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Ascending aorta dilatation is associated to hard cardiovascular events, follow-up from multicentric ARGO-Perspective

Lorenzo Airale1, Francesco Borrelli1, Alessio Arrivi2

  • 1Department of Medical Sciences, Hypertension Center-University of Torino-AOU Città della Salute e della Scienza di Torino, Torino, Italy.

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|June 16, 2023
PubMed

Insights

Aortic root dilatation is linked to a higher risk of major adverse cardiovascular events in hypertensive patients. This finding highlights aortic dilatation as a significant predictor of cardiovascular outcomes, even after accounting for other risk factors.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Medicine

Background:

  • Aortic root dilatation is a potential hypertension-mediated organ damage (HMOD).
  • Previous studies on aortic root dilatation as HMOD are heterogeneous, lacking clarity on its role.
  • Essential hypertension poses significant cardiovascular risks, necessitating identification of all HMODs.

Purpose of the Study:

  • To investigate the association between aortic root dilatation (AAD) and major adverse cardiovascular events (MACE).
  • To determine if AAD is an independent predictor of MACE in patients with essential hypertension.
  • To clarify the role of AAD as a potential HMOD.

Main Methods:

  • A cohort of 445 hypertensive patients was recruited from six Italian hospitals (ARGO-SIIA study).
  • Patients were followed for a median of 60 months, with data collected via telephone and hospital records.
  • Aortic dilatation was defined using sex-specific thresholds (41 mm for males, 36 mm for females).

Main Results:

  • AAD was significantly associated with an increased occurrence of MACE (HR=4.07, p<0.001).
  • This association remained significant after adjusting for age, sex, and body surface area (HR=2.91, p=0.020).
  • AAD was an independent predictor of MACE, even after correction for established HMODs like left atrial enlargement and left ventricular hypertrophy (HR=2.43, p=0.045).

Conclusions:

  • Ascending aorta dilatation is associated with a substantially increased risk of MACE in hypertensive individuals.
  • AAD should be considered a significant predictor of cardiovascular events in essential hypertension.
  • Identifying and managing aortic root dilatation may be crucial for preventing cardiovascular complications in hypertensive patients.

Keywords:
Arterial hypertensionAscending aortaAscending aorta dilatationPrognosisTransthoracic echocardiography

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