A Novel Evaluation for Predicting Aortic Complicated Lesions Using Calcification on Chest X-ray

Area of Science:

• Cardiology
• Neurology
• Radiology

Background:

• The aorta is a primary source of cerebral thromboembolisms.
• Aortic complicated lesions (ACLs) are crucial for identifying embolic sources.
• Transesophageal echocardiography (TEE) is invasive, prompting investigation into alternative predictive methods.

Purpose of the Study:

• To investigate the relationship between aortic arch calcification (AAC) on chest X-ray and ACLs.
• To evaluate AAC as a non-invasive predictor of ACLs, an indicator of stroke risk.

Main Methods:

• 300 patients with ischemic stroke/TIA underwent TEE and chest X-ray.
• AAC was graded (0-3) and measured for thickness; ACLs defined by intima-media thickness (IMT) ≥4.0 mm or plaques.
• Diagnostic abilities of AAC grade, AAC thickness, and carotid IMT were compared.

Main Results:

• ACLs were found in 23.7% of patients.
• Higher AAC grade and thickness were significantly associated with ACLs (p < 0.001).
• AAC thickness (≥6 mm) was a significant predictor of ACLs and ulcerated/mobile plaques.

Conclusions:

• AAC on chest X-ray is significantly associated with ACLs.
• AAC thickness is a more useful predictor of ACLs than AAC grade.
• AAC thickness shows predictive value comparable to carotid IMT for ACLs.