Severe aortic arch calcification depicted on chest radiography strongly suggests coronary artery calcification

Background: We aimed to investigate the association between aortic arch and coronary artery calcification (CAC). We postulated that low‐ and high‐risk CAC scores could be predicted with the evaluation of standard chest radiography for aortic arch calcification (AAC). Patients and methods: Consecutive patients who were referred for a multidetector computerized tomography (MDCT) examination were enrolled prospectively. All patients were scanned using a commercially available 64‐slice MDCT scanner for the evaluation of CAC score. A four‐point grading scale (0, 1, 2 and 3) was used to evaluate AAC on the standard posterior‐anterior chest radiography images. Results: The study group consisted of 248 patients. Median age of the study group was 52 (IQR: 10) years, and 165 (67 %) were male. AAC grades (r = 0.676, p < 0.0001) and age (r = 0.518, p < 0.0001) were significantly and positively correlated with CAC score. Presence of AAC was independently associated with the presence of CAC (OR: 11.20, 95 % CI 4.25 to 29.52). An AAC grade of ≥ 2 was the strongest independent predictor of a high‐risk CAC score (OR: 27.42, 95 % CI 6.09 to 123.52). Receiver operating characteristics curve analysis yielded a strong predictive ability of AAC grades for a CAC score of ≥ 100 (AUC = 0.892, P < 0.0001), and ≥ 400 (AUC = 0.894, P < 0.0001). Absence of AAC had a sensitivity, specificity and accuracy of 90 %, 84 % and 89 %, respectively, for a CAC score of < 100. An AAC grade of ≥ 2 predicted a CAC score of ≥400 with a sensitivity, specificity and accuracy of 68 %, 98 % and 95 %, respectively. Conclusions: AAC is a strong and independent predictor of CAC. The discriminative performance of AAC is high in detecting patients with low‐ and high‐risk CAC scores.

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Evaluation of aortic arch calcification in type 2 diabetic patients

VASA ◽

10.1024/0301-1526.34.2.113 ◽

2005 ◽

Vol 34 (2) ◽

pp. 113-117 ◽

Cited By ~ 4

Author(s):

Papanas ◽

Symeonidis ◽

Maltezos ◽

Giannakis ◽

Mavridis ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Aortic Arch ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Insulin Dependence ◽

Artery Disease ◽

Type 2 Diabetic ◽

Aortic Arch Calcification

Background: The purpose of this study is to evaluate the severity of aortic arch calcification among type 2 diabetic patients in association with diabetes duration, diabetic complications, coronary artery disease and presence of cardiovascular risk factors. Patients and methods: This study included 207 type 2 diabetic patients (101 men) with a mean age of 61.5 ± 8.1 years and a mean diabetes duration of 13.9 ± 6.4 years. Aortic arch calcification was assessed by means of posteroanterior chest X-rays. Severity of calcification was graded as follows: grade 0 (no visible calcification), grade 1 (small spots of calcification or single thin calcification of the aortic knob), grade 2 (one or more areas of thick calcification), grade 3 (circular calcification of the aortic knob). Results: Severity of calcification was grade 0 in 84 patients (40.58%), grade 1 in 64 patients (30.92%), grade 2 in 43 patients (20.77%) and grade 3 in 16 patients (7.73%). In simple regression analysis severity of aortic arch calcification was associated with age (p = 0.032), duration of diabetes (p = 0.026), insulin dependence (p = 0.042) and presence of coronary artery disease (p = 0.039), hypertension (p = 0.019), dyslipidaemia (p = 0.029), retinopathy (p = 0.012) and microalbuminuria (p = 0.01). In multiple regression analysis severity of aortic arch calcification was associated with age (p = 0.04), duration of diabetes (p = 0.032) and presence of hypertension (p = 0.024), dyslipidaemia (p = 0.031) and coronary artery disease (p = 0.04), while the association with retinopathy, microalbuminuria and insulin dependence was no longer significant. Conclusions: Severity of aortic arch calcification is associated with age, diabetes duration, diabetic complications (retinopathy, microalbuminuria), coronary artery disease, insulin dependence, and presence of hypertension and dyslipidaemia.

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Coronary Artery And Aortic Arch Calcification In Ungated Lung Ct Scans As Predictors Of Ascvd In The Multi-ethnic Study Of Atherosclerosis: Methods And Reproducibility

Journal of Cardiovascular Computed Tomography ◽

10.1016/j.jcct.2021.06.236 ◽

2021 ◽

Vol 15 (4) ◽

pp. S35

Author(s):

I. Golub ◽

J. Sheppard ◽

S. Lakshmanan ◽

S. Dahal ◽

A. Kinninger ◽

...

Keyword(s):

Coronary Artery ◽

Aortic Arch ◽

Ct Scans ◽

Ethnic Study ◽

Lung Ct ◽

Aortic Arch Calcification

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Simple evaluation of aortic arch calcification by chest radiography in hemodialysis patients

Hemodialysis International ◽

10.1111/j.1542-4758.2009.00366.x ◽

2009 ◽

Vol 13 (3) ◽

pp. 301-306 ◽

Cited By ~ 39

Author(s):

Tetsuya OGAWA ◽

Hideki ISHIDA ◽

Nami MATSUDA ◽

Ayuko FUJIU ◽

Akiko MATSUDA ◽

...

Keyword(s):

Aortic Arch ◽

Chest Radiography ◽

Hemodialysis Patients ◽

Simple Evaluation ◽

Aortic Arch Calcification

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Porcelain Aorta: Multislice Computed Tomography for Imaging of Aortic Arch Calcification and Modified Coronary Artery Bypass Graft

Herz ◽

10.1007/s00059-009-3171-3 ◽

2009 ◽

Vol 34 (1) ◽

pp. 71-72

Author(s):

Christoph Langer ◽

Dieter Horstkotte ◽

Hans-Joachim Trappe ◽

Georg Kleikamp ◽

Thomas Butz

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Coronary Artery Bypass Graft ◽

Aortic Arch ◽

Multislice Computed Tomography ◽

Artery Bypass ◽

Bypass Graft ◽

Artery Bypass Graft ◽

Porcelain Aorta ◽

Aortic Arch Calcification

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Digital tomosynthesis for aortic arch calcification evaluation: performance comparison with chest radiography with CT as the reference standard

Acta Radiologica ◽

10.1258/ar.2011.110347 ◽

2012 ◽

Vol 53 (1) ◽

pp. 17-22 ◽

Cited By ~ 7

Author(s):

Eun Young Kim ◽

Myung Jin Chung ◽

Yeon Hyeon Choe ◽

Kyung Soo Lee

Keyword(s):

Radiation Dose ◽

Aortic Arch ◽

Chest Radiography ◽

Calcium Score ◽

Performance Comparison ◽

Observer Agreement ◽

Kappa Statistics ◽

Digital Tomosynthesis ◽

Reference Standard ◽

Aortic Arch Calcification

Background Recently developed digital tomosynthesis has shown improved detection of pulmonary lesions with a radiation dose comparable to conventional CR but with a much lower radiation dose than CT. Purpose To compare the diagnostic performance of digital tomosynthesis (DT) with that of chest radiography (CR) for the detection of aortic arch calcification (AAC). Material and Methods The study included 100 patients who underwent multidetector computed tomography (MDCT), DT, and CR (DT and CR were obtained within one week of CT examination). We evaluated and compared the diagnostic performances of DT and CR for the detection of AAC with MDCT as the reference standard. The extent (four grades 0–3) of AAC on DT and CR was also compared with CT calcium score. Inter-observer agreement was analyzed by using kappa statistics. Results On DT, overall accuracy for AAC was superior to that of CR (94% and 71%, respectively, P < 0.01). Inter-observer agreement was good with DT and CR (kappa values = 0.74 and 0.62, respectively) for the presence of AAC, and good with DT and moderate with CR (kappa value = 0.64 and 0.53, respectively) for AAC grading. The overall correlation coefficient on AAC grading between DT and CT (calcium score) was superior to that between CR and CT (0.90 and 0.60, respectively). Conclusion DT is superior to CR for detection and extent evaluation of AAC.

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Prognostic Implication of Longitudinal Changes in Cardiothoracic Ratio and Aortic Arch Calcification in Hemodialysis Patients

Journal of Personalized Medicine ◽

10.3390/jpm11080788 ◽

2021 ◽

Vol 11 (8) ◽

pp. 788

Author(s):

Tung-Ling Chung ◽

Yi-Hsueh Liu ◽

Jiun-Chi Huang ◽

Pei-Yu Wu ◽

Hung-Pin Tu ◽

...

