NEW INDEXES TO CLASSIFY LOCATION, SEVERITY AND PROGRESSION OF CALCIFIC LESIONS IN THE ABDOMINAL-AORTA - A 25-YEAR FOLLOW-UP-STUDY

The purpose of the present study was to assess the location, severity and progression of radiopaque lumbar aortic calcifications and to eval uate the utility of summary scores of lumbar calcification in a popula tion-based cohort. Lateral lumbar films, obtained in 617 Framingham he art study participants, were analysed for the presence of abdominal ao rtic wall calcification in the region corresponding to the first throu gh fourth lumbar vertebrae. The severity of the anterior and posterior aortic calcification were graded individually on a 0-3 scale for each lumbar segment and the results were summarized to develop four differ ent composite scores: (1) affected segments score (range 0-4); (2) ant erior and posterior affected score (range 0-8); and (3) antero-posteri or severity score (range 0-24). The prevalence of aortic calcification was 37% in men and 27% in women at baseline and 86% in both genders a l the follow-up exam 25 years later. During the follow-up interval, th e mean of the affected segments score increased from 0.7 in men (0.5 i n women) to 2.7 (2.8 in women), the mean of the anterior and posterior affected score from 1.2 (0.8 in women) (P = 0.012 for difference betw een genders) and the mean of the antero-posterior severity score incre ased from 1.5 (1.3 in women) to 9.3 (10.3 in women). The antero-poster ior severity score offered a slight advantage over other composite sco res and had the highest inter-rater intra-class correlations. In summa ry, lumbar aortic calcification can be graded and composite summary sc ores are reproducible. This technique appears to provide a simple, low cost assessment of subclinical vascular disease. (C) 1997 Elsevier Sc ience Ireland Ltd.