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Ascending Aortic Dimensions and Body Size: Allometric Scaling, Normative Values, and Prognostic Performance
Hamed Tavolinejad1, Cameron Beeche2, Marie-Joe Dib1
1Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
JACC. Cardiovascular Imaging
|August 22, 2025
Summary
The area/height index accurately reflects ascending aortic dimensions across body sizes, unlike other methods. This allometrically correct index is linked to adverse cardiovascular events.
Area of Science:
- Cardiovascular imaging and diagnostics
- Biometric analysis and allometry
- Medical data analysis
Background:
- Ascending aortic (AscAo) dimensions are influenced by body size.
- Current methods for indexing AscAo dimensions, such as to height and body surface area (BSA), assume linear relationships.
- The accuracy of these linear allometric relationships is uncertain.
Purpose of the Study:
- To evaluate the allometric relationships of AscAo dimensions.
- To determine normative values for AscAo dimension indices.
- To assess the prognostic performance of different AscAo indices.
Main Methods:
- Utilized UK Biobank (n=49,271) and Penn Medicine BioBank (n=8,426) datasets.
- Employed a convolutional neural network for thoracic aorta segmentation from medical images.
- Derived normal allometric exponents using log-log models and assessed prognostic associations with Cox models.
Main Results:
- AscAo diameter/height, diameter/BSA, and area/BSA showed highly nonlinear relationships.
- The area/height index demonstrated an allometric exponent near unity, indicating a linear relationship with height.
- Area/height was the only index that consistently identified aortic dilation across body sizes and was associated with adverse events.
Conclusions:
- The area/height index is allometrically accurate for AscAo dimensions.
- This index is independent of body size and consistently predicts adverse cardiovascular events.
- Area/height offers a more reliable method for assessing AscAo dilation.
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