Prevalence Of Aortic Root Dilatation Research Articles

Cardiac defects of hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders: a retrospective cohort study.

Defective connective tissue structure may cause individuals with hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorders (HSD) to develop cardiac defects. We conducted a retrospective chart review of adult patients treated in the EDS Clinic from November 1, 2019, to June 20, 2022 to identify those with cardiac defects. Echocardiogram data were collected using a data collection service. All EDS Clinic patients were evaluated by a single physician and diagnosed according to the 2017 EDS diagnostic criteria. Patient demographic, family and cardiac history were extracted from self-reported responses from a REDCap clinical intake questionnaire. Patients with at least 1 available echocardiogram (ECHO) were selected for the study (n = 568). The prevalence of aortic root dilation in patients with hEDS was 2.7% and for HSD was 0.6%, with larger measurements for males than females and with age. Based on self-reported cardiac history that was verified from the medical record, patients with hEDS with bradycardia (p = 0.034) or brain aneurysm (p = 0.015) had a significantly larger average adult aortic root z-score. In contrast, patients with HSD that self-reported dysautonomia (p = 0.019) had a significantly larger average aortic root z-score. The prevalence of diagnosed mitral valve prolapse in patients with hEDS was 3.5% and HSD was 1.8%. Variants of uncertain significance were identified in 16 of 84 patients that received genetic testing based on family history. These data reveal a low prevalence of cardiac defects in a large cohort of well-characterized hEDS and HSD patients. Differences in cardiovascular issues were not observed between patients with hEDS vs. HSD; and our findings suggest that cardiac defects in patients with hEDS or HSD are similar to the general population.

Aortic Root Dilatation Measured by Cardiac Magnetic Resonance in Patients with Repaired Tetralogy of Fallot

Background: Aortic root dilatation (AoD) frequently occurs following repaired tetralogy of Fallot (rTOF). The objective of this study was to assess aortic dimensions, investigate the prevalence of AoD, and identify predictors of AoD in rTOF patients. Methods: A cross-sectional retrospective study was conducted in repaired TOF patients from 2009 to 2020. Aortic root diameters were measured by cardiac magnetic resonance (CMR). Severe AoD of the aortic sinus (AoS) was defined as a Z-score (z) of >4, reflecting a mean percentile ≥99.99%. Results: Two hundred forty-eight patients, with a median age of 28.2 years (10.2–65.3 years), were included in the study. The median age at the time of repair was 6.6 years (0.8–40.5 years) and the median interval between the repair and CMR study was 18.9 years (2.0–54.8 years). The prevalence of severe AoD was found to be 35.2% when defined by an AoS z greater than 4 and 27.6% when defined by a AoS diameter ≥40 mm, respectively. A total of 101 patients (40.7%) had aortic regurgitation (AR), with 7 patients (2.8%) having moderate AR. Multivariate analysis revealed that severe AoD was only associated with the left ventricular end diastolic volume index (LVEDVi) and a longer duration after repair. The age at the time of repair for TOF was found not to be correlated with the development of AoD. Conclusions: After repair of TOF, severe AoD was found to be prevalent, but no fatal complications were observed in our study. Mild AR was also commonly observed. Larger LVEDVi and a longer duration after repair were identified as factors associated with the development of severe AoD. Therefore, routine monitoring of AoD is recommended.

Aortic Root Dimensions and Pulse Wave Velocity in Young Competitive Athletes

The assessment of aortic root dimensions is a cornerstone in cardiac pre-participation screening as dilation can result in severe cardiac events. Moreover, it can be a hint for an underlying connective tissue disease, which needs individualized sports counseling. This study examines the prevalence of aortic root dilatation in a cohort and its relationship to arterial stiffness as an early marker of cardiovascular risk due to vascular aging. From May 2012 to March 2018, we examined 281 young male athletes (14.7 ± 2.1 years) for their aortic root dimension. Moreover, we noninvasively assessed arterial stiffness parameter during pre-participation screening. Mean aortic diameter was 25.9 ± 3.1 mm and 18 of the 281 (6.4%) athletes had aortic root dilation without other clinical evidence of connective tissue disease. After adjusting for BSA, there was no association of aortic root diameter to pulse wave velocity (p = −0.054 r = 0.368) nor to central blood pressure (p = −0.029 r = 0.634). Thus, although a significant proportion of young athletes had aortic root dilatation, which certainly needs regular follow up, no correlation with arterial stiffness was found. It could be suggested that a dilated aortic root in young athletes does not alter pulse waveform and pulse reflection, and thus there is no increased cardiovascular risk in those subjects.

