Association Between Thoracic Aorta Calcium and Thoracic Aorta Geometry in a Cohort of Asymptomatic Participants at Increased Cardiovascular Risk

Rev Esp Cardiol (Engl Ed). 2016 Sep;69(9):827-35. doi: 10.1016/j.rec.2016.01.031. Epub 2016 May 4.
[Article in English, Spanish]

Abstract

Introduction and objectives: Thoracic aorta calcium detection is known to improve cardiovascular risk prediction for cardiac and noncardiac events beyond traditional risk factors. We investigated the influence of thoracic aorta morphometry on the presence and extent of aortic calcifications.

Methods: Nonenhanced computed tomography heart scans were performed in 970 asymptomatic participants at increased cardiovascular risk. An automated algorithm estimated the geometry of the entire thoracic aorta and quantified the aortic calcium Agatston score. A nonparametric model was used to analyze the percentiles of calcium score by age. Logistic regression models were calculated to identify anatomical associations with calcium levels.

Results: Calcifications were concentrated in the aortic arch and descending portions. Higher amounts of calcium were associated with an enlarged, unfolded, less tapered and more tortuous aorta. The size of the ascending aorta was not correlated with aortic calcium score, whereas enlargement of the descending aorta had the strongest association: the risk of having a global calcium score > 90th percentile was 3.62 times higher (confidence interval, 2.30-5.91; P < .001) for each 2.5-mm increase in descending aorta diameter. Vessel taper, tortuosity, unfolding and aortic arch and descending volumes were also correlated with higher amounts of calcium.

Conclusions: Thoracic aorta calcium was predominantly found at the arch and descending aorta and was positively associated with the size of the descending aorta and the aortic arch, but not with the size of the ascending aorta. These findings suggest that aortic dilatation may have different mechanisms and may consequently require different preventive strategies according to the considered segments.

Keywords: Aorta; Ateroesclerosis; Atherosclerosis; Calcio; Calcium; Computed tomography; Tomografía computarizada.

Publication types

  • Multicenter Study

MeSH terms

  • Aorta, Thoracic / diagnostic imaging*
  • Aorta, Thoracic / metabolism
  • Aortic Diseases / diagnosis
  • Aortic Diseases / metabolism
  • Asymptomatic Diseases*
  • Calcium / metabolism*
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / metabolism
  • Female
  • Global Health
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods*
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors

Substances

  • Calcium