Abstract 2224: Coronary Artery Disease Severity Selectively Correlates with Atheroma Burden of the Proximal Carotid Bulb and the Distal Thoracic Aorta
Objective: Measurements of atheroma burden (AB) of non-coronary vessels are extensively used in clinical research, with potential for use in clinical practice for cardiovascular risk stratification and treatment evaluation. We determined the distribution of atherosclerosis in the thoracic aorta and the carotid arteries and investigated the relationship between carotid, aortic and coronary atherosclerosis.
Methods: In 100 patients undergoing coronary angiography, MRI of the aorta and carotid arteries was also performed. Coronary artery disease (CAD) severity was scored using the modified Gensini method. For MRI assessment of atherosclerosis, cross-sectional vessel wall images covering the descending thoracic aorta and common carotid arteries were acquired. Atheroma was expressed as mean cross-sectional vessel wall area (WA) and mean plaque index (PI) (PI= wall area/total vessel area).
Results: Carotid AB was greatest in the carotid bulb (CB) compared to the distal common carotid (DCC) and proximal common carotid artery (PCC) (Figure 1a,b⇓) and in the middle descending aorta (MDA) and distal descending aorta (DDA) compared to the proximal descending aorta (PDA) (Figure 1c,d⇓.). CAD severity correlated with AB in CB (r<0.252, P<0.05), MDA(r<0.208, P<0.05), and DDA(r<0.222, P<0.05) but not with AB in other sites.
Only segments of the aorta and the carotid arteries with the highest AB correlate with CAD severity.
Although atherosclerosis is a systemic disease, quantification of AB in these sites has greater sensitivity for predicting extent of coronary disease;
these data emphasize the importance of the extended anatomical coverage afforded by MRI.