Differences in Echocardiographic Measures of Aortic Dimensions by Race

It is not clear whether there are differences in aortic dimensions by race. Our hypothesis was that race-specific differences in aortic size exist. We compared the relation between race and aortic dimensions among 15,295 adults without known risk factors for cardiovascular disease or aortic dilatation, who underwent clinically indicated transthoracic echocardiography. We compared inner edge-to-inner edge measurements between whites (n = 12,932), blacks (n = 958), Asians (n = 827), Hispanics (n = 366), Native Americans (n = 38), and others (n = 174). Multivariate analysis compared measurements indexed with body surface area (BSA) between races and adjusted for variables including age, gender, and mean blood pressure. Mean age was 49.9 ± 17.6 years, and 58.7% were female. On gender-specific comparisons, there were significant differences in aortic size between races (p <0.001 for each). Using whites as a baseline, multivariable analysis demonstrated that blacks had smaller BSA-indexed aortic sinus (-0.34 mm/m², p <0.001) and ascending aorta (-0.43 mm/m², p <0.001) dimensions; Asians had larger BSA-indexed aortic sinus (0.36 mm/m², p <0.001), ascending aorta (0.41 mm/m², p <0.001), and aortic arch (0.20 mm/m², p = 0.002) dimensions; Hispanics had larger BSA-indexed aortic arch dimensions (0.15 mm/m², p = 0.01); Native Americans had increased BSA-indexed aortic arch dimensions (0.32 mm/m², p = 0.01); and other races had increased BSA-indexed aortic arch dimensions (0.11 mm/m², p = 0.03). In a cohort without known risk factors for aortic dilatation, race is associated with significant differences in aortic dimensions. In conclusion, these findings suggest that reference ranges for aortic size should be established using racially diverse cohorts to prevent misdiagnosis of aortic dilatation based on race.