Influence of Differential Calcification in the Descending Thoracic Aorta on Aortic Pulse Pressure

Ahmad, Mirza Nubair; Pir, Syed Haris Ahmed; Muhammad, Mustafa Noor; Hussaini, Sharmeen Fatima; Kiani, Immad; Razzaque, Imaad; Syed, Muhammad Nabeel; Ullah, Rafath; Allaqaband, Suhail; Gupta, Anjan; Port, Steven C.; Ammar, Khawaja Afzal

doi:10.17294/2330-0698.1448

Cited by 5 publications

(6 citation statements)

References 27 publications

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“…22 Of note, DTAC burden was the greatesta finding that is not peculiar to this study and may be associated with a larger change in pulse pressure and compliance found in DTAC compared with other vascular beds, although the exact mechanism is still under investigation. 42 Our observation that ideal levels of the metrics for smoking, BMI, cholesterol, blood pressure, and blood glucose were protective against the development of ECC is not surprising, and the mechanisms driving the associations have been well documented in prior studies. [43][44][45][46][47] However, we observed that the protective effect was not consistent across all 4 vascular beds, which may suggest that the risk factors for calcification in extracoronary sites do not always overlap.…”

Section: Explanation Of Resultsmentioning

confidence: 64%

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Favorable Cardiovascular Health Is Associated With Lower Prevalence, Incidence, Extent, and Progression of Extracoronary Calcification: MESA

Ogunmoroti

Osibogun

Mathews

et al. 2022

Circ: Cardiovascular Imaging

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Background: Ideal cardiovascular health (CVH) is associated with a lower incidence of cardiovascular disease. Extracoronary calcification (ECC)—measured at the aortic valve, mitral annulus, ascending thoracic aorta, and descending thoracic aorta—is an indicator of systemic atherosclerosis. This study examined whether favorable CVH was associated with a lower risk of ECC. Methods: We analyzed data from MESA (Multi-Ethnic Study of Atherosclerosis) participants aged 45 to 84 years without cardiovascular disease at baseline. ECC was measured by noncontrast cardiac computed tomography scan at baseline and after an average of 2.4 years. Prevalent ECC was defined as an Agatston score >0 at the baseline scan. Incident ECC was defined as Agatston score >0 at the follow-up scan among participants with Agatston score of 0 at the baseline scan. Each CVH metric (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol, and blood glucose) was scored 0 to 2 points, with 2 indicating ideal; 1, intermediate; and 0, poor. The aggregated CVH score was 0 to 14 points (0–8, inadequate; 9–10, average; 11–14, optimal). We used Poisson and linear mixed-effects regression models to examine the association between CVH and ECC adjusted for sociodemographic factors. Results: Of 6504 participants, 53% were women with a mean age (SD) of 62 (10) years. Optimal and average CVH scores were associated with lower ECC prevalence, incidence, and extent. For example, optimal CVH scores were associated with 57%, 56%, 70%, and 54% lower risk of incident aortic valve calcification, mitral annulus calcification, ascending thoracic aorta calcification, and descending thoracic aorta calcification, respectively. In addition, optimal and average CVH scores were associated with lower ECC progression at 2 years, although these associations were only significant for mitral annulus calcification and descending thoracic aorta calcification. Conclusions: In this multiethnic cohort, favorable CVH was associated with a lower risk of extracoronary atherosclerosis. These findings emphasize the importance of primordial prevention as an intervention to reduce the burden of cardiovascular disease.

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Section: Explanation Of Resultsmentioning

confidence: 64%

“…22 Of note, DTAC burden was the greatest—a finding that is not peculiar to this study and may be associated with a larger change in pulse pressure and compliance found in DTAC compared with other vascular beds, although the exact mechanism is still under investigation. 42…”

Section: Discussionmentioning

confidence: 99%

Favorable Cardiovascular Health Is Associated With Lower Prevalence, Incidence, Extent, and Progression of Extracoronary Calcification: MESA

Ogunmoroti

Osibogun

Mathews

et al. 2022

Circ: Cardiovascular Imaging

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“…This study did not consider the potential effect of calcification on the deformation of the thoracic aorta. Based on previous studies, we opine that highly calcified regions (mostly in the descending aorta) undergo less cardiac-induced deformation than non-calcified regions, which result in less change of deformation due to TEVAR [ 31 ]. This study did not investigate the differences between different endograft designs, or include the dynamics of the aortic arch, which is an important region to consider in the context of branched TEVAR.…”

Section: Discussionmentioning

confidence: 99%

Multiaxial pulsatile dynamics of the thoracic aorta and impact of thoracic endovascular repair

Suh

Bondesson

Zhu

et al. 2021

European Journal of Radiology Open

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“…Thoracic aortic calcium (TAC) is a common imaging finding that reflects systemic atherosclerosis [ 1 ]. Besides, aortic wall calcium exacerbates arterial stiffening [ 2 ], which is associated with end-organ damage [ 3 ]. Several studies have shown that TAC and coronary artery calcium (CAC) are associated with distinct risk factors [ 4 , 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Segmental Evaluation of Thoracic Aortic Calcium and Their Relations with Cardiovascular Risk Factors in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Pedrosa

Brant

Aquino³

et al. 2021

Cells

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Thoracic aortic calcium (TAC) appears to be a subclinical marker of cardiovascular disease (CVD) and to predict cardiovascular (CV) mortality. However, studies on TAC use tomographic scans obtained for coronary artery calcium (CAC) score, which does not include the aortic arch. This study evaluates TAC prevalence in aortic arch (AAC), ascending (ATAC) and descending thoracic aorta (DTAC) and verify whether they are associated with the same CV risk factors. Cross-sectional analysis, including 2427 participants (mean age 55.6 ± 8.7; 54.1% women) of the ELSA-Brasil cohort. Nonenhanced ECG-gated tomographies were performed in 2015–2016. Multivariable logistic regression estimated the CV risk factors associated with calcium in each segment. Overall prevalence of ATAC, AAC and DTAC was, 23.1%, 62.1%, and 31.2%, respectively. About 90.4% of the individuals with TAC had AAC and only 19.5% had calcium in all segments. In the multivariable analysis, increasing age, lower levels of schooling, current smoking, higher body mass index, and hypertension remained associated with calcium in all segments. No sex or race/ethnicity differences were found in any aortic segment. Diabetes and dyslipidemia were associated with ATAC and DTAC, but not with AAC, suggesting that AAC may reflect an overlap of mechanisms that impact vascular health, including atherosclerosis.

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Influence of Differential Calcification in the Descending Thoracic Aorta on Aortic Pulse Pressure

Cited by 5 publications

References 27 publications

Favorable Cardiovascular Health Is Associated With Lower Prevalence, Incidence, Extent, and Progression of Extracoronary Calcification: MESA

Favorable Cardiovascular Health Is Associated With Lower Prevalence, Incidence, Extent, and Progression of Extracoronary Calcification: MESA

Multiaxial pulsatile dynamics of the thoracic aorta and impact of thoracic endovascular repair

Segmental Evaluation of Thoracic Aortic Calcium and Their Relations with Cardiovascular Risk Factors in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

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