Normal values of aortic root diameters in sub-Saharan Africans: The TAHES study

Abstract

Reported ranges of normal values are mostly issued from Caucasian cohorts. Data on black African subjects are sparse and not issued from community-dwelling cohorts. Our study aimed to establish reference values for ARD in a Beninese general population cohort. This study is a part of TAHES, a population-based prospective cohort study initiated in 2015 in the district of Tanvè, Republic of Benin. Transthoracic echocardiography examinations were performed by 4 cardiologists, and analyzed off-line by a single observer. ARD were measured using inner-edge to inner-edge diameters for sinuses of Vasalva (SV), sinotubular junction (STJ), proximal ascending aorta (AA), and annulus. Normal limits were defined as the 95th percentiles. Variables are presented as mean ± SD (5th–95th percentiles). We included 513 normotensive individuals (206 men and 307 women, age 40 ± 14 years [26–68]). The absolute values of ARD were significantly greater in men: the non-indexed ARD values for the annulus, SV, STJ and AA were respectively 21.3 ± 2 (18.5–25), 28.5 ± 3.4 (23–34), 24.1 ± 3 (19–29) and 27 ± 3 (22.5–32) mm for men and 19.3 ± 1.8 (15–22), 25.8 ± 2.8 (21.6–30), 22 ± 2.7 (18–26) and 24.8 ± 2.8 (21–30) mm for women, respectively (all P < 0.0001). No significant differences between sexes were recorded for body surface area (BSA)-indexed ARD for Annulus, STJ and AA. BSA-indexed SV dimension was greater in men (17.3 ± 2.6 mm; 13.5–22) than women (16.8 ± 2.5 mm; 13–21). There was a correlation between SV, STJ, AA indexed-diameters and age in both sexes but not for annulus indexed-diameter ( r = 0.14, 0.19 and 0.36 for women and 0.34, 0.45 and 0.32 for men, all P < 0.05). The upper limits for ARD are summarized in Table 1 . Normal values from a general population in West Africa could to differ from those established in Caucasian populations. This ethnic-appropriate reference is proposed for appropriate diagnosis in patients in sub-Saharan Africa.