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Abstract
The purpose of the present study was to assess the location, severity and progression
of radiopaque lumbar aortic calcifications and to evaluate the utility of summary
scores of lumbar calcification in a population-based cohort. Lateral lumbar films,
obtained in 617 Framingham heart study participants, were analysed for the presence
of abdominal aortic wall calcification in the region corresponding to the first through
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 different composite scores: (1) affected segments score
(range 0-4); (2) anterior and posterior affected score (range 0-8); and (3) antero-posterior
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 at the follow-up exam 25 years
later. During the follow-up interval, the mean of the affected segments score increased
from 0.7 in men (0.5 in 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 between
genders) and the mean of the antero-posterior severity score increased from 1.5 (1.3
in women) to 9.3 (10.3 in women). The antero-posterior severity score offered a slight
advantage over other composite scores and had the highest inter-rater intra-class
correlations. In summary, lumbar aortic calcification can be graded and composite
summary scores are reproducible. This technique appears to provide a simple, low cost
assessment of subclinical vascular disease.