Abstract 10968: Risk Factors of Aortic Plaque Progression: Evaluation of Chronological Changes With Transesophageal Echocardiography
Objectives: Aortic plaque may cause systemic embolism and patients with severe aortic plaque show poor prognosis. However, there are few data about chronological changes of aortic plaque. The purpose of this study is to examine the chronological changes of aortic plaque through transesophageal echocardiography (TEE), and to clarify the risk factors of aortic plaque progression.
Methods: Among 2675 consecutive patients who underwent TEE between 1991 and 2011, we retrospectively investigated 252 patients who underwent follow-up TEE with more than 3 years interval. The thickness and morphology of the aortic plaque were examined. Aortic plaque was graded as mild (thickness5mm, or complex plaque). Chronological changes of aortic plaque were investigated by comparing the grade between initial and follow-up TEE. Clinical factors, such as age, gender, underlying diseases, coronary risk factors, and medications, and laboratory data were evaluated.
Results: Among 252 study patients, grade of aortic plaque was unchanged in 213 patients (group U), but progression was seen in 32 patients (group P) and regression in 7 patients (group R). Patients in group P were older (64±8 vs 58±11years, p=0.004), more male (75 vs 53%, p=0.02), and had higher prevalence of ischemic heart disease (44% vs 8%, p<0.0001), hypertension (41% vs 20%, p=0.01), hyperlipidemia (34% vs 19%, p=0.06), smoking history (72% vs 37%, p=0.0004), and moderate or severe plaque at the initial TEE (63% vs 11%, p<0.0001) than group U. In multivariate analysis, moderate or severe plaque at the initial TEE was the strongest predictor of plaque progression. Among 252 patients, 50 patients showed moderate or severe plaque at the initial TEE, consisting of 20 patients in group P, 23 patients in group U and 7 patients in group R. Smoking history (p=0.04), no anticoagulant therapy (p=0.03) and renal dysfunction (p=0.05) were predictors of plaque progression among patients with moderate or severe plaque at the initial TEE.
Conclusions: We should follow the aortic plaque using TEE in patients with moderate or severe plaque at the initial TEE, in whom anticoagulant therapy may suppress aortic plaque progression.
- © 2013 by American Heart Association, Inc.