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Title: Incidental Thoracic Aortic Dilation On Chest Computed Tomography In Patients With Atrial Fibrillation.
Austin Authors: Ramchand, Jay ;Bansal, Agam;Saeedan, Mnahi Bin;Wang, Tom Kai Ming;Agarwal, Ritu;Kanj, Mohamed;Wazni, Oussama;Svensson, Lars G;Desai, Milind Y;Harb, Serge C;Schoenhagen, Paul;Burrell, Louise M ;Griffin, Brian P;Popović, Zoran B;Kalahasti, Vidyasagar
Affiliation: Section of Cardiovascular Imaging, Imaging Institute, Cleveland Clinic, OH, USA
Medicine (University of Melbourne)
Aorta Center, Heart and Vascular Institute, Cleveland Clinic, OH, USA
Section of Cardiovascular Imaging, Imaging Institute, Cleveland Clinic, OH, USA
Section of Electrophysiology, Cardiovascular Institute, Cleveland Clinic
Aorta Center, Heart and Vascular Institute, Cleveland Clinic, OH, USA
Issue Date: Feb-2021
Date: 2020-10-31
Publication information: The American Journal of Cardiology 2021; 140: 78-82
Abstract: Individuals with atrial fibrillation (AF) have risk factors that predispose to thoracic aneurysmal disease (TAD) and atherosclerosis. In this study in individuals with AF, we assessed the occurrence of incidental TAD and assessed if a validated predictive score used to predict AF, the CHARGE-AF score, was associated with greater aortic dimensions. We also assessed the prevalence of coronary calcification. We conducted a cross-sectional study of 1,000 consecutive individuals with AF undergoing chest multidetector CT during evaluation for pulmonary vein isolation. A dilated aortic root (AR) or ascending aorta (AA, dimension/ body surface area >2.05cm/m2) were found in 195 (20%). A total of 12 (1%) had significant aortic aneurysmal enlargement of > 5.0cm. Advancing age, a bicuspid aortic valve, hypertension and male gender were associated with increased aortic dimensions. Aortic root dimensions increased linearly (P<0.001) and ascending aortic dimensions increased non-linearly across CHARGE-AF deciles (P<0.001). Nearly two-thirds (63%) had coronary calcification, 38% of whom were not on lipid-lowering therapy. In conclusion, in individuals with AF undergoing gated chest CT, 1 in 5 had previously undetected TAD, with a small proportion having significantly aneurysmal dimensions approaching surgical thresholds. Risk factors previously established to increase the propensity to develop AF are also associated with increased TAD. These findings raise the need to consider a surveillance strategy for TAD in patients with AF, particularly in those with other risk factors for aortic disease. A high prevalence of coronary calcium was also detected, representing an opportunity to optimize statin therapy in patients with AF.
DOI: 10.1016/j.amjcard.2020.10.059
Journal: The American Journal of Cardiology
PubMed URL: 33144160
Type: Journal Article
Subjects: Aortopathy
atrial fibrillation
computed tomography
Appears in Collections:Journal articles

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