Related Experiment Video
Updated: Jul 12, 2025
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
Thoracic Aortic Volume as a Predictor of Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis
Sreeja Sanampudi1, Gisela Teixidó-Turà2, Tomoki Fujii3
1The University of Kentucky, Lexington, Kentucky, USA.
Insights
Greater thoracic aortic volume (TAV) is linked to increased cardiovascular (CV) event risk. This study found TAV associates with age and hypertension, but inversely with diabetes and lipid medication use in a multiethnic cohort.
Area of Science:
- Cardiovascular Imaging and Diagnostics
- Aortic Disease Research
- Biomarker Discovery for Cardiovascular Risk
Background:
- The prognostic value of thoracic aortic volume (TAV) for cardiovascular (CV) disease risk remains uncertain.
- Assessing TAV's utility in cardiovascular risk stratification is crucial for clinical decision-making.
Purpose of the Study:
- To investigate the cross-sectional associations between TAV and traditional CV risk factors.
- To determine the longitudinal association of TAV with incident CV events within the Multi-Ethnic Study of Atherosclerosis (MESA).
Main Methods:
- A retrospective cohort analysis of prospective data from 1182 participants without prior CV disease was conducted.
- TAV was quantified using Simpson's method from MRI scans, encompassing the ascending aorta, arch, and descending segments.
- Cox regression models assessed the association between TAV and incident CV events over a 9-year follow-up.
Main Results:
- Higher TAV was independently associated with an increased risk of incident CV events (HR: 1.057 per 10 mL).
- TAV showed direct associations with age, male gender, systolic blood pressure, and hypertension medication use.
- Inverse associations were observed between TAV and lipid medication use, as well as treated diabetes. Significant ethnic variations in TAV were also noted.
Conclusions:
- Increased thoracic aortic volume is an independent predictor of incident cardiovascular events.
- TAV is associated with key cardiovascular risk factors including age and hypertension, with differential associations based on treatment status and ethnicity.
Background:
It is unclear whether thoracic aortic volume (TAV) is useful for cardiovascular (CV) disease prognosis and risk assessment.
Purpose:
This study evaluated cross-sectional associations of TAV with CV risk factors, and longitudinal association with incident CV events in the multiethnic study of atherosclerosis.
Study Type:
Retrospective cohort analysis of prospective data.
Population:
1182 participants (69 ± 9 years, 54% female, 37% Caucasian, 18% Chinese, 31% African American, 14% Hispanic, 60% hypertensive, and 20% diabetic) without prior CV disease.
Field Strength And Sequences:
Axial black-blood turbo spin echo or bright blood steady-state free precession images on 1.5T scanners.
Assessment:
TAV was calculated using Simpson's method from axial images, and included the ascending arch and descending segments. Traditional CV risk factors were assessed at the time of MRI. CV outcomes over a 9-year follow-up period were recorded and represented a composite of stroke, stroke death, coronary heart disease (CHD), CHD death, atherosclerotic death, and CVD death.
Statistical Tests:
Multivariable linear regression models adjusted for height and weight were used to determine the relationship (β coefficient) between TAV and CV risk factors. Cox regression models assessed the association of TAV and incident CV events. A P-value of <0.05 was deemed statistically significant.
Results:
Mean TAV was = 139 ± 41 mL. In multivariable regression, TAV was directly associated with age (β = 1.6), male gender (β = 23.9), systolic blood pressure (β = 0.1), and hypertension medication use (β = 7.9); and inversely associated with lipid medication use (β = -5.3) and treated diabetes (β = -8.9). Compared to Caucasians, Chinese Americans had higher TAV (β = 11.4), while African Americans had lower TAV (β = -7.0). Higher TAV was independently associated with incident CV events (HR: 1.057 per 10 mL).
Conclusion:
Greater TAV is associated with incident CV events, increased age, and hypertension in a large multiethnic population while treated diabetes and lipid medication use were associated with lower TAV.
Level Of Evidence:
2 TECHNICAL EFFICACY: Stage 2.
Related Concept Videos
01:15Thoracic Aorta
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:27Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
01:11Cardiac Output and Stroke Volume
In an average resting adult male, the typical cardiac...
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:15Aortic Regurgitation I: Introduction