Abstract MP62: Aortic Root Dilation and Incident Cardiovascular Events in African Americans: The Jackson Heart Study

Abstract

Introduction: The structure and function of the proximal aorta is thought to be associated with central aortic pressure. Therefore, it might be associated with cardiovascular (CV) events. Hypothesis: Increased aortic root diameter (AoD) is associated with CV events in a large community-based African American cohort in Jackson, MS. Methods: We conducted a longitudinal analysis in the Jackson Heart Study, a study of risk factors for CV disease in African Americans. AoD at the sinuses of Valsalva was measured by echocardiography at visit 1 (2000 - 2004). Participants without relevant information on covariates or with past history of CV diseases at baseline were excluded. CV events were defined as coronary heart disease, stroke, or incident heart failure (HF) identified as the first hospitalization for HF after 2005. Cox proportional hazards models were used to evaluate the association between baseline AoD and CV events. Kaplan-Meier survival curves were constructed for two groups classified by the sex-stratified top quintile of AoD (35.2±2.8 mm) vs. others quintiles as a group (AoD 30.8±2.8 mm). Results: Among 5301 JHS participants, 3386 participants were included in our study (mean age 56.0 years, 64% women). Participants in the top quintile of AoD were more likely to be older, hypertensive, and obese compared with the rest. Over a mean follow-up of 8.3 years, there were 214 CV events (incident rate: 7.6 per 1,000 person-years). After adjustment for traditional risk factors including age, gender, systolic blood pressure, antihypertensive medications, total cholesterol/HDL ratio, diabetes and smoking status, AoD was independently associated with CV events (hazard ratio per 1 mm increase: 1.05; 95% CI: 1.007-1.102, p < 0.05). Participants in the top AoD quintile had a higher incidence of CV events than those not in the top quintile (Figure). Conclusions: An increased AoD was associated with an increased risk of CV events in a community-based African American cohort. AoD measurements may be useful for CV event risk stratification.