Aortic Root Diameter in Hypertensive Patients With Various Stages of Obstructive Sleep Apnea.

BACKGROUNDObstructive sleep apnea (OSA) is a risk factor of several cardiovascular diseases. We investigated the association between aortic root diameter and hypoxia-related parameters in hypertensive patients with OSA.METHODSOur study included 242 hypertensive patients with OSA (52 mild, 71 moderate, and 119 severe). All the patients underwent echocardiography for measuring aortic root diameter and polysomnography for measuring apnea–hypopnea index (AHI), oxygen desaturation index, and time spent with oxygen desaturation less than 90%.RESULTSThe study patients included 19.8% women and had a mean (±SD) age of 49.9 ± 12.9 years, a mean aortic root diameter of 33.4 ± 2.6 mm, and a prevalence of echocardiographic aortic root dilation of 3.7%. Patients with mild, moderate, and severe OSA had similar echocardiographic left ventricular structure. However, patients with severe OSA had a significantly (P < 0.05) greater aortic root diameter (33.9 ± 2.4 mm vs. 32.4 ± 2.2 and 33.4 ± 2.9 mm, respectively) and higher prevalence of aortic root dilatation (5% vs. 1% and 3%, respectively) than those with mild and moderate OSA. Aortic root diameter corrected by body height was significantly (P < 0.001) associated with AHI, oxygen desaturation index and time spent with oxygen desaturation less than 90% (r = 0.23–0.33). After adjustment for various confounding factors, the associations between aortic root diameter and polysomnography parameters remained statistically significant (P < 0.05).CONCLUSIONSThe severity of OSA was associated with the aortic root diameter. Patients with severe OSA had a greater aortic root diameter.

Two-Dimensional and Three-Dimensional Echocardiographic Assessment of Aortic Root Diameter in Patients with Coronary Ectasia

Background: Coronary artery ectasia (CAE) is a well-recognized but relatively uncommon finding encountered during diagnostic coronary angiography. It is commonly defined as in appropriate dilation of the coronary arteries exceeding the largest diameter of an adjacent normal vessel more than 1.5-fold. CAE is not an isolated and benign disease but a reflection of a generalized vascular media defect. Objective: The aim of this study was to compare 2D-TTEand 3D-TTE measurements of the aortic root diameter in patients with coronary artery ectasia to assess the presence of aortic root dilatation. Patients and methods: This prospective observational study included 50 consecutive patients came to the Department of Cardiology, Al-Azhar University Hospital, New Damietta for coronary angiography. The study was carried out from November 2017 until December 2018. Injection aortography was used as a gold standard and to assess the presence of ascending aorta dilatation in those patients. Results: The present study shows that there was a good correlation between 3D-TTE and aortography at the levels of aortic annulus, sinuses of Valsalva, sinotubular junction (r =0.98,0.95,0.98) but a rough correlation between 2D-TTE and aortography at these levels (r =0.49,0.48,0.46). The present study shows that there was increase prevalence of aortic root dilatation 13 patients (26%) and ascending aorta dilatation 9patients(18%) in patients with CAE. Conclusions: Accuracy of aortic root measurement by 3DTTE was superior to that by 2DTTE, because the values by 2DTTE were underestimated compared to those measured by 3DTTE and aortography. Increase prevalence of aortic root dilatation and ascending aorta dilatation in patients with coronary artery ectasia. Dilated Ascending aorta was associated with a higher prevalence of aortic root dilatation.

Factors associated with aortic root dilatation after surgically repaired ventricular septal defect.

