Dilated aortic root is related to a global aortic dilating diathesis

• Published in: Journal of vascular surgery 2010-10, Vol.52 (4), p.867-871
• Main Authors: Alegret, Josep M., PhD, Calvo, Nahum, MD, Ligero, Carme, MD, Palomares, Raquel, MD, Millá, Lidón, MD, Martín-Paredero, Vicente, PhD, Montero, Manuel, MD, Joven, Jorge, PhD
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aorta, Abdominal - diagnostic imaging; Aorta, Abdominal - pathology; Aorta, Thoracic - diagnostic imaging; Aorta, Thoracic - pathology; Aortic Aneurysm - etiology; Aortic Aneurysm - pathology; Aortic Valve - abnormalities; Aortic Valve - diagnostic imaging; Aortic Valve Insufficiency - complications; Aortic Valve Insufficiency - diagnostic imaging; Aortography - methods; Biological and medical sciences; Blood and lymphatic vessels; Body Surface Area; Cardiology. Vascular system; Chi-Square Distribution; Dilatation, Pathologic; Diseases of the aorta; Echocardiography; Female; Humans; Linear Models; Male; Medical sciences; Middle Aged; Prospective Studies; Risk Assessment; Risk Factors; Severity of Illness Index; Spain; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tomography, Spiral Computed; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2010.04.073

Objective The purpose of this study was to analyze the association between the dilatation of the aortic root and the diameters of the rest of the aorta and to identify some related factors that could be used to identify patients at higher risk of presenting with an aortic aneurysm. Methods In 71 consecutive patients with a dilated aortic root identified by transthoracic echocardiography, prospective helical computed tomography was performed. Aortic diameters were measured perpendicular to the flow at seven levels in the thoracic and abdominal aorta. Results Ascending aorta diameter showed a moderate correlation with aortic indexed diameters at the thoracic and abdominal level in tricuspid aortic valve patients ( r ranging from 0.37-0.56), whereas in patients with a bicuspid aortic valve, a moderate correlation between the ascending aorta diameters and the thoracic descending aorta diameters was observed ( r 0.51-0.53). In a multivariate analysis, age was independently related to indexed diameter at all aortic sites (β ranging from 0.06-0.12 per year), whereas aortic regurgitation was independently related only to thoracic aorta diameter (β ranging from 1.17-1.84). Age ( P < .0001), body surface area ( P < .0001), and grade of aortic valve regurgitation ( P = .001) independently predicted aortic volume. Conclusion Different patterns of aortic diameters were observed in patients with dilated aortic root, depending on age, aortic valve morphology, and function. When a dilated aortic root is detected in older patients with a tricuspid aortic valve, an accurate cardiovascular survey that includes the entire aorta is needed. These results provide further evidence about the systemic nature of aortic dilatation.