Growth of the thoracic aorta in the smoking population: The Danish Lung Cancer Screening Trial. (15th January 2020)

• Record Type: Journal Article
• Authors: Bons, Lidia R.; Sedghi Gamechi, Zahra; Thijssen, Carlijn G.E.; Kofoed, Klaus F.; Pedersen, Jesper H.; Saghir, Zaigham; Takkenberg, Johanna J.M.; Kardys, Isabella; Budde, Ricardo P.J.; de Bruijne, Marleen; Roos-Hesselink, Jolien W.
• Is Part Of: International journal of cardiology. Volume 299(2020)
• Page Start: 276
• Page End: 281
• Publication Date: 2020-01-15
• Subjects: Aortic growth -- Thoracic aorta -- Computed tomography -- Smoking; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2019.06.010
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Although the descending aortic diameter is larger in smokers, data about thoracic aortic growth is missing. Our aim is to present the distribution of thoracic aortic growth in smokers and to compare it with literature of the general population. Methods: Current and ex-smokers aged 50–70 years from the longitudinal Danish Lung Cancer Screening Trial, were included. Mean and 95th percentile of annual aortic growth of the ascending aortic (AA) and descending aortic (DA) diameters were calculated with the first and last non-contrast computed tomography scans during follow-up. Determinants of change in aortic diameter over time were investigated with linear mixed models. Results: A total of 1987 participants (56% male, mean age 57.4 ± 4.8 years) were included. During a median follow-up of 48 months, mean AA and DA growth rates were comparable between males (AA 0.12 ± 0.31 mm/year and DA 0.10 ± 0.30 mm/year) and females (AA 0.11 ± 0.29 mm/year and DA 0.13 ± 0.27 mm/year). The 95th percentile ranged from 0.42 to 0.47 mm/year, depending on sex and location. Aortic growth was comparable between current and ex-smokers and aortic growth was not associated with pack-years. Our findings are consistent with aortic growth rates of 0.08 to 0.17 mm/years in the general population. Larger aortic growth was associated with lower age, increased height, absence of medication for hypertension or hypercholesterolemia and lower Agatston scores. Conclusions: This longitudinal study of smokers in the age range of 50–70 years shows that ascending and descending aortic growth is approximately 0.1 mm/year and is consistent with growth in the general population. Highlights: In current and ex-smokers, the ascending and descending aorta grows on average 0.1 mm/year Aortic growth was comparable between current and ex-smokers and was not associated with pack-years Thoracic aortic growth in smokers is consistent with cross-sectional data from the general population Annual growth did not statistically significantly differ between males and females Based on 95th percentiles, aortic growth of 0.5 mm/year can be considered the upper limit of normal