Risk Factors of Aortic Plaque Progression Evaluated by Long-Term Follow Up Data With Transesophageal Echocardiography

• Published in: The American journal of cardiology 2017-06, Vol.119 (11), p.1872-1876
• Main Authors: Izumi, Chisato, MD, PhD, Miyake, Makoto, MD, Amano, Masashi, MD, Matsutani, Hayato, BS, Hashiwada, Sumiyo, BS, Kuwano, Kazuyo, BS, Kuroda, Maiko, MD, Nishimura, Shunske, MD, Yoshikawa, Yusuke, MD, Takahashi, Yusuke, MD, Onishi, Naoaki, MD, Tamaki, Yodo, MD, PhD, Enomoto, Soichiro, MD, PhD, Tamura, Toshihiro, MD, PhD, Kondo, Hirokazu, MD, PhD, Kaitani, Kazuaki, MD, PhD, Nakagawa, Yoshihisa, MD, PhD
• Format: Article
• Language: English
• Subjects: Aneurysms; Anticoagulants; Aorta; Aorta, Thoracic - diagnostic imaging; Aortic Diseases - diagnosis; Atherosclerosis; Blood clots; Cardiovascular; Cardiovascular disease; Cholesterol; Coronary artery; Coronary artery disease; Coronary vessels; Creatinine; Diabetes; Disease Progression; Echocardiography; Echocardiography, Transesophageal - methods; Female; Follow-Up Studies; Forecasting; Health risks; Heart diseases; Humans; Hypertension; Laboratories; Lipids; Male; Middle Aged; Morphology; Multivariate analysis; NMR; Nuclear magnetic resonance; Patients; Plaque, Atherosclerotic - diagnosis; Plaques; Prognosis; Quality; Regression analysis; Reproducibility of Results; Retrospective Studies; Risk analysis; Risk Factors; Severity of Illness Index; Smoking; Statins; Stroke; Warfarin
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2017.02.036

Abstract There are few longitudinal data regarding aortic plaque. This study aimed to examine chronological changes in aortic plaques with transesophageal echocardiography (TEE), and to clarify the risk factors of aortic plaque progression. Among 2675 consecutive patients who underwent TEE, we retrospectively investigated 252 patients who underwent follow-up TEE with an interval >3years. The thickness and morphology of aortic plaques were examined. Chronological changes in aortic plaques were investigated by comparing baseline and follow-up TEE. Clinical factors, laboratory data, and medications were evaluated. Among 252 study patients, the grade of aortic plaques was unchanged in 213 (group U), but progression was observed in 32 (group P) and regression in 7 patients (group R). Patients in group P were older, they had a higher prevalence of coronary artery disease, hypertension, smoking habit, and moderate or severe plaque at baseline TEE, more patients were using statins and no warfarin, and they had higher creatinine levels than those in group U. In multivariate analysis, moderate or severe plaques at baseline TEE were the strongest predictor of plaque progression. Among 50 patients who showed moderate or severe plaque at baseline TEE, smoking habit and no anticoagulation therapy were predictors of plaque progression. In conclusion, aortic plaques should be followed up using TEE in patients with moderate or severe plaque at baseline TEE.