Aortic root dilatation (ARD) in congenital heart disease is related to aortic aneurysm, rupture, and dissection. This study aimed to investigate the factors associated with ARD in patients with surgically repaired ventricular septal defect (VSD). This cross-sectional study included 152 patients with surgically repaired VSD. Two definitions of ARD were used: (1) observed Valsalva diameter to body surface area (BSA) ratio >2.1cm/m2 and (2) absolute value of Valsalva diameter ≥4.0cm. Odds ratios (ORs) and 95% confidence intervals (CIs) of ARD presence were calculated using multivariate logistic regressions. The prevalence of ARD ranged between 8.6% and 32.9%. Using the definition of observed aortic root diameter/BSA >2.1cm/m2 , patients with nonsubarterial VSD type were more likely to have ARD (OR 5.65, 95% CI; 1.83-17.44, P=.003) than those with subarterial type, and patients with preoperative right- or noncoronary cusp prolapse (R/NCCP) were more likely to have ARD (OR 3.68, 95% CI; 1.20-11.23, P=.022) than patients without preoperative R/NCCP after adjustment for sex, age at repair (ie, shunt duration), VSD size, and postoperative follow-up period. Using the definition of absolute Valsalva diameter ≥4cm, nonsubarterial VSD type and presence of R/NCCP were also significantly associated with ARD after adjustment for the same covariates. Anatomical and morphological features (nonsubarterial type and presence of preoperative R/NCCP) are independently correlated with ARD in patients with VSD regardless of the different definitions of ARD. Patients with surgically repaired VSD may need careful monitoring for potential ARD development.

Progressive aortic root dilatation in pediatric heart transplant recipients.

To determine prevalence, clinical implication, and risk factors for aortic root dilation (ARD) in pediatric heart transplant recipients. Serial echocardiograms were reviewed in all pediatric heart transplant recipients from 1999 to 2014 to assess maximal systolic diameter at the aortic annulus, aortic sinus, aortic sino-tubular (ST) junction, and ascending aorta. ARD was defined by a sinus/annulus ratio >1.56, ST junction/annulus ratio >1.28,and/or ascending aorta/annulus ratio >1.35. A total of 147 subjects (53% male) were evaluated; 50% had congenital heart disease (CHD). Of the 74 with CHD, 38 had prior aortic arch reconstruction. The median age at transplant was 3years (7days-20.3years) with a median duration of follow-up of 3.88years (3months-15years). Prevalence of ARD significantly increased in the cohort from 15.6% at the initial echocardiogram to 49.6% at later follow-up (P<.0001). The median duration to development of ARD was 7.6months. There were no significant differences in prevalence of ARD or days to maximum ratio based on the pretransplant diagnosis. Aortic regurgitation was very rare (7 with ≤mild) and did not correlate with ARD or require any interventions. During intermediate follow-up, ARD commonly develops in children post-heart transplant, and prevalence increases with time after transplant. Within 1year after transplant, almost 50% had developed abnormalities in aortic root size that were not apparent at the initial posttransplant echocardiogram. Preexisting CHD or need for prior arch reconstruction did not increase the risk of ARD.

Associations of Age and Sex With Marfan Phenotype: The National Heart, Lung, and Blood Institute GenTAC (Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions) Registry.

The associations of age and sex with phenotypic features of Marfan syndrome have not been systematically examined in a large cohort of both children and adults. We evaluated 789 Marfan patients enrolled in the National Heart, Lung, and Blood Institute GenTAC (Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions) Registry (53% male; mean age 31 [range: 1-86 years]). Females aged ≥15 and males aged ≥16 years were considered adults based on average age of skeletal maturity. Adults (n=606) were more likely than children (n=183) likely to have spontaneous pneumothorax, scoliosis, and striae but were comparable in revised Ghent systemic score, ectopia lentis, and most phenotypic features, including prevalence of aortic root dilatation. Prophylactic aortic root replacement and mitral valve surgery were rare during childhood versus adulthood (2% versus 35% and 1% versus 9%, respectively, both P<0.0001). Adult males were more likely than females to have aortic root dilatation (92% versus 84%), aortic regurgitation (55% versus 36%), and to have undergone prophylactic aortic root replacement (47% versus 24%), all P<0.001. Prevalence of previous aortic dissection tended to be higher in males than females (25% versus 18%, P=0.06); 44% of dissections were type B. Type B dissection was strongly associated with previous prophylactic aortic root replacement. Pulmonary, skeletal, and aortic complications, but not other phenotypic features, are more prevalent in adults than children in Marfan syndrome. Aortic aneurysms and prophylactic aortic surgery are more common in men. Aortic dissection, commonly type B, occurs in an appreciable proportion of Marfan patients, especially in men and after previous prophylactic aortic root replacement.

