Prevalence and Clinical Implication of Complex Atherosclerotic Plaque in the Descending Thoracic Aorta of Japanese Patients Assessed by Transesophageal Echocardiography

Abstract

Background: Aging and westernization of lifestyle has accelerated the prevalence and severity of atherosclerotic cardiovascular diseases in the Japanese population. The aim of this study was to examine the prevalence of complex plaque formation in the descending thoracic aorta (DTA) as assessed by real-time 3-dimensional transesophageal echocardiography (3DTEE) and its relation to clinical factors. Methods and Results:A prospective analysis of atherosclerotic plaque in the DTA of 350 consecutive patients who were clinically indicated for real-time 3DTEE was performed. Systematic assessment of the DTA plaques was performed using a biplane mode from the aorta at the level of the stomach to the aortic arch. When a large plaque (>4 mm) was identified, detailed 3-dimensional (D) observations were performed using a 3D zoom mode. Complex plaque was defined as either mobile or an ulcer-like pouch in the DTA. Complex plaques were detected in 51 patients (15%), who were more advanced in age and had a higher prevalence of chronic kidney disease. A multivariate analysis revealed that the presence of complex plaque was an independent predictor of renal impairment. Conclusions:The prevalence of complex plaque was not low in the this Japanese study population. A close association between complex plaque and renal dysfunction raises the possibility that complex plaque in the DTA is a potential cause of renal dysfunction. (Circ J 2010; 74: 2627 - 2632

Thrombus Attached to the Left Atrial Septal Pouch Assessed on 3-Dimensional Transesophageal Echocardiography

“…The 2-D transesophageal echocardiography is an established modality for the evaluation of intracardiac mass, but 3D-TEE allows volumetric data acquisition for specific structure, from which the same 2-D cutting plane can be extracted, resulting in accurate and reliable evaluation for the serial change in specific pathologies. 5, 6 As far as we know, this is the first report to describe serial assessment of thrombus attached to LASP, which disappeared after anticoagulation therapy on 2-D-and 3D-TEE. Further prospective study is required to determine the impact of LASP as a potential cause of cardiac embolism.…”

Complex Atheromatous Plaques in the Descending Aorta and the Risk of Stroke

“…25 Age, smoking history, and pulse pressure were independently associated with a higher frequency of atherosclerosis and complex atherosclerosis in the aorta. 18 Increasing age was not only associated with plaque complexity in all aortic segments, 20 but particularly with increasing plaque thickness in both the aortic arch and the descending aorta. 19 Aortic plaques are mainly observed, with almost the same frequency, in the aortic arch and the descending aorta, probably because of the tortous S-shaped blood flow in these segements of the aorta.…”

“…The remaining 11 studies were included both in qualitative and in quantitative synthesis ( Figure 1). [13][14][15][16][17][18][19][20][21][22][23] The characteristics of included studies are summarized in Table 1.…”

Prevalence and morphological analysis of the atheromatous plaque in digital panoramic radiograph of a brazilian subpopulation

“…The morphology of the plaque of atheroma is dynamic, with frequent formation and resolution of the movable components. Based on this, the atheroma can still be classified in simple or complex plaques through transesophageal echocardiography exams (Haruki et al, 2010). The simple atheroma has greater chance to have intimal thickening and calcification areas.…”