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Prevalence and distribution of aortic plaque by sex and age group among community-dwelling adults

  • Saadia Qazi
    Correspondence
    Corresponding author at: Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States of America.
    Affiliations
    The National Heart, Lung and Blood Institute's (NHLBI) Framingham Heart Study, Framingham, MA, United States of America

    Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, United States of America

    Harvard Medical School, Boston, MA, United States of America
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  • Philimon N. Gona
    Affiliations
    The National Heart, Lung and Blood Institute's (NHLBI) Framingham Heart Study, Framingham, MA, United States of America

    Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, United States of America
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  • Noriko Oyama-Manabe
    Affiliations
    Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
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  • Carol J. Salton
    Affiliations
    Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
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  • Christopher J. O'Donnell
    Affiliations
    The National Heart, Lung and Blood Institute's (NHLBI) Framingham Heart Study, Framingham, MA, United States of America

    Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, United States of America

    Harvard Medical School, Boston, MA, United States of America
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  • Warren J. Manning
    Affiliations
    Harvard Medical School, Boston, MA, United States of America

    Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, MA, United States of America

    Department of Radiology Beth Israel Deaconess Medical Center, Boston, MA, United States of America
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  • Michael L. Chuang
    Affiliations
    Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
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Published:December 01, 2022DOI:https://doi.org/10.1016/j.clinimag.2022.11.019

      Highlights

      • Among 1726 community-dwelling adults from the Framingham Heart Study, the prevalence of non-calcified plaque in the ascending and descending aorta was slightly under 50% on CMR.
      • Plaque prevalence was similar between the sexes. Both prevalence and burden of aortic plaque increase with greater age.
      • Noncalcified plaque was not an uncommon finding on thoraco-abdominal CMR in the general population.

      Abstract

      Rationale and objectives

      Atherosclerosis of the aorta is associated with increased risk of cardiovascular mortality and vascular events. We aim to describe the prevalence and distribution of non-calcified atherosclerotic plaque in the descending aorta as quantified by noncontrast cardiovascular magnetic resonance (CMR) in a community-dwelling cohort of adults.

      Materials and methods

      We used CMR to quantify noncalcified aortic plaque in 1726 participants (aged 65 ± 9 years, 46.7% men) from the Cohort Study Offspring cohort. ECG-gated, fat-suppressed, T2-weighted, black blood turbo spin echo sequence was used to acquire 36 transverse slices covering the descending aorta from just below the arch to the aortoiliac bifurcation. Plaque was defined as discrete luminal protrusions ≥1 mm; these were manually traced, then summed to determine total descending aortic plaque (DAP) and segmental thoracic and abdominal aortic plaque (TAP, AAP). Participants were stratified by sex and age group (<55, 55–64, 65–74, ≥75y). A healthy referent group (without clinical cardiovascular disease, smoking, diabetes, impaired renal function; (N = 768, 43.8% men) was used to determine upper 90th percentile cutpoints for DAP and AAP which were then applied to the overall study cohort.

      Results

      Prevalence of DAP was similar between men (47.3%) and women (48.9%), p = 0.50, as was AAP prevalence (men: 44.5%, women: 46.7%, p = 0.16); TAP was less prevalent in both sexes (men: 8.9%, women: 7.1%, p = 0.15). Both prevalence and burden of DAP, AAP and TAP increased with advancing age.

      Conclusion

      Noncalcified plaque prevalence, visualized on CMR, in community-dwelling adults is similar between the sexes, and both prevalence and burden of aortic plaque increase with greater age.

      Abbreviations:

      CMR (cardiovascular magnetic resonance), MR (magnetic resonance), CVD (cardiovascular disease), BMI (body mass index), CKD-Epi (chronic kidney disease epidemiology), eGFR (estimated glomerular filtration rate), TAP (thoracic aortic plaque), AAP (abdominal aortic plaque), DAP (descending aortic plaque), P90 (upper 90th percentile)

      Keywords

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