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Computed tomography of dynamic changes of the aortic root during systole and diastole in patients with coronary artery calcification

Xiaohan Hu, Claudia Frellesen, Ralf Bauer, J Matthias Kerl, Martin Beeres, Boris Bodelle, Thomas Lehnert, Thomas J Vogl & Julian L Wichmann

abstract

PURPOSE
This study was done to investigate the dynamic changes of the aortic root during systole and diastole in patients with coronary artery calcification (CAC) using dual-source computed tomography (DSCT).

MATERIALS AND METHODS
We retrospectively analysed 77 consecutive patients who underwent calcium-scoring and angiographic cardiac DSCT. The long- and short-axis dimensions, axis areas of the aortic annulus, sinotubular junction and ascending aorta at the level of the pulmonary trunk in diastole and systole were measured. Average dimensions and relative areal changes between diastole and systole (%RA) of aortic annulus, sinotubular junction and ascending aorta were compared.

RESULTS
Systolic and diastolic long- and short-axis dimensions of the aortic annulus in patients with CAC (n = 44) demonstrated statistically significant differences (27.00 ± 2.84 mm vs. 28.04 ± 2.62 mm; P < 0.001; 21.78 ± 2.55 mm vs. 20.88 ± 2.31 mm; P < 0.001), while differences in average diameters and areas of the aortic annulus were nonsignificant (P > 0.586). Systolic and diastolic axial areas of the sinotubular junction in patients with CAC demonstrated significant differences (7.21 ± 1.80 cm(2) vs. 6.92 ± 1.75 cm(2); P < 0.001). The %RA of the ascending aorta in patients with severe CAC (CAC score >400; n = 15) was significantly reduced compared to patients with minimal-to-moderate CAC (CAC score <400; n = 29; 4.77 ± 2.88 vs. 7.51 ± 3.81, P = 0.014).

CONCLUSIONS
In comparison with patients without CAC, the long- and short-axis dimensions of the aortic annulus and areas of the sinotubular junction show significant differences during the cardiac cycle in patients with CAC. The presence of severe CAC significantly influences the flexibility of the wall of the ascending aorta.
   
citation Hu X, Frellesen C, Bauer R, Kerl J M, Beeres M, Bodelle B, Lehnert T, Vogl T J, Wichmann J L. Computed tomography of dynamic changes of the aortic root during systole and diastole in patients with coronary artery calcification. Radiol Med 2015; 120:595-602.
   
type journal paper/review (English)
date of publishing 03-02-2015
journal title Radiol Med (120/7)
ISSN electronic 1826-6983
pages 595-602
PubMed 25644250
DOI 10.1007/s11547-015-0503-7