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Volume 9, Issue 2, Pages 187-196 (June 2014) Computed Tomographic Evidence of Atherosclerosis in the Mummified Remains of Humans From Around the World Randall C. Thompson, Adel H. Allam, Albert Zink, L. Samuel Wann, Guido P. Lombardi, Samantha L. Cox, Bruno Frohlich, M. Linda Sutherland, James D. Sutherland, Thomas C. Frohlich, Samantha I. King, Michael I. Miyamoto, Janet M. Monge, Clide M. Valladolid, Abd el-Halim Nur el-din, Jagat Narula, Adam M. Thompson, Caleb E. Finch, Gregory S. Thomas Global Heart Volume 9, Issue 2, Pages 187-196 (June 2014) DOI: 10.1016/j.gheart.2014.03.2455 Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 1 An Egyptian mummy undergoing computed tomographic scanning. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 2 Coronal thick maximum intensity projection reconstruction of the computed tomographic scan of Hatiay, a scribe from the 18th Dynasty of Ancient Egypt. There are heavy calcifications in the superficial femoral arteries (arrows). Reprinted, with permission, from Allam et al. [13]. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 3 Sagittal thick maximum intensity projection reconstruction of the computed tomographic scan of Hatiay, a scribe from the 18th Dynasty of Ancient Egypt. There are heavy calcifications in the left carotid bulb (arrows). Reprinted, with permission, from Allam et al. [13]. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 4 Volume-rendered computed tomographic image of the mummy Hatiay, a scribe from the 18th Dynasty of Ancient Egypt. There are heavy calcifications in the carotid bulbs, the brachiocephalic artery and the left subclavian artery (arrows). Reprinted, with permission, from Thompson et al. [14]. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 5 Coronal thick maximum intensity projection image of the computed tomography of Princess Ahmose-Meryet-Amon, a member of the royal household in the 17th Dynasty of Ancient Egypt. There are heavy calcifications at the aortic bifurcation and in the common iliac arteries (arrows). Reprinted, with permission, from Allam et al. [13]. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 6 Volume-rendered computed tomographic image of the mummy of Princess Ahmose-Meryet-Amon, a member of the royal household in the 17th Dynasty of Ancient Egypt. There are heavy calcifications in the right and left coronary arteries (arrows). RCA, right coronary artery. Reprinted, with permission, from Allam et al. [13]. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 7 Sagittal view, thick maximum intensity projection reconstruction of a computed tomographic scan of the Egyptian mummy Djeher. There are heavy calcifications in the left coronary artery (arrow). Reprinted, with permission, from Allam et al. [12]. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 8 Volume-rendered computed tomographic reconstruction of the Egyptian mummy Lady Hudson. There are heavy calcifications in the carotid bulbs (arrows). Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 9 Modified axial thick maximum projection image of the computed tomographic scan of the neck of the Egyptian mummy Lady Hudson. Heavy calcifications in the right and left carotid bulb are seen (arrows). Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 10 Volume-rendered reconstruction of the computed tomographic scan of an ancient Egyptian mummy. There are heavy calcifications in the abdominal aorta and the internal and external iliac arteries. Reprinted, with permission, from Thompson et al. [14]. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 11 Historical distribution of mummies with and without atherosclerosis from the Horus Study and The Tyrolean Iceman (*). Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 12 An ancient Peruvian mummy bundle being scanned by computed tomography. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 13 Volume-rendered whole-body computed tomographic scan image of an ancient Peruvian mummy. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 14 Mummy of Rosita, a woman who lived in ancient Peru (Chancay culture, Late Intermediate Period, ad 1000 to 1534) and is housed at the Huando Museum in Peru. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 15 Modified axial view thick maximum intensity projection image of the computed tomographic scan of Rosita, an ancient Peruvian mummy (Chancay culture, Late Intermediate Period, ad 1000 to 1534). There are calcifications in the aortic arch vessels (arrow). Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 16 Volume-rendered image of a computed tomographic scan of the mummy of an Ancestral Puebloan woman. Calcifications in the aorta and iliac arteries are seen. Reprinted, with permission, from Thompson et al. [14]. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 17 Volume-rendered reconstruction of a computed tomographic scan of the mummy of an ancient Peruvian woman. There are heavy calcifications at the aortic bifurcation and in the right iliac. Reprinted, with permission, from Thompson et al. [14]. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 18 Volume-rendered image of a computed tomographic scan of the mummy of an Aleutian Island woman. Heavy calcifications are seen in the ascending aorta and the aortic arch and in the right coronary artery. RCA, right coronary artery. Reprinted, with permission, from Thompson et al. [14]. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 19 The Tyrolean Iceman, Ötzi. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 20 Oblique coronal maximum intensity projection image of the computed tomographic scan of the pelvis of the mummy of the Tyrolean Iceman. There are calcifications in the distal abdominal aorta (arrow). Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 21 Modified axial view maximum intensity projection image of the upper chest of a Mongolian mummy (circa 1450) found in the Gobi Desert. There is an atherosclerotic arterial calcification in an aortic arch vessel (arrow). Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 22 Volume-rendered image of the computed tomographic scan of the Mongolian mummy seen in Figure 21. This individual died from strangulation. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions

Figure 23 Mean estimated age at death of the mummies in the 3 categories of atherosclerosis in the Horus Study. Error bars show 95% confidence intervals. Reprinted, with permission, from Thompson et al. [14]. Global Heart 2014 9, 187-196DOI: (10.1016/j.gheart.2014.03.2455) Copyright © 2014 World Heart Federation (Geneva) Terms and Conditions