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

Abstract

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.

Percutaneous transluminal coronary angioplasty in a 52‐year‐old patient with porcelain aorta and calcified coronaries: A case report

“…Porcelain aorta is more common in the elderly population, with a study revealing the median age of 79 years 6 . Our patient was a 52‐year‐old female, and this early extensive calcification of the porcelain aorta and coronaries could be attributed to smoking and dyslipidemia, which are risk factors known to accelerate atherosclerosis and aortic calcification 7,8 . This case report shows that PCI is a valuable treatment option for multivessel coronary disease when surgical revascularization is not feasible.…”

“…6 Our patient was a 52-year-old female, and this early extensive calcification of the porcelain aorta and coronaries could be attributed to smoking and dyslipidemia, which are risk factors known to accelerate atherosclerosis and aortic calcification. 7,8 This case report shows that PCI is a valuable treatment option for multivessel coronary disease when surgical revascularization is not feasible. CABG or coronary artery bypass grafting involves cannulation and clamping of the diseased aorta, which can lead to embolization from the atheromatous heavily calcified aorta, increasing the risk of stroke and other thromboembolic complications.…”

Association of arterial stiffness with coronary artery calcium score in the general-population: the Swedish CArdioPulmonary bioImage study

“…However, prior studies summarized above conducted in other populations have shown the same direction of association. We did not have information on the calcium content in the aorta which has shown to increase arterial stiffness [37]. However, still is much unknown regarding the relationship between PWV and aortic calcification in the general population.…”

The relationship of fibroblast growth factor 23 with calcification of the thoracic aorta according to the results of multislice computed tomography in patients with resistant arterial hypertension

“…артериосклероз развивается в результате кальцификации медиального слоя сосудистой стенки и сопровождается повышением жёсткости сосудистой стенки, пульсового ад и развитием гипертрофии левого желудочка (глж) [3], что в конечном итоге способствует прогрессированию сердечной недостаточности [4]. артериосклероз наблюдается при хронической болезни почек (хбп), сахарном диабете (Сд) и артериальной гипертензии (аг) [5].…”