Aortic Root Dimension as an Independent Predictor for All‐Cause Death in Adults &lt;65 Years of Age (from The Chin‐Shan Community Cardiovascular Cohort Study)

Lai, Chao‐Lun; Chien, Kuo–Liong; Hsu, Hsiu-Ching; Su, Ta‐Chen; Chen, Ming-Fong; Lee, Yuan‐Teh

doi:10.1111/j.1540-8175.2009.01072.x

Cited by 28 publications

(38 citation statements)

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“…The main reason of the discrepancy between the results of our study and the previous ones may be related to the characteristics of our study population, including chiefly patients with CKD and impaired renal function, whereas in the other studies conducted in essential hypertensive individuals [5,7,10,11], or in population-based cohorts [8,[15][16][17][18], patients with kidney disease were excluded or were minimally represented.…”

Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 93%

“…In the majority of these studies kidney functional status was not evaluated [6,9,[12][13]17,31] or assessed by using serum creatinine [5,8,11,[15][16]18], or creatinine clearance [7]. For example, in the above-mentioned CCCC study [16] serum creatinine tended to be higher in the participants with greater ARD/BSA, even if this trend did not attain statistical significance (P ¼ 0.10). Similar findings were obtained in the LIFE (Losartan Intervention For Endpoint reduction in hypertension) trial by Bella et al [10], and in the 3366 essential hypertensive patients enrolled in the Evaluation of Target Organ Damage in Hypertension (ETODH) observational registry by Cuspidi et al [5], as well as in another investigation performed by the same authors in a subset of never treated patients with primary hypertension [11].…”

Section: Discussionmentioning

confidence: 93%

“…For the great influence of BSA on aortic root dimensions, it has been proposed to normalize the absolute values of ARD for BSA [1][2]30], considering also that such an indexation predicted the risk of rupture, dissection and death in patients with thoracic aortic aneurysms, better than did unadjusted aortic root size [2,4]. Furthermore, ARD indexed for BSA showed a significant association with all-cause death in the participants aged below 65 years, enrolled in the Chin-Shan Community Cardiovascular Cohort (CCCC) study [16].…”

Section: Discussionmentioning

confidence: 98%

“…There are some data, although not unanimous, that seem to support the concept that in hypertensive patients aortic root dilatation may represent an index of target organ damage, paralleling markers of well documented prognostic value such as left ventricular (LV) hypertrophy (LVH), carotid atherosclerosis and microalbuminuria [5][6][7][8][9][10][11][12][13][14]. Recent population-based studies showed that an enlarged ARD might predict an adverse prognosis, even in absence of aneurysmatic alterations [15][16][17][18].…”

Section: Introductionmentioning

confidence: 92%

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Relationship between aortic root size and glomerular filtration rate in hypertensive patients

Mulè

Nardi

Morreale

et al. 2016

Journal of Hypertension

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 92%

See 3 more Smart Citations

Relationship between aortic root size and glomerular filtration rate in hypertensive patients

Mulè

Nardi

Morreale

et al. 2016

Journal of Hypertension

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The Relationship Between Aortic Root Size and Hypertension: An Unsolved Conundrum

