Key result
Heart diameter (HR 1.04; 95% CI 1.03-1.06) and ascending thoracic diameter (HR 1.002; 95% CI 1.001-1.004) on routine chest CT predicted incident cardiovascular events.
Why the study?
Do diameter measurements of the thoracic aorta and heart on routine chest CT predict future cardiovascular events in patients without cardiovascular indications?
Cohort (n=10,410)
Do diameter measurements of the thoracic aorta and heart on routine chest CT predict future cardiovascular events in patients without cardiovascular indications?
Incidental findings of enlarged intrathoracic diameters on routine chest CT can serve as prognostic markers for future cardiovascular events in patients without known cardiovascular indications.
Answers are grounded in this paper and cite their sources.
May support opportunistic CV risk assessment on routine CT; hypothesis-generating and should not yet change practice.
OBJECTIVES: The aim of the study was to investigate whether diameter measurements of the thoracic aorta and the heart can be used as prognostic markers for future cardiovascular disease. METHODS: Following a case-cohort design, a total of 10,410 patients undergoing chest computed tomography were followed up for a mean period of 17 months. The ones with a cardiovascular indication were excluded. Diameter measurements were evaluated with Cox proportional hazard analysis. RESULTS: Five hundred fifteen incident cardiovascular events occurred during follow-up. The heart (hazard ratio [HR], 1.04; 95% confidence interval [CI], 1.03-1.06) and ascending thoracic (HR, 1.002; 95% CI, 1.001-1.004) diameter showed an exponential prognostic effect beyond a threshold diameter of, respectively, 11 and 30 mm; the descending aortic diameter (HR, 1.04; 95% CI, 1.01-1.13) and cardiothoracic ratio (HR, 1.06; 95% CI, 1.04-1.08) showed linear prognostic effects beyond, respectively, 25 and 0.45 mm. CONCLUSION: Intrathoracic diameter measurements can be used as markers to predict cardiovascular events in patients not referred for that disease outcome.
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Gondrie et al. (2011) conducted a cohort in Patients undergoing chest computed tomography without cardiovascular indications (n=10,410). Vascular and heart diameter measurements on routine chest CT was evaluated on Incident cardiovascular events (HR 1.04, 95% CI 1.03-1.06). Heart diameter (HR 1.04; 95% CI 1.03-1.06) and ascending thoracic diameter (HR 1.002; 95% CI 1.001-1.004) on routine chest CT predicted incident cardiovascular events.
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