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Background-Coronary atherosclerosis and cognitive impairment are both age-related diseases, with similar risk factors. Coronary artery calcium (CAC), a marker of coronary atherosclerosis, may play a role in early detection of individuals prone to cognitive decline. This study aimed to investigate the relationship between CAC and cognitive function, and the capability of CAC to identify participants with a high risk of dementia in a Chinese community-based population. Methods-A total of 1 332 participants, aged 40-80 years and free of dementia from a community located in Beijing were included. All participants completed neurocognitive questionnaires and noncontrast CT examinations. Cognitive performance tests (including verbal memory, semantic fluency, executive function, and global cognitive function tests), the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CIDE) risk score, and the CAC score (CACS) were evaluated by questionnaires and CT. A CAIDE score ≥ 10 was considered to indicate a high risk of dementia in late-life. Participants were divided into three groups according to CACS (0, 1-399, ≥ 400). Results-After adjusting for risk factors, CACS was significantly associated with verbal memory ( r = -0.083, P = 0.003) and global cognitive function ( r = -0.070, P = 0.012). The prevalence of a high risk of dementia in the subgroups of CACS = 0, 1-399, and ≥ 400 was 4.67%, 13.66%, and 24.79%, respectively ( P < 0.001). Individuals with CACS ≥ 400 had a higher risk of CAIDE score ≥ 10 [OR = 2.30 (1.56, 4.56), P = 0.014] than those with CACS = 0. The receiver-operating characteristic curves showed that the capability of CACS to identify participants with a high risk of dementia was moderate (AUC = 0.70, 95% CI: 0.67-0.72, P < 0.001). Conclusions-CAC, a marker of subclinical atherosclerosis, was significantly associated with cognitive performance in verbal memory and global cognitive function. CAC had a moderate capability to identify participants with a high risk of dementia, independent of age, education, and other risk factors. [ABSTRACT FROM AUTHOR]

Background: A limitation associated with coronary computed tomography angiography (CCTA) is the lack of a normal reference value for aortic root dimensions and the uncertainty of the influence of age and gender on these dimensions. The purpose of the present study was to identify the normal values and variations of aortic root dimensions in healthy individuals and investigate how gender and age affect aortic root size. Methods: A total of 1286 healthy yellow population (52.7 ± 11.0 years, 634 male) who underwent CCTA were retrospectively included in the present study. Male and female patients were divided into seven groups according to age (< 30 years old, 30– 39, 40– 49, 50– 59, 60– 69, 70– 79, ≥ 80 years old). In these age groups, we measured and compared the parameters of the aortic root. Results: After body surface area (BSA) correction, the aortic root parameters of females were found to be greater than those of males in the 40– 49 age group (P< 0.05). There were no significant differences in aortic root parameters between genders in other age groups, except for the diameter of the ascending aorta, which was greater in females (P< 0.05). In males, age was positively correlated with aortic root parameters (P< 0.05), except for the annulus short diameter and LVOT short diameter. In females, age was positively correlated with aortic root parameters (P< 0.05), except for the left coronary ostia height and the LVOT short diameter. Conclusion: Aortic root dimensions are affected by age and gender. After BSA correction, females show larger aortic root dimensions than males, and aortic root diameters increase with age. [ABSTRACT FROM AUTHOR]

