title: The prognostic value of vascular diameter measurements on routine chest computed tomography in patients not referred for cardiovascular indications.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Intrathoracic diameter measurements can be used as markers to predict cardiovascular events in patients not referred for that disease outcome.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. M.gondrie@umcutrecht.nl
authors.forename: Martijn J A
authors.initials: MJ
authors.lastname: Gondrie
authors.forename: Yolanda
authors.initials: Y
authors.lastname: van der Graaf
authors.forename: Peter C
authors.initials: PC
authors.lastname: Jacobs
authors.forename: Stan C F M
authors.initials: SC
authors.lastname: Buckens
authors.forename: Willem P Th M
authors.initials: WP
authors.lastname: Mali
mesh_terms: D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D013902:Radiography, Thoracic; D012044:Regression Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods*