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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Article info
Publication history
Published online: December 01, 2022
Accepted:
November 28,
2022
Received in revised form:
October 4,
2022
Received:
August 8,
2022
Identification
Copyright
© 2022 Published by Elsevier Inc.
