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PURPOSE
This study was done to investigate the dynamic changes of the aortic root during systole and diastole in patients with coronary artery calcification (CAC) using dual-source computed tomography (DSCT).

MATERIALS AND METHODS
We retrospectively analysed 77 consecutive patients who underwent calcium-scoring and angiographic cardiac DSCT. The long- and short-axis dimensions, axis areas of the aortic annulus, sinotubular junction and ascending aorta at the level of the pulmonary trunk in diastole and systole were measured. Average dimensions and relative areal changes between diastole and systole (%RA) of aortic annulus, sinotubular junction and ascending aorta were compared.

RESULTS
Systolic and diastolic long- and short-axis dimensions of the aortic annulus in patients with CAC (n = 44) demonstrated statistically significant differences (27.00 ± 2.84 mm vs. 28.04 ± 2.62 mm; P < 0.001; 21.78 ± 2.55 mm vs. 20.88 ± 2.31 mm; P < 0.001), while differences in average diameters and areas of the aortic annulus were nonsignificant (P > 0.586). Systolic and diastolic axial areas of the sinotubular junction in patients with CAC demonstrated significant differences (7.21 ± 1.80 cm(2) vs. 6.92 ± 1.75 cm(2); P < 0.001). The %RA of the ascending aorta in patients with severe CAC (CAC score >400; n = 15) was significantly reduced compared to patients with minimal-to-moderate CAC (CAC score <400; n = 29; 4.77 ± 2.88 vs. 7.51 ± 3.81, P = 0.014).

CONCLUSIONS
In comparison with patients without CAC, the long- and short-axis dimensions of the aortic annulus and areas of the sinotubular junction show significant differences during the cardiac cycle in patients with CAC. The presence of severe CAC significantly influences the flexibility of the wall of the ascending aorta.