Background: For complicated Stanford type B aortic dissection (TBAD), thoracic endovascular aortic repair (TEVAR) is the recommended treatment; however, the type of renal artery that should be repaired remains controversial. The study aimed to investigate the changes in the renal artery and renal volume in complicated TBAD after TEVAR and the predictors of renal atrophy., Methods: The cohort study retrospectively enrolled patients with acute and subacute complicated TBAD who underwent aortic computed tomography angiography (CTA) 1 month before as well as 1 week and half a year after TEVAR from January 2010 to May 2017. According to the source of blood supply shown in preoperative CT, the renal artery was classified in 3 ways: type 1, supplied by the aortic true lumen; type 2, supplied by the aortic false lumen; or type 3, supplied by both the true and false lumen., Results: A total of 91 patients (81 men and 10 women) with an average age of 48.12±10.35 years were enrolled. Renal arteries were classified as type 1 (n=91), type 2 (n=35), and type 3 (n=56). There was no difference in the distribution of the 3 types on the left and right sides (type 1 vs. type 2 vs. type 3: 52:39 vs. 15:20 vs. 24:32; P=0.152). After TEVAR, type 3 was more likely to have spontaneous healing than type 2 (16.1% vs. 2.9%; P=0.049). There was no significant difference in the preoperative volume of kidneys of the 3 types (type 1 vs. type 2 vs. type 3: 198.23±38.68 vs. 197.37±41.77 vs. 195.10±36.11 mL; P=0.893). The postoperative volume of types 2 and 3 was smaller than that of type 1 (type 1 vs. type 2 vs. type 3: 190.09±43.25 vs. 165.15±52.63 vs. 170.70±45.28 mL; P=0.006). The renal volume was reduced in all 3 types of renal artery, especially in type 2 (the change of renal volume for type 1 vs. type 2 vs. type 3: -8.14±29.31 vs. -32.22±41.59 vs. -24.41±38.44 mL; P=0.001). The relative change of renal volume for type 1 vs. type 2 vs. type 3: (-3.64±15.69)% vs. (-16.00±21.29)% vs. (-11.97±18.22)%; P=0.001). During the median follow-up of 668 days, 7 patients (7.7%) belonging to types 2 and 3 developed renal atrophy. False lumen thrombosis in the abdominal aorta and/or the renal artery was the predictor of renal atrophy [hazard ratio (HR) =17.757; P=0.008]., Conclusions: Patients with type 2 or 3 renal artery and false lumen thrombosis in the abdominal aorta and/or renal artery should be monitored closely and actively intervened to prevent renal atrophy., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-21-1240/coif). The authors have no conflicts of interest to declare., (2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Background: The napkin-ring sign (NRS) was accepted as unstable plaques at coronary computed tomography angiography (CCTA). However, the incidence is relatively low. We sought to assess whether the newly defined diamond-attenuation-sign [DAS, defined as a qualitative plaque feature in a mixed plaque (MP) on CCTA cross-section images by the presence of two features: a visual calcification (in the shape of a diamond) accompanied by an annular-shape lower attenuation plaque tissue surrounding the lumen like a ring], could be accurately identified as unstable atherosclerotic plaques., Methods: Eight heart transplant recipients (8 male; mean age, 48.5±11.6 years; range, 37-65 years) underwent CCTA exams prior to heart transplant surgery. Segment-based CCTA sections were independently evaluated for various plaque patterns including non-calcified plaque (NCP) with NRS (NCP-NRS), NCP without NRS (NCP-non-NRS), MP with DAS (MP-DAS), MP without DAS sign (MP-non-DAS), and calcified plaque (CP)., Results: NCP-NRS plaques in 6.4% (23/358), NCP-non-NRS plaques in 24.0% (86/358), MP-DAS plaques in 18.2% (65/358), MP-non-DAS plaques in 20.1% (72/358), and calcified-plaques in 7.0% (25/358) of all cases. The specificity and positive predictive values of the MP-DAS and NCP-NRS signs to identify unstable plaque features were excellent (97.1% vs . 98.6%, 90.8% vs. 87.0%, respectively). DAS plaques were more frequently seen on CCTA exams than that of NRS (39.3% vs. 13.3%, respectively, P=0.001). The diagnostic performance of MP-DAS to identify unstable coronary lesions was superior compared to NCP-NRS [area under the receiver operating characteristic curve (ROC), 0.756; 95% CI: 0.717-0.791 vs. 0.558; 95% CI: 0.514-0.600, respectively, P<0.001]., Conclusions: Both the DAS and NRS had a high specificity and positive predictive value for the presence of unstable lesions. DAS was a better identification of unstable atherosclerotic plaques in the assessment of plaque-calcification-pattern (PCP)., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-21-521/coif). The authors have no conflicts of interest to declare., (2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.)