Natural history of aortic root dilation through young adulthood in a hypermobile Ehlers-Danlos syndrome cohort.

Hypermobile Ehlers-Danlos syndrome (hEDS) is a common inherited connective tissue disorder characterized by joint hypermobility. The natural history of aortic root dilation (AoD), a potential complication of EDS, has not been well characterized in this population. We describe the natural history of aortic root size in a large cohort of patients with hEDS. A cohort of 325 patients with HEDS was identified at Cincinnati Children's Hospital Medical Center (CCHMC), including 163 patients from a previous study. Medical records were reviewed and each participant's height, weight, and aortic dimensions from up to four echocardiograms were documented. Aortic root z-scores were calculated using two established formulas based on age (Boston or Devereux). Overall prevalence of AoD and prevalence by age were calculated and longitudinal regression was performed. The prevalence of AoD with a z-score ≥ 2.0 was 14.2% (46/325) and with a z-score of ≥3.0 was 5.5% (18/325). No significant increases in z-score were seen over time for patients with multiple echocardiograms. Participants under the age of 15 years had an average decline of 0.1 standard deviations (SDs)/year. No significant change was found after 15 of age. Between the ages of 15 and 21 years, Boston z-scores were 0.96 higher than Devereux z-scores. The nearly 1 z-score unit difference between formulas indicates caution prior to diagnosing AoD in patients with hEDS. In light of the low prevalence and lack of progression of AoD, routine echocardiograms may not be warranted for pediatric patients with hEDS.

Aortic Root Dilatation in Mucopolysaccharidosis I-VII.

The prevalence of aortic root dilatation (ARD) in mucopolysaccharidosis (MPS) is not well documented. We investigated aortic root measurements in 34 MPS patients at the Children’s Hospital of Orange County (CHOC). The diagnosis, treatment status, age, gender, height, weight and aortic root parameters (aortic valve annulus (AVA), sinuses of Valsalva (SoV), and sinotubular junction (STJ)) were extracted by retrospective chart review and echocardiographic measurements. Descriptive statistics, ANOVA, and paired post-hoc t-tests were used to summarize the aortic dimensions. Exact binomial 95% confidence intervals (CIs) were constructed for ARD, defined as a z-score greater than 2 at the SoV. The patient age ranged from 3.4–25.9 years (mean 13.3 ± 6.1), the height from 0.87–1.62 meters (mean 1.24 ± 0.21), and the weight from 14.1–84.5 kg (mean 34.4 ± 18.0). The prevalence of dilation at the AVA was 41% (14/34; 95% CI: 25%–59%); at the SoV was 35% (12/34; 95% CI: 20%–54%); and at the STJ was 30% (9/30; 95% CI: 15%–49%). The highest prevalence of ARD was in MPS IVa (87.5%). There was no significant difference between mean z-scores of MPS patients who received treatment with hematopoietic stem cell transplantation (HSCT) or enzyme replacement therapy (ERT) vs. untreated MPS patients at the AVA (z = 1.9 ± 2.5 vs. z = 1.5 ± 2.4; p = 0.62), SoV (z = 1.2 ± 1.6 vs. z = 1.3 ± 2.2; p = 0.79), or STJ (z = 1.0 ± 1.8 vs. z = 1.2 ± 1.6; p = 0.83). The prevalence of ARD was 35% in our cohort of MPS I–VII patients. Thus, we recommend screening for ARD on a routine basis in this patient population.

Cardiovascular and Musculoskeletal Assessment of Elite US Volleyball Players.

The aim of this study was to characterize the cardiovascular and musculoskeletal systems of elite volleyball players, including aortic dimensions. Previous studies have shown that the upper limit of normal aortic sinus diameter for male and female athletes is 4 and 3.4 cm, respectively. Cross-sectional analysis. United States Olympic Volleyball Training Facility and Rady Children's Hospