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Updated: Mar 21, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Association Between Thoracic Aorta Calcium and Thoracic Aorta Geometry in a Cohort of Asymptomatic Participants at
Damian Craiem1, Jean-Marc Alsac2, Mariano E Casciaro3
1Facultad de Ingeniería Ciencias Exactas y Naturales, Universidad Favaloro, CONICET, Buenos Aires, Argentina; Centre de Médecine Préventive Cardiovasculaire, APHP, Hôpital Européen Georges Pompidou, Paris, France; INSERM U970, APHP, Hôpital Européen Georges Pompidou, Paris, France; Université Paris-Descartes, Paris-Centre de Recherche Cardiovasculaire, Hôpital Européen Georges Pompidou, Paris, France.
Insights
Thoracic aorta calcifications are linked to aortic size and shape, particularly in the descending aorta and arch. These findings may inform different prevention strategies for aortic dilatation.
Area of Science:
- Cardiovascular imaging
- Aortic disease research
- Medical diagnostics
Background:
- Thoracic aorta calcium detection enhances cardiovascular risk prediction beyond traditional factors.
- Aortic calcifications are increasingly recognized as a marker for cardiovascular events.
Purpose of the Study:
- To investigate the relationship between thoracic aorta morphometry and the presence/extent of aortic calcifications.
- To determine how aortic geometry influences aortic calcium deposition.
Main Methods:
- Utilized nonenhanced computed tomography scans from 970 asymptomatic individuals at high cardiovascular risk.
- Employed an automated algorithm to assess thoracic aorta geometry and quantify aortic calcium (Agatston score).
- Applied nonparametric and logistic regression models to analyze calcium scores and anatomical associations.
Main Results:
- Aortic calcifications were primarily located in the aortic arch and descending aorta.
- Higher calcium amounts correlated with an enlarged, unfolded, less tapered, and more tortuous aorta.
- Descending aorta enlargement showed the strongest association with high calcium scores (OR 3.62 per 2.5-mm increase).
Conclusions:
- Thoracic aorta calcium is concentrated in the arch and descending segments, associated with their size.
- Ascending aorta size was not correlated with aortic calcium, suggesting distinct pathomechanisms.
- Aortic dilatation may require segment-specific preventive strategies based on underlying mechanisms.
Introduction And Objectives:
Thoracic aorta calcium detection is known to improve cardiovascular risk prediction for cardiac and noncardiac events beyond traditional risk factors. We investigated the influence of thoracic aorta morphometry on the presence and extent of aortic calcifications.
Methods:
Nonenhanced computed tomography heart scans were performed in 970 asymptomatic participants at increased cardiovascular risk. An automated algorithm estimated the geometry of the entire thoracic aorta and quantified the aortic calcium Agatston score. A nonparametric model was used to analyze the percentiles of calcium score by age. Logistic regression models were calculated to identify anatomical associations with calcium levels.
Results:
Calcifications were concentrated in the aortic arch and descending portions. Higher amounts of calcium were associated with an enlarged, unfolded, less tapered and more tortuous aorta. The size of the ascending aorta was not correlated with aortic calcium score, whereas enlargement of the descending aorta had the strongest association: the risk of having a global calcium score > 90th percentile was 3.62 times higher (confidence interval, 2.30-5.91; P < .001) for each 2.5-mm increase in descending aorta diameter. Vessel taper, tortuosity, unfolding and aortic arch and descending volumes were also correlated with higher amounts of calcium.
Conclusions:
Thoracic aorta calcium was predominantly found at the arch and descending aorta and was positively associated with the size of the descending aorta and the aortic arch, but not with the size of the ascending aorta. These findings suggest that aortic dilatation may have different mechanisms and may consequently require different preventive strategies according to the considered segments.
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