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Ascending Aorta 4D Time to Peak Distention Sexual Dimorphism and Association with Coronary Plaque Burden Severity in

Ahmed H Hamimi1, Ahmed M Ghanem1, Fady Hannah-Shmouni2

  • 1Biomedical and Metabolic Imaging Branch (BMIB), National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), 10 Center Drive, 1C334, Bethesda, MD, 20892, USA.

Journal of Cardiovascular Translational Research
|August 9, 2023
PubMed

Insights

A new method using aortic time-to-peak-distention (TPD) offers an objective way to assess coronary artery disease (CAD) risk. This technique shows particular promise for accurately evaluating risk in asymptomatic women.

Area of Science:

  • Cardiovascular Imaging
  • Biomedical Engineering
  • Radiology

Background:

  • Coronary artery disease (CAD) risk assessment in asymptomatic individuals, especially mid-age women, is often subjective and underestimated.
  • Traditional methods for evaluating subclinical atherosclerosis may lack objectivity and speed.
  • There is a need for improved, independent surrogate markers for early atherosclerosis detection.

Purpose of the Study:

  • To develop and validate an automatic ascending aorta time-to-peak-distention (TPD) analysis for rapid screening of subclinical atherosclerosis.
  • To evaluate TPD as an independent surrogate marker for coronary plaque burden, particularly in asymptomatic women.
  • To investigate the association between TPD and severe coronary plaque burden (Segment Involvement Score > 5).

Main Methods:

  • Coronary computed tomography angiography (CCTA) was performed on 50 asymptomatic adults.
  • Automatic TPD analysis and plaque burden (Segment Involvement Score, SIS) were quantified for all subjects.
  • Logistic regression analyses were used to assess the relationship between CAD risk scores, TPD, and severe plaque burden (SIS > 5).

Main Results:

  • Automatic TPD analysis was found to be a significant independent predictor of severe coronary plaque burden (SIS > 5).
  • Sex was identified as a significant effect modifier, with TPD showing a stronger statistically significant association with SIS > 5 in women.
  • The findings suggest TPD can effectively identify individuals with significant plaque burden.

Conclusions:

  • Four-dimensional aortic time-to-peak distention (TPD) can serve as a valuable supplement to conventional CCTA analysis.
  • TPD offers a rapid and objective screening tool for assessing plaque burden severity and cardiovascular disease risk.
  • This method holds particular importance for improving CAD risk stratification in asymptomatic women.

Keywords:
Ascending aortaAtherosclerosisCoronary artery diseaseDistensibility mapPlaque burdenPulse wave velocityTime to peak distention

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