Risk stratification of non-contrast CT beyond the coronary calcium scan

Madaj, Paul; Budoff, Matthew J.

doi:10.1016/j.jcct.2012.02.008

Cited by 23 publications

(16 citation statements)

References 52 publications

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“…As expected, FRS was higher in men with respect to women (p<0.001). Thoracic aorta mean diameter, length and volume resulted 2.88±0.25cm, 25.1±2.3cm, 151±34cm 3 and aortic arch width, height and tortuosity resulted 7.54±1.04cm, 5.25±1.11cm and 1.83±0.19, respectively. All measures were bigger in men than in women (p<0.001) except for aortic arc height and tortuosity (Table 2).…”

Section: Resultsmentioning

confidence: 95%

“…The presence and extent of coronary calcium have been associated with higher risk of cardiovascular diseases and mortality in large prospective studies [2]. From the same heart scans, extra-coronary information as thoracic aorta calcium (TAC) can be assessed [3]. The marginal impact of TAC over CAC detection on risk prediction is still controversial [4,5].…”

Section: Introductionmentioning

confidence: 99%

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Automated Assessment of Thoracic Aorta Morphology and Calcium Distribution

et al. 2015

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Abstract-Calcifications are heterogeneously distributed within different vascular beds. The presence and extent of calcium can be measured from non-contrast CT images and has been associated with higher cardiovascular risks. Using heart scans, thoracic aorta calcium (TAC) can be simultaneously assessed, although the aortic arch is systematically excluded. In this work we developed an automated technique that estimated the thoracic aorta (TA) morphology in 3D and the associated calcifications. One hundred non-diabetic patients (male gender 50%, aging 55-to-60 y.o.) at intermediate risk were randomly selected. Extended non-contrast CT scans, that included the aortic arch, were conducted. A custom software segmented the thoracic aorta using an adaptive circle fitting method that estimated the aortic centerline and diameter in 140 points per patient. Traditional risk factors were similar between men and women (p=NS). As expected, the Framingham risk score was higher in men (p<0.001). All TA size measurement were larger in men, including mean diameter, length and volume (p<0.001). In shape variables, aortic arch width was wider in men (p<0.001), although the arch height and tortuosity were similar with respect to women (p=NS). We did not find differences in TAC distribution for the ascending, arch and descending segments. Calcifications were mostly concentrated in the aortic arch and the proximal descending portions. We conclude that, in spite of having larger and wider TAs, men and women had similar calcification distribution. Calcium appeared along the TA curvilinear portion that remains invisible in traditional coronary calcium examinations. Further analyses are required to evaluate if this extended TAC inspection could be used to revise its prognostic value in prospective studies.

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Section: Resultsmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Automated Assessment of Thoracic Aorta Morphology and Calcium Distribution

et al. 2015

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“…ECC has the added benefit of high reproducibility and visualization with several imaging modalities, such as CT and echocardiography [25-27]. Additionally, ECC has been associated with angiographic coronary artery disease (CAD) extent and severity.…”

Section: Discussionmentioning

confidence: 99%

Extra-coronary calcification (aortic valve calcification, mitral annular calcification, aortic valve ring calcification and thoracic aortic calcification) in HIV seropositive and seronegative men: Multicenter AIDS Cohort Study

Rezaeian

Miller

Haberlen

et al. 2016

Journal of Cardiovascular Computed Tomography

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Introduction Previous studies have demonstrated an association between HIV infection and coronary artery disease (CAD); little is known about potential associations between HIV infection and extra-coronary calcification (ECC). Methods We analyzed 621 HIV infected (HIV+) and 384 HIV uninfected (HIV-) men from the Multicenter AIDS Cohort Study who underwent non-contrast computed tomography (CT) from 2010-2013. Agatston scores were calculated for mitral annular calcification (MAC), aortic valve calcification (AVC), aortic valve ring calcification (AVRC), and thoracic aortic calcification (TAC). The associations between HIV infection and the presence of each type of ECC (score > 0) were evaluated by multivariable logistic regression. We also evaluated the association of ECC with inflammatory biomarker levels and coronary plaque morphology. Results Among HIV+ and HIV− men, the age-standardized prevalences were 15% for TAC (HIV+ 14%/ HIV− 16%), 10% for AVC (HIV+ 11%/ HIV− 8%), 24% for AVRC (HIV+ 23% HIV− 24%), and 5% for MAC (HIV+ 7%/ HIV− 3%). After adjustment, HIV+ men had 3-fold greater odds of MAC compared to HIV− men (OR=3.2, 95% CI: 1.5-6.7), and almost twice the odds of AVC (1.8, 1.1-2.9). HIV serostatus was not associated with TAC or AVRC. AVRC was associated with higher Il-6 and sCD163 levels. TAC was associated with higher ICAM-1, TNF-α RII, and Il-6 levels. AVC and AVRC calcification were associated with presence of non-calcified plaque in HIV+ but not HIV− men. Conclusion HIV infection is an independent predictor of MAC and AVC. Whether these calcifications predict mortality in HIV+ patients deserves further investigation.

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“…This discrepancy between EATV from contrast enhanced and non-contrast CT series at equal thresholds has previously been suspected in line with our findings [16], though this had not been further investigated. Increased comparability through threshold matching can benefit ease of application of routine clinical use of EATV [27]. In the clinical setting, preexisting cardiac imaging records may consist of CTA or CTA and calcium scoring series.…”

Section: Discussionmentioning

confidence: 99%