Aortic arch plaque morphology in patients with coronary artery disease undergoing coronary computed tomography angiography with wide-volume scan

Abstract

Background Wide-volume scanning with 320row multidetector computed tomography coronary angiography (CTCA-WVS) enables the assessment of the aortic arch plaque (AAP) morphology and coronary arteries without requiring additional contrast volume. This study aimed to investigate the prevalence of AAPs and their association with coronary artery disease (CAD) and major adverse cardiovascular events (MACEs) in patients who underwent CTCA-WVS. MethodsThis study included 204 patients without known CAD (mean age, 65 years; 53% men) who underwent CTCA-WVS. We evaluated the presence of aortic plaques in the ascending aorta, aortic arch, and thoracic descending aorta using CTCA-WVS. Large aortic plaques were defined as plaques of at least 4 mm in thickness. A complex aortic plaque was defined as a plaque with ulceration or protrusion. MACEs were defined as composite events of cardiovascular (CV) death, nonfatal myocardial infarction, and ischemic stroke. ResultsAAPs and large/complex AAPs were identified in 51% (n = 105) and 18% (n = 36) of the study patients, respectively. The prevalence of AAPs with large/complex morphology increased with CAD severity (2.1% in no CAD, 12% in nonobstructive CAD, and 39% in obstructive CAD). The univariate Cox hazard model demonstrated that the predictors associated with MACEs were diabetes, obstructive CAD, and large/complex AAPs. Independent factors associated with large/complex AAPs were male sex [odds ratio (OR), 2.90; P = 0.025], stroke history (OR, 3.48; P = 0.026), obstructive CAD (OR, 3.35; P = 0.011), and thoracic aortic calcification (OR, 1.77; P = 0.005). ConclusionCTCA-WVS provides a comprehensive assessment of coronary atherosclerosis and thoracic aortic plaques in patients with CAD, which may improve the stratification of patients at risk for CV events.

Extent of coronary atherosclerosis is associated with deterioration of left ventricular global longitudinal strain in patients with preserved ejection fraction undergoing coronary computed tomography angiography

“…The Agatston method was used to assess coronary artery calcium score (CACS) at a fixed thickness of 3 mm [20] . A bolus tracking method was used for image acquisition, in which a nonionic contrast medium of 270 mg I/kg was administered using a power injector.…”

“…and H.I.). To evaluate the extent and severity of CAD, segment stenosis score (SSS) and segment involvement score (SIS) were calculated [20] . Briefly, using 16 segments, we measured the percentage of luminal stenosis in images with plaques on CPR short-axis images and classified luminal stenosis as grade 1 to grade 5.…”

Thoracic Aortic Plaque Burden and Prediction of Cardiovascular Events in Patients Undergoing 320-row Multidetector CT Coronary Angiography

“…Recently, we introduced CCTA with a 320-row multidetector CT using wide volume scan (WVS), which enables detailed visualization of the aortic arch (second volume scan) without an increase in the volume of contrast medium injection during the conventional CCTA imaging (first volume scan) 11) . An additional benefit of this method is that it eliminates redundant radiation exposure as compared to the helical scan, which requires oversampling or entire thoracic aorta.…”

“…All CCTA-WVS examinations were performed using a 320-row multidetector CT (Aquilion ONE/ NATURE Edition, Cannon Medical Systems, Inc., Tochigi, Japan) 11) . Two WVSs were performed during a single breath-hold, enabling visualization of the Advance Publication Journal of Atherosclerosis and Thrombosis Accepted for publication: July 20, 2023 Published online: September 14, 2023 and T3, ≥ 10).…”

Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review

“…Unlike TOE, CTA cannot be used to assess plaque mobility [51,52]. CTCA-WVS (wide-volume scanning with 320-row multidetector computed tomography coronary angiography) is another imaging modality that can be considered, as it is able to identify large and complex aortic arch atheroma morphology and its association with ischaemic stroke without requiring additional contrast volume [74].…”