title: Ascending thoracic aneurysms are associated with decreased systemic atherosclerosis.
abstract: OBJECTIVE
  We noted clinically that patients with aortic root aneurysms and dissections seemed to have little systemic atherosclerosis. It is our objective to determine whether there is a negative association between ascending thoracic aneurysms and systemic atherosclerosis.
  
  
  METHODS
  Atherosclerosis was quantified by evaluating non-contrast CT images of the chest and scoring the degree of calcifications as a marker for atherosclerosis in the coronary arteries and aorta.
  
  
  METHODS
  The degree of calcification was compared in 64 patients with aortic root aneurysm (annuloaortic ectasia, 31 patients; type A dissection, 33 patients) vs 86 control subjects. Multivariable analysis was applied to test for an association between aortic root aneurysms and systemic calcification independent of risk factors for atherosclerosis.
  
  
  RESULTS
  Multivariable analysis revealed that patients with ascending aortic aneurysms of the annuloaortic ectasia type and patients with type A dissections had significantly lower overall calcification scores in their arterial vessels compared to patients in the control group (p = 0.03 and p < 0.0001, respectively). These results were independent of all other risk factors for atherosclerosis. Smoking, dyslipidemia, diabetes, and age were all found to increase the degree of atherosclerosis (p < 0.01 to 0.05).
  
  
  CONCLUSIONS
  Aortic root pathology (annuloaortic ectasia or type A dissection) is associated with decreased systemic atherosclerosis. It is possible that a mechanism exists whereby the same genetic mutations predisposing patients to ascending aortic aneurysms also exert a protective effect against systemic atherosclerosis.
authors.affiliation: Section of Cardiothoracic Surgery, Yale University School of Medicine, 333 Cedar St, 121 FMB, New Haven, CT 06520, USA.
authors.forename: Hardean
authors.initials: H
authors.lastname: Achneck
authors.forename: Biren
authors.initials: B
authors.lastname: Modi
authors.forename: Coralie
authors.initials: C
authors.lastname: Shaw
authors.forename: John
authors.initials: J
authors.lastname: Rizzo
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Albornoz
authors.forename: Daniel
authors.initials: D
authors.lastname: Fusco
authors.forename: John
authors.initials: J
authors.lastname: Elefteriades
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging; D001011:Aorta; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000000981:diagnostic imaging; D001027:Aortography; D001161:Arteriosclerosis / Q000150:complications* / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003331:Coronary Vessels; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed