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Association of Aortic Arch Width Assessed by Noncontrast Cardiac Computed Tomography With Cardiac Remodeling, Cardiac Function, and Atherosclerosis in a Japanese Cohort

Purpose: Age-related aortic changes are related to adverse cardiac remodeling and reduced cardiac function. Here, we aim to assess the correlations between aortic arch width (AAW) and left ventricular (LV) remodeling and LV function as well as coronary artery calcification (CAC). Materials and Methods: This retrospective study included 194 patients (ages, 67±12 y) who underwent both coronary computed tomography angiography and echocardiography. The AAW is defined as the longest width between the ascending and descending aorta on a transaxial noncontrast coronary computed tomography angiography image at the level of the pulmonary artery bifurcation. Left ventricular mass, relative wall thickness ratio, left ventricular ejection fraction, left atrial volume, and early mitral inflow velocity to mitral annular early diastolic velocity ratio (E/e’) were evaluated by echocardiography. CAC was assessed by Agatston score. The relationships between AAW and echocardiography parameters were assessed, and adjusted for demographic data and cardiovascular disease risk factors by multivariate linear regression analysis. Results: AAW (mean±SD, 11.6±1.4 cm) was positively correlated with left ventricular mass (r=0.28, P<0.0001), left atrial volume (r=0.28, P<0.0001), and E/e’ (r=0.21, P<0.01). These correlations remained significant after adjustment for demographic data and cardiovascular disease risk factors. There was no correlation between AAW and left ventricular ejection fraction or relative wall thickness. There was a significant difference of AAW between the groups with Agatston score <100 and those with Agatston score ≥100, and this difference persisted after adjustment for all covariates (P<0.01). Conclusion: Greater AAW was significantly associated with LV remodeling and impaired function as well as advanced CAC.