Aortic root diameter and risk of cardiovascular events in a general population

Abstract

Our results for the first time show that ARD indexed to height is predictive of incident nonfatal and fatal cardiovascular events among middle-aged individuals in the community and support the view that assessment of ARD in addition to left ventricular mass may refine cardiovascular risk stratification and preventive strategies in the general population.

Increased Proximal Aortic Diameter is Associated With Risk of Cardiovascular Events and All‐Cause Mortality in Blacks The Jackson Heart Study

“…AoD indexed to BSA has been recommended in the current American Society of Echocardiography and European Association of Echocardiography guidelines 28. However, in several previous cross‐sectional and longitudinal studies, height was the most important determinant of AoD and therefore was regarded as more appropriate to normalize AoD 1, 10, 11. In the cross‐sectional analysis of the current study, height and BSA were significantly correlated with AoD, but both correlations were modest.…”

“…In the Cardiovascular Health Study, a greater AoD was associated with a higher incidence of several cardiovascular events, including incident HF, stroke, cardiovascular mortality, and all‐cause mortality 9. In the Pamela study, a larger AoD indexed to height, but not absolute AoD or AoD indexed to BSA, was associated with cardiovascular events 11. In the Framingham Heart Study, a larger AoD was associated with incident HF 8.…”

“…Cox proportional hazards models after testing for proportionality assumption were used to estimate the hazard ratios (HRs) of cardiovascular events or all‐cause mortality using AoD as a continuous variable as well as categorical variable (top quintile versus the rest). We used absolute AoD, AoD indexed to height (in cm), and AoD indexed to body surface area (BSA; in m 2 ) as suggested by previous literature and guidelines 11. Two models, minimally and fully adjusted models, were constructed to evaluate associations of AoD with outcomes, and we did not include squared measures for any of the variables in these analyses.…”

Relationship between aortic root size and glomerular filtration rate in hypertensive patients

“…There are some data, although not unanimous, that seem to support the concept that in hypertensive patients aortic root dilatation may represent an index of target organ damage, paralleling markers of well documented prognostic value such as left ventricular (LV) hypertrophy (LVH), carotid atherosclerosis and microalbuminuria [5][6][7][8][9][10][11][12][13][14]. Recent population-based studies showed that an enlarged ARD might predict an adverse prognosis, even in absence of aneurysmatic alterations [15][16][17][18].…”

How to Identify Hypertensive Patients at High Cardiovascular Risk? The Role of Echocardiography

“…In 6,483 participants to Framingham Heart Study, followed-up over an 8-year period, the risk of incident heart failure progressively increased with baseline ARD values [41]; the association of ARD with incident heart failure, however, lost statistical significance after adjustment for LV mass. In the PAMELA population, the adjusted risk for non-fatal and fatal cardiovascular events in subjects with both LVH and ARD was three-fold higher (HR = 2.8, 95 % CI 1.6-5.1, p \ 0.0005) than in reference group and much higher than in subjects with isolated LVH (HR = 1.9, 95 % CI 1.2-2.9, p = 0.003) [42]. Overall, these findings point towards an adverse prognostic significance of ARD even the absence of aneurysmatic aortic disease.…”