Atherosclerosis of the descending aorta predicts cardiovascular events: a transesophageal echocardiography study.
OBJECTIVE
Previous studies have shown that atherosclerosis of the descending aorta detected by transesophageal echocardiography (TEE) is a good marker of coexisting coronary artery disease. The aim of our study was to evaluate whether the presence of atherosclerosis on the descending aorta during TEE has any prognostic impact in predicting cardiovascular events.


METHODS
The study group consisted of 238 consecutive in-hospital patients referred for TEE testing (135 males, 103 females, mean age 58 +/- 11 years) with a follow up of 24 months. The atherosclerotic lesions of the descending aorta were scored from 0 (no atherosclerosis) to 3 (plaque >5 mm and/or "complex" plaque with ulcerated or mobile parts).


RESULTS
Atherosclerosis was observed in 102 patients, (grade 3 in 16, and grade 2 in 86 patients) whereas 136 patients only had an intimal thickening or normal intimal surface. There were 57 cardiovascular events in the follow-up period. The number of events was higher in the 102 patients with (n = 34) than in the 136 patients without atherosclerosis (n = 23, p < 0.01). The frequency of events was in close correlation with the severity of the atherosclerosis of the descending aorta. Fifty percent of the patients with grade 3 experienced cardiovascular events. Excluding patients with subsequent revascularization, the multivariate analysis only left ventricular function with EF < 40% (HR 3.0, CI 1.3-7.1) and TEE atherosclerotic plaque >=2 (HR 2.4, CI 1.0-5.5) predicted hard cardiovascular events.


CONCLUSIONS
Atherosclerosis of the descending aorta observed during transesophageal echocardiography is a useful predictor of cardiovascular events.
Varga
Albert
A
2nd Department of Medicine and Cardiology Center, University of Sciences, Szeged, Hungary. vargaa@in2nd.szote.u-szged.hu
Gruber
Noemi
N
Forster
Tamás
T
Piros
Györgyi
G
Havasi
Kálmán
K
Jebelovszki
Eva
E
Csanády
Miklos
M
D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality*; D003643:Death; D017548:Echocardiography, Transesophageal / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality*; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D020521:Stroke / Q000000981:diagnostic imaging / Q000401:mortality*