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Ascending Aortic Dimensions in Hypertensive Subjects: Reference Values for Two-Dimensional Echocardiography
Enrico Vizzardi1, Francesco Maffessanti2, Roberto Lorusso3
1Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Community Hospital and University of Brescia, Brescia, Italy.
Summary
Hypertension is linked to larger aortic diameters, particularly at the sinotubular junction and aortic arch. This study confirms hypertension as an independent factor for aortic dilation, impacting cardiovascular disease risk.
Area of Science:
- Cardiology
- Vascular Biology
- Medical Imaging
Background:
- Aortic dilation is a key indicator of cardiovascular disease risk.
- The relationship between hypertension and aortic dilation remains debated, with limited data on the ascending aorta.
- Previous studies primarily focused on the aortic root, neglecting other segments.
Purpose of the Study:
- To investigate ascending aorta (AscAo) dimensions in hypertensive individuals.
- To determine if hypertension is an independent risk factor for aortic dilation across multiple aortic segments.
- To assess the prevalence of aortic dilation in hypertensive patients.
Main Methods:
- Prospective enrollment of 1,027 hypertensive patients and 1,002 healthy controls.
- Two-dimensional echocardiography used to measure aortic diameters at four levels: sinuses of Valsalva, sinotubular junction (STJ), AscAo, and aortic arch (AoArch).
- Measurements were taken at end-diastole using the leading edge-to-leading edge convention.
Main Results:
- Hypertensive patients exhibited significantly larger aortic diameters compared to controls.
- Age, body size, and male sex were correlated with increased aortic diameters.
- Multivariate analysis confirmed hypertension as an independent factor associated with increased diameters at all measured levels, with notable increases at the STJ (4.1 mm) and AoArch (2.2 mm).
- A high prevalence of aortic dilation was observed in hypertensive patients at the STJ (14%) and AoArch (7%).
Conclusions:
- Hypertension is an independent predictor of aortic dilation, alongside age, sex, and body surface area.
- The study highlights increased aortic diameters in hypertensive patients across all measured segments.
- Aortic dilation is more prevalent at the sinotubular junction and aortic arch in hypertensive individuals, underscoring the need for cardiovascular risk assessment.
