Abstract 9460: Increased Aortic and Main Pulmonary Arterial Diameters Are Independent Predictors of Incident Cardiovascular Disease Events
Introduction: Aortic dilation is associated with multiple cardiovascular disease (CVD) risk factors. We sought to determine whether enlargement of the aorta or main pulmonary artery (MPA) is an independent predictor of future adverse CVD events.
Methods: 1715 Framingham Offspring cohort members without prevalent CVD (69±9 y, 47% men) underwent cardiovascular magnetic resonance (CMR) of the aorta and MPA during 2002-2005. CMR at 1.5T used a free-breathing, ECG gated, black blood, fat suppressed T2-W turbo spin-echo sequence with 1.03x0.64-mm2 spatial resolution and 5-mm slice thickness. Luminal diameters of the ascending (ASC) and descending thoracic (DTA) aorta and MPA were measured at the level of MPA bifurcation, the abdominal aorta (ABD) was measured just below the renal arteries. Incident hard CVD events included CV death, myocardial infarction, coronary insufficiency, stroke and hospitalized congestive heart failure. For each vessel segment Cox proportional hazards regression models (adjusted for age, sex, body mass index, systolic blood pressure, pack years smoked; treatment for hypertension, diabetes or dyslipidemia; current smoking; emphysema) were used to assess hazard of a hard CVD event per 5mm of vessel diameter.
Results: Over a mean 6.5-year follow up there were 60 (3.3%) incident hard CVD events. The Table shows mean±SD diameters by sex and sex-pooled hazard ratios (HR) and 95% confidence intervals (CI) for hard CVD events per 5 mm increase in vessel diameter. Men had greater mean diameters than women. Increasing diameter of each vessel segment, except ASC, was associated with greater multi-variable adjusted hazard of adverse CVD events. Results were qualitatively similar after indexation of diameters to height.
Conclusion: In a community-dwelling cohort of adults initially free of clinical CVD, greater luminal diameter of the descending aorta or the MPA, measured by noncontrast CMR, is an independent predictor of future adverse CVD events.
- © 2013 by American Heart Association, Inc.