Risks of stroke and heart attack increase with larger thoracic aortic diameter, research shows

Tuesday in Radiology, researchers highlighted a correlation between the diameter of the thoracic aorta as a biomarker for future heart attacks and adverse cardiovascular events in men and women. 

Over an average period of nine years, experts followed up with more than 2,000 patients who had undergone multi-detector CT scans of the ascending (AA) and descending thoracic aorta (DA). In both men and women, larger BMI-indexed AA and DA diameters were associated with higher risk of all-cause mortality. 

"While enlargement of the thoracic aorta is a frequent finding in clinical practice, few longitudinal data regarding its long-term prognosis for major cardiovascular disease outcomes at the population level exist," said study senior author Maryam Kavousi, MD, from the Department of Epidemiology at Erasmus MC, University Medical Center Rotterdam in Rotterdam, the Netherlands. 

The study consisted of 2,178 participants (average age of 69) who underwent multi-detector CT scans between 2003 and 2006. Using those scans, researchers indexed the participants’ thoracic aorta diameters for body mass index (BMI). After imaging, patients were followed for an average of nine years. 

For women, researchers observed that a larger BMI-indexed AA diameter was associated with a 33% higher cardiovascular mortality risk. There was also a correlation between increased risk of stroke (38%) and cardiovascular mortality (46%) in participants with larger BMI-indexed DA diameters. The experts noted that although larger BMI-indexed AA and DA diameters were associated with increased risk of adverse cardiovascular outcomes in both men and women, women in particular appeared to be more susceptible to quicker deterioration of the aging aorta. 

"Aging could affect aortic health and structure more adversely in women than in men," Kavousi explained. "This provides an exciting and unique opportunity to study sex-specific risk profiles and patterns of growth in thoracic aorta in the general population.” 

Experts involved in the study noted that these CT findings could lead to more sex-specific prevention strategies in symptomatic men and women, and that thoracic aorta size assessment could be easily implemented into current cardiovascular disease screening protocols since cardiac CT scans are already common practice. 

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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