Mulè

Nardi

Morreale

et al. 2016

Advances in Experimental Medicine and Biology

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Thoracic aortic aneurysms rupture and dissection are among the most devastating vascular diseases, being characterized by elevated mortality, despite improvements in diagnostic imaging and surgical techniques.An increased aortic root diameter (ARD) represents the main risk factor for thoracic aortic dissection and rupture and for aortic valve regurgitation.Even though arterial hypertension is commonly regarded as a predisposing condition for the development of thoracic aorta aneurysms, the role of blood pressure (BP) as determinant of aortic root enlargement is still controversial. The use of different methods for indexation of ARD may have in part contributed to the heterogeneous findings obtained in the investigations exploring the relationships between ARD and BP. Indeed, the best methods for ARD indexation, as well as the normal values of aortic root size, are still a matter of debate.Several non-hemodynamic factors influence ARD, including age, gender, and anthropometric variables, such as height, weight and their derivatives body surface area (BSA) and body mass index. Of these factors, anthropometric variables have the greatest impact.Several studies documented an association between ARD enlargement, assessed by echocardiography, and some indices of hypertensive target organ damage such as left ventricular hypertrophy, diastolic dysfunction, and carotid intima-media thickening. Recently, we found that ARD, expressed either as absolute values or normalized for BSA (ARD/BSA) or height (ARD/H), was significantly greater in hypertensive subjects with chronic kidney disease (CKD) when compared to their counterparts with normal renal function. Moreover, at univariate analyses estimated glomerular filtration rate (eGFR) showed significant inverse correlations with ARD not indexed and with ARD/BSA and ARD/H. Taking into account the effect of age, sex, duration of hypertension and other potentially confounding factors, in multiple regression analyses, only the association of GFR with ARD/H and that between GFR and ARD/BSA remained statistically significant. The receiver-operating characteristic curve analysis revealed that an estimated GFR of about 50 ml/min/1.73 m represents the better threshold to distinguish hypertensive patients with dilated aortic root from those with a normal one.Some population-based studies showed that an enlarged ARD might predict an adverse prognosis, even in absence of aneurysmatic alterations.In the Cardiovascular Health Study, a dilated aortic root was independently associated with an increased risk for stroke, cardiovascular and total mortality in both sexes and with incident congestive heart failure only in men. The relationship between ARD and heart failure has been observed also in the Framingham Heart Study. More recently, the PAMELA (Pressioni Arteriose Monitorate E Loro Associazioni) study demonstrated an independent relationship of ARD/H with incident cardiovascular morbidity and mortality.Although the relationship between BP and aortic root size is still a matter of debate, in...

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Transthoracic echocardiographic reference values of the aortic root: results from the Hamburg City Health Study

Wenzel¹,

Nikorowitsch²,

Senftinger³

et al. 2021

Int J Cardiovasc Imaging

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Here we generate up-to-date reference values of transthoracic echocardiographic aortic root dimensions matched by sex, age, and body surface area (BSA) derived from the population-based Hamburg City Health Study (HCHS) cohort. In 1687 healthy subjects (mean age 57.1 ± 7.7, 681 male and 1006 female), derived from the first prospectively-recruited 10,000 HCHS participants, dimensions of the aortic root were measured in systole and diastole using state-of-the-art 2-dimensional transthoracic echocardiography. Diameters were assessed at four levels: aortic annulus, Sinus of Valsalva, sinotubular junction, and ascending aorta. Female sex was associated with significantly smaller absolute aortic root dimensions, while indexing for BSA resulted in a reverse effect at all levels. There was a strong age dependency of all aortic root diameters as well as aortic annulus/sinotubular junction ratio for both sexes. Multivariate analysis revealed age, sex, weight, height, and BSA to be significant determinants of aortic root size. Finally, formulas were generated for the calculation of individual aortic root reference values considering age, sex, weight, and height. We provide population-based reference values of aortic root diameters based on a standardized transthoracic echocardiographic protocol of the population-based HCHS which may support the diagnosis, monitoring, and treatment of aortic root disease.

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Aortic Root Dimension as an Independent Predictor for All‐Cause Death in Adults <65 Years of Age (from The Chin‐Shan Community Cardiovascular Cohort Study)

Abstract: Our study showed a significant association between AOI and all-cause death in adults <65 years in an ethnic Chinese population. (Echocardiography 2010;27:487-495).

Cited by 28 publications

References 28 publications

Relationship between aortic root size and glomerular filtration rate in hypertensive patients

Relationship between aortic root size and glomerular filtration rate in hypertensive patients

The Relationship Between Aortic Root Size and Hypertension: An Unsolved Conundrum

Transthoracic echocardiographic reference values of the aortic root: results from the Hamburg City Health Study

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