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Published on: June 29, 2014
Dilated aortic root is related to a global aortic dilating diathesis
Josep M Alegret1, Nahum Calvo, Carme Ligero
1Secció de Cardiologia, Hospital Universitari de Sant Joan, Reus, Spain. txalegret@hotmail.com
Insights
Dilated aortic root is linked to varied aortic diameters, influenced by age and valve type. Older patients with tricuspid aortic valves require comprehensive aortic assessment due to systemic dilatation risks.
Area of Science:
- Cardiovascular Imaging
- Aortic Diseases
- Radiology
Background:
- Aortic root dilatation is a critical indicator of potential aortic aneurysm.
- Understanding the relationship between aortic root and other aortic segments is vital for risk stratification.
Purpose of the Study:
- To analyze the association between aortic root dilatation and the diameters of the entire aorta.
- To identify factors predicting higher risk of aortic aneurysm.
Main Methods:
- Prospective helical computed tomography (CT) in 71 patients with dilated aortic root.
- Measurement of aortic diameters at seven levels in the thoracic and abdominal aorta.
Main Results:
- Moderate correlation between ascending aorta and thoracic/abdominal aorta diameters in tricuspid aortic valve patients.
- Age and aortic regurgitation independently predicted aortic diameters.
- Age, body surface area, and aortic regurgitation grade predicted aortic volume.
Conclusions:
- Aortic diameter patterns vary with age, aortic valve morphology, and function.
- Older patients with tricuspid aortic valves and dilated aortic roots need thorough cardiovascular evaluation.
- Findings support the systemic nature of aortic dilatation.
Objective:
The purpose of this study was to analyze the association between the dilatation of the aortic root and the diameters of the rest of the aorta and to identify some related factors that could be used to identify patients at higher risk of presenting with an aortic aneurysm.
Methods:
In 71 consecutive patients with a dilated aortic root identified by transthoracic echocardiography, prospective helical computed tomography was performed. Aortic diameters were measured perpendicular to the flow at seven levels in the thoracic and abdominal aorta.
Results:
Ascending aorta diameter showed a moderate correlation with aortic indexed diameters at the thoracic and abdominal level in tricuspid aortic valve patients (r ranging from 0.37-0.56), whereas in patients with a bicuspid aortic valve, a moderate correlation between the ascending aorta diameters and the thoracic descending aorta diameters was observed (r 0.51-0.53). In a multivariate analysis, age was independently related to indexed diameter at all aortic sites (β ranging from 0.06-0.12 per year), whereas aortic regurgitation was independently related only to thoracic aorta diameter (β ranging from 1.17-1.84). Age (P < .0001), body surface area (P < .0001), and grade of aortic valve regurgitation (P = .001) independently predicted aortic volume.
Conclusion:
Different patterns of aortic diameters were observed in patients with dilated aortic root, depending on age, aortic valve morphology, and function. When a dilated aortic root is detected in older patients with a tricuspid aortic valve, an accurate cardiovascular survey that includes the entire aorta is needed. These results provide further evidence about the systemic nature of aortic dilatation.
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