Keyword(s):

Aortic Arch ◽

Chest Radiography ◽

Antiplatelet Agents ◽

Older Age ◽

X Rays ◽

Cardiothoracic Ratio ◽

Follow Up Study ◽

Significant Difference ◽

Aortic Arch Calcification

Patients with end-stage renal disease have a high prevalence of cardiovascular disease. Chest radiography can be used to assess cardiothoracic ratio (CTR) and aortic arch calcification (AoAC). The aims of this longitudinal follow-up study were to investigate factors associated with changes in CTR and AoAC and understand whether these changes are associated with overall and cardiovascular mortality in hemodialysis (HD) patients. We enrolled 260 patients undergoing HD who had at least two available chest X-rays from 2008 to 2015. CTR and AoAC were assessed in each patient using measurements from baseline and annual chest X-rays. The CTR increased from 49.05% to 51.86% and the AoAC score increased from 3.84 to 9.73 over 7 years. The estimated slopes were 0.24 (p < 0.0001) for CTR and 0.08 (p = 0.0441) for AoAC. Increased AoAC, older age, female sex, coronary artery disease, and decreased albumin were associated with an increase in CTR, and older age, cerebrovascular disease, decreased albumin, increased Kt/V, and the use of antiplatelet agents were associated with an increase in AoAC. During follow-up, 136 of the 260 (52.3%) patients died, of whom 72 died due to cardiovascular causes. The change in CTR was greater in those who died (p = 0.0125) than in those who survived. The AoAC score was also higher in those who died than in those who survived, although there was no significant difference in the change in AoAC between the two groups (p = 0.8035). CTR and AoAC increased significantly over time in the HD patients in this longitudinal follow-up study, and the change in CTR was greater in those who died than in those who survived. Chest radiography is a simple and useful tool to assess the progression of CTR and AoAC as a prognostic marker.

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Aortic Arch Calcification Is a Strong Predictor of the Severity of Coronary Artery Disease in Patients with Acute Coronary Syndrome

BioMed Research International ◽

10.1155/2019/7659239 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Xiaoteng Ma ◽

Fangjie Hou ◽

Jing Tian ◽

Zhen Zhou ◽

Yue Ma ◽

...

Keyword(s):

Coronary Artery Disease ◽

Acute Coronary Syndrome ◽

Coronary Artery ◽

Aortic Arch ◽

Prognostic Value ◽

Correct Identification ◽

X Rays ◽

Coronary Syndrome ◽

Artery Disease ◽

Aortic Arch Calcification

Background. The purpose of this study was to investigate the correlation of the extent of aortic arch calcification (AAC) detectable on chest X-rays with the severity of coronary artery disease (CAD) as evaluated by the SYNTAX score (SS) in patients with acute coronary syndrome (ACS). Methods. A total of 1,418 patients (344 women; 59 ± 10 years) who underwent coronary angiography for ACS and were treated with coronary revascularization were included in the present study; chest X-rays were performed on admission. The AAC extent was divided into four grades (0–3). SS was calculated based on each patient’s coronary angiographic findings. The relationship between the AAC extent and SS was assessed. Results. The AAC extent was positively correlated with SS (ρ = 0.639, P < 0.001). In the multivariate analysis, compared with grade 0, odds ratios (ORs) of AAC grades 1, 2, and 3 in predicting SS >22 were 12.95 (95% CI, 7.85–21.36), 191.76 (95% CI, 103.17–356.43), and 527.81 (95% CI, 198.24–1405.28), respectively. Receiver operating characteristic curve analysis yielded a strong predictive ability of the AAC extent for SS >22 (area under curve = 0.840, P < 0.001). Absence of AAC had a sensitivity, specificity, positive prognostic value, negative prognostic value, and accuracy of 46.7%, 95.9%, 94.1%, 56.4%, and 67.3%, respectively, for SS ≤22. AAC grades ≥2 had a sensitivity of 66.3%, specificity of 89.2%, positive prognostic value of 81.5%, negative prognostic value of 78.6%, and accuracy of 79.6% for the correct identification of SS >22. Conclusions. The extent of AAC detectable on chest X-rays might provide valuable information in predicting CAD severity in ACS patients.

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