Abstract 13199: Longitudinal Change in Aortic Plaque Volume Using Cardiovascular Magnetic Resonance: Clinical Correlates
Introduction: Cardiovascular magnetic resonance (CMR) allows reproducible, noninvasive quantitation of aortic atheromatous plaque. We sought to assess change in aortic plaque volume across serial CMR examinations in the Framingham Heart Study Offspring cohort and to determine clinical correlates of change in plaque burden.
Methods: 237 adults (59±9 ys, 118M) underwent aortic CMR (axial T2W black-blood turbo spin echo) in 1998–99 (CMR1) and again 2002–2005 (CMR2)). Plaque was defined as luminal protrusions ≥1-mm radial thickness and manually segmented. Participants were classified as: NONE = no plaque on either exam, INCR = increased plaque volume on CMR2, and DECR = decreased plaque volume on CMR2. Pearson correlation coefficient and analysis of covariance (ANCOVA) adjusting for well established covariates were used to assess association between clinical characteristics and change in aortic plaque burden.
Results: Mean interval between CMR1 and CMR2 was 5.2±0.5 years. There were 79 INCR participants (33%), 68 (29%) DECR and 90 (38%) NONE participants. Mean absolute change in plaque volume was 2.5-fold greater in INCR than in DECR (Table), i.e. overall plaque gains were greater than losses. Smoking (p=0.0008), diastolic blood pressure (p=0.01) and greater age (p=0.0003) at CMR1 were associated with an increase in plaque burden at CMR2. Sex, anthropometric measures, systolic blood pressure, cholesterol levels and glycemic status at CMR1 were not significantly associated with change in aortic plaque.
Discussion: Serial CMR examinations demonstrate an increase in aortic plaque burden over 5 years in one-third of participants. While 29% had a decrease in measured aortic plaque, the magnitude of change was 2.5 fold smaller and may be related to noncontiguous coverage (interslice gap) or plaque remodeling. Smoking, diastolic blood pressure and age were the strongest predictors of plaque progression.
- © 2010 by American Heart Association, Inc.