Aortic Unfolding Measurement Using Non-Contrast Cardiac CT: Normal Range of Low-Risk Subjects

PURPOSE: This study aimed to assess the factors influencing aortic unfolding (AU) defined by aortic width on coronary artery calcium (CAC) scan and determine the normal limits for AU. MATERIALS AND METHODS: In this retrospective study, we measured AU in 924 asymptomatic subjects who underwent CAC scanning during routine health screening from June 2015 to June 2018. Multivariate regression analysis was used to evaluate the factors influencing AU. After the exclusion of subjects with risk factors associated with AU, 283 subjects were included in the analysis of normal values of AU. Mean AU, standard deviation, and upper normal limit were calculated. RESULTS: Sex, age, CAC score, body mass index, body surface area, hypertension, left ventricular hypertrophy, plasma creatinine, and smoking were significantly associated with AU. The mean AU was 102.2 ± 12.8 mm for men and 93.1 ± 10.7 mm for women. AU increased with advancing age (9.6 mm per decade). CONCLUSION: AU determined from a single measurement on CAC scans was associated with cardiovascular risk factors. The normal limits of AU were defined by age, sex, and body surface area in low-risk subjects in this study.