Heart Circ Physiol, 297, pp. H163-H170
  • Wong, N.D., Sciammarella, M., Arad, Y., Miranda-Peats, R., Polk, D., Relation of thoracic aortic and aortic valve calcium to coronary artery calcium and risk assessment (2003) Am J Cardiol, 92, pp. 951-955
  • Kim, K.P., Einstein, A.J., Berrington De Gonzalez, A., Coronary artery calcification screening: Estimated radiation dose and cancer risk (2009) Arch Intern Med, 169, pp. 1188-1194
  • Gerber, T.C., Carr, J.J., Arai, A.E., Dixon, R.L., Ferrari, V.A., Ionizing radiation in cardiac imaging: A science advisory from the American Heart Association Committee on Cardiac Imaging of the Council on Clinical Cardiology and Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention (2009) Circulation, 119, pp. 1056-1065
  • Voros, S., Rivera, J.J., Berman, D.S., Blankstein, R., Budoff, M.J., Guideline for minimizing radiation exposure during acquisition of coronary artery calcium scans with the use of multidetector computed tomography: A report by the Society for Atherosclerosis Imaging and Prevention Tomographic Imaging and Prevention Councils in collaboration with the Society of Cardiovascular Computed Tomography (2011) J Cardiovasc Comput Tomogr, 5, pp. 75-83
  • Zhu, D., Mackenzie, N.C., Farquharson, C., Macrae, V.E., Mechanisms and clinical consequences of vascular calcification (2012) Front Endocrinol (Lausanne), 3, p. 95
  • De Jong, P.A., Hellings, W.E., Takx, R.A., Isgum, I., Van Herwaarden, J.A., Computed tomography of aortic wall calcifications in aortic dissection patients (2014) PLoS One, 9, p. e102036

Citas:

---------- APA ----------
Craiem, D., Chironi, G., Casciaro, M.E., Graf, S. & Simon, A. (2014) . Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT. PLoS ONE, 9(10).
http://dx.doi.org/10.1371/journal.pone.0109584
---------- CHICAGO ----------
Craiem, D., Chironi, G., Casciaro, M.E., Graf, S., Simon, A. "Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT" . PLoS ONE 9, no. 10 (2014).
http://dx.doi.org/10.1371/journal.pone.0109584
---------- MLA ----------
Craiem, D., Chironi, G., Casciaro, M.E., Graf, S., Simon, A. "Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT" . PLoS ONE, vol. 9, no. 10, 2014.
http://dx.doi.org/10.1371/journal.pone.0109584
---------- VANCOUVER ----------
Craiem, D., Chironi, G., Casciaro, M.E., Graf, S., Simon, A. Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT. PLoS ONE. 2014;9(10).
http://dx.doi.org/10.1371/journal.pone.0109584