SPC365

Screening of thoracic aortic calcification by computed tomography for predicting clinical outcomes in patients undergoing cardiac surgery

Session: Posters (Sessão 6 - Écran 8) - Tomografia Computorizada Cardíaca
Speaker: Diana Vale Carvalho

Congress: CPC 2023
Topic: B. Imaging
Theme: 03. Imaging
Subtheme: 03.2 Computed Tomography
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Diana Vale Carvalho; Margarida Cabral; Rita Veiga; Raquel Ferreira; Mesquita Bastos; Rita Faria; Nuno Ferreira
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Background</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Thoracic aortic calcification (TAC) is a well-known marker of cardiovascular (CV) risk. Due to the risk of perioperative adverse events associated with aortic calcification, computed tomography (CT) prior to cardiac surgery (CS) is often performed. Few studies have quantified aortic calcification and correlated it with postoperative events.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Purpose</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">The aim of the study was to quantify the volume of calcium in the thoracic aorta and correlate it with perioperative clinical outcomes.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Methods</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Retrospective study including patients submitted to cardiac surgery who underwent prior concontrast CT. TAC was quantified using a volume-rendering method. The volume of calcium in each segment of the thoracic aorta was also evaluated. Demographic data, comorbidities and clinical events were compared between groups.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Results</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="background-color:white"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">148 patients were included (mean age=70,5&plusmn;4,9 years; 60,8% men). The mean value of the thoracic aortic calcification volume (TACV) was 2,079 &plusmn;&nbsp;2,390 cm3. The mean value of euroscore II was 3,2 &plusmn; 10,4. Most patients underwent aortic valve replacement surgery (66.9%). There was manipulation of the aorta in all surgeries. Dyslipidemia and arterial hypertension were the most prevalent risk factors (77% and 75%, respectively). Considering cardiovascular risk factors and comorbidities, in univariate analysis, dyslipidemia and chronic kidney disease (GFR &lt;60</span></span></span> <span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">ml/min/1.73m2) were significantly related to the TACV (p= 0.004 and p&lt;0.001, respectively). Patients with a history of coronary artery disease and peripheral artery disease also had a higher TACV (p= 0.002 and p=0.033, respectively). Regarding clinical outcomes, it was found that TACV was correlated with the occurrence of any clinical outcome in the postoperative period (p=0.036), as well as with the occurrence of atrial fibrillation [AF (p=0.05)]. Calcification of the descending thoracic aorta was also correlated with the occurrence of any complication (p=0.033), which was not significant in Cox multivariate analysis [HR 1,03 (IC 0,89-1,18; p=0,72)]</span></span></span><span style="font-size:10.0pt"><span style="font-family:&quot;ArialRegular&quot;,serif"><span style="color:black">.</span></span></span> <span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">Circumferential calcification was not associated with clinical outcomes in the postoperative period (p=0.339).</span></span></span></span></span></span></p>

<p style="text-align:justify">&nbsp;</p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Conclusions</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Aortic calcification is a risk marker for clinical outcomes in postoperative cardiac surgery. In patients undergoing CS who performed CT, outcomes seems not to be related to aortic manipulation. Our cohorts suggests that aortic calcification is a determinant of patient&#39;s CV risk, predicting complications during hospitalization namely AF. The assessment of aortic calcium volume can be an important tool to define the in-hospital risk of patients undergoing CS. </span></span></span></span></p>