Atherosclerosis of the descending aorta predicts cardiovascular events: a transesophageal echocardiography study

The study group consisted of 238 consecutive in-hospital patients referred for TEE testing (135 males, 103 females, mean age 58 +/- 11 years) with a follow up of 24 months. The atherosclerotic lesions of the descending aorta were scored from 0 (no atherosclerosis) to 3 (plaque >5 mm and/or "complex" plaque with ulcerated or mobile parts).Atherosclerosis was observed in 102 patients, (grade 3 in 16, and grade 2 in 86 patients) whereas 136 patients only had an intimal thickening or normal intimal surface. There were 57 cardiovascular events in the follow-up period. The number of events was higher in the 102 patients with (n = 34) than in the 136 patients without atherosclerosis (n = 23, p < 0.01). The frequency of events was in close correlation with the severity of the atherosclerosis of the descending aorta. Fifty percent of the patients with grade 3 experienced cardiovascular events. Excluding patients with subsequent revascularization, the multivariate analysis only left ventricular function with EF < 40% (HR 3.0, CI 1.3–7.1) and TEE atherosclerotic plaque >=2 (HR 2.4, CI 1.0–5.5) predicted hard cardiovascular events.Atherosclerosis of the descending aorta observed during transesophageal echocardiography is a useful predictor of cardiovascular events.During the past decades many methods and factors have been proposed as good prognostic tools or markers for cardiovascular risk stratification. However, even with the most sophisticated stress testing procedures the prediction capability still remains imperfect [1]. Previous studies have shown that atherosclerosis of the descending aorta detected by transesophageal echocardiography (TEE) is a good marker of coexisting coronary artery disease [2-9]. Cohen et al. have demonstrated, that in patients with brain infarction, "complex" plaques (with ulcerated surface, mobile parts and thrombi) are powerful predictors of future cardiovascular events [10]. The aim of this study was to evaluate whether the presence of atheroscl