Association Between Aortic Wall Parameters on Multidetector Computed Tomography and Ruptured Plaques By Nonobstructive General Angioscopy

Masatsugu Miyagawa, Keisuke Kojima, Kurara Takahashi, Yuki Nakajima, Shohei Migita, Saki Mizobuchi, Yudai Tanaka, Katsunori Fukumoto, Riku Arai, Tomoyuki Morikawa, Takashi Mineki, Nobuhiro Murata, Mitsumasa Sudo, Daisuke Fukamachi, Yasuo Okumura

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Nonobstructive general angioscopy (NOGA) can identify vulnerable plaques in the aortic lumen that serve as potential risk factors for cardiovascular events such as embolism. However, the association between computed tomography (CT) images and vulnerable plaques detected on NOGA remains unknown. METHODS AND RESULTS: We investigated 101 patients (67±11 years; women, 13.8%) who underwent NOGA and contrastenhanced CT before or after 90 days in our hospital. On CT images, the aortic wall thickness, aortic wall area (AWA), and AWA in the vascular area were measured at the thickest point from the 6th to the 12th thoracic vertebral levels. Furthermore, the association between these measurements and the presence or absence of NOGA-derived aortic plaque ruptures (PRs) at the same vertebral level was assessed. NOGA detected aortic PRs in the aortic lumens at 145 (22.1%) of the 656 vertebral levels. The presence of PRs was significantly associated with greater aortic wall thickness (3.3±1.7 mm versus 2.1±1.2 mm), AWA (1.33±0.68 cm2 versus 0.89±0.49 cm2), and AWA in the vascular area (23.2%±9.3% versus 17.2%±7.6%) (P<0.001 for all) on the CT scans compared with the absence of PRs. The frequency of PRs significantly increased as the aortic wall thickness increased. Notably, a few NOGA-derived PRs were detected on CT in near-normal intima. CONCLUSIONS: The presence of NOGA-derived PRs was strongly associated with increased aortic wall thickness, AWA, and AWA in the vascular area, measured using CT. NOGA can detect PRs in the intima that appear almost normal on CT scans.

Original languageEnglish
Article numbere033233
JournalJournal of the American Heart Association
Volume13
Issue number6
DOIs
Publication statusPublished - 19 Mar 2024

Keywords

  • NOGA
  • angioscopy
  • aortic wall area
  • aortic wall thickness
  • plaque ruptures

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