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Ultrasound Imaging of the Thoracic and Abdominal Aorta in Mice to Determine Aneurysm Dimensions
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Site-Specific Analysis of Thoracic Aortic Aneurysm and Cardiovascular Mortality: Insights From the National Echo

James Nadel1, Avan Suinesiaputra2, Elizabeth D Paratz3

  • 1School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; Clinical Research Group, Heart Research Institute, Newtown, Australia; Cardiology Department, St. Vincent's Hospital, Darlinghurst, Australia.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|November 16, 2025
PubMed

Insights

Severe thoracic aortic aneurysm (TAA) significantly increases cardiovascular disease (CVD) mortality risk. Ascending aorta dilatation poses a higher CVD risk than aortic root aneurysms, informing future risk stratification and surgical management.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Public Health

Background:

  • Aortic diameter is the primary criterion for thoracic aortic aneurysm (TAA) surgical correction.
  • Current guidelines do not differentiate TAA management based on aneurysm location (root vs. ascending aorta).
  • Understanding site-specific TAA impact on cardiovascular disease (CVD) mortality is crucial for improving clinical practice.

Purpose of the Study:

  • To investigate the association between thoracic aortic aneurysm (TAA) dimensions at different sites and cardiovascular disease (CVD) mortality.
  • To determine if ascending aortic aneurysm size influences CVD mortality risk differently than aortic root aneurysm size.

Main Methods:

  • Utilized the National Echo Database Australia (NEDA) linked to the National Death Index.
  • Stratified patients based on aortic diameters at the sinuses of Valsalva, sinotubular junction, and ascending aorta (AscAo).
  • Grouped aortic dimensions into normal (<4 cm) and dilated categories (mild, moderate, severe).

Main Results:

  • Severe TAA at any site increased 10-year CVD mortality risk (31% vs. 14%, P < .0001).
  • CVD mortality risk increased progressively from the aortic root to the ascending aorta.
  • Ascending aorta dilatation showed the highest CVD mortality risk (45%, HR 3.96, P < .001).

Conclusions:

  • Severe TAA elevates cardiovascular mortality probability.
  • Ascending aortic dilatation presents a higher CVD mortality risk than aortic root aneurysms.
  • Findings suggest revised risk stratification and surgical management considerations for ascending aortic aneurysms.
Abstract

Keywords:
Aortic aneurysmAortic dissectionAortopathyCardiovascular mortalityEchocardiographyEpidemiology

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