Inverse Correlation Between Calcium Accumulation and the Expansion Rate of Abdominal Aortic Aneurysms

Background:When the maximal diameter of an abdominal aortic aneurysm (AAA) exceeds a threshold, the likelihood of catastrophic rupture increases markedly. Therefore, surveillance at optimal intervals should be offered to patients with AAA. However, other than AAA diameter, there is no useful marker...

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Published in:Circulation Journal 2016/01/25, Vol.80(2), pp.332-339
Main Authors: Nakayama, Atsuko, Morita, Hiroyuki, Hayashi, Naoto, Nomura, Yukihiro, Hoshina, Katsuyuki, Shigematsu, Kunihiro, Ohtsu, Hiroshi, Miyata, Tetsuro, Komuro, Issei
Format: Article
Language:English
Subjects:
Abdominal aortic aneurysm
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - diagnostic imaging
Aortic Aneurysm, Abdominal - metabolism
Atherosclerosis
Calcium - metabolism
Calcium accumulation
Computed tomography
Expansion rate
Female
Follow-Up Studies
Humans
Male
Multidetector Computed Tomography - methods
Retrospective Studies
Vascular Calcification - diagnostic imaging
Vascular Calcification - metabolism
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Summary:Background:When the maximal diameter of an abdominal aortic aneurysm (AAA) exceeds a threshold, the likelihood of catastrophic rupture increases markedly. Therefore, surveillance at optimal intervals should be offered to patients with AAA. However, other than AAA diameter, there is no useful marker or index for predicting the expansion rate of an AAA or determining the optimal intervals for surveillance. The aim of this study was to evaluate the usefulness of calcium accumulation in the AAA for predicting its expansion rate.Methods and Results:We performed a retrospective cohort study in 414 patients with infrarenal AAA who visited The University of Tokyo Hospital. The maximal diameter and extent of calcification of each AAA were evaluated by multidetector-row computed tomography imaging. There was an inverse correlation between the extent of calcification and the subsequent AAA expansion. A lower extent of calcification in the AAA as well as the AAA diameter and absence of coronary artery disease correlated with an accelerated expansion of the AAA.Conclusions:In AAA, a lower extent of calcification correlated with accelerated expansion. The calcification index of an AAA can be a useful predictor of its expansion rate. The study findings also support the theory that the mechanisms for progression in atherosclerosis with calcification and external expansion of an aneurysm are distinct. (Circ J 2016; 80: 332–339)
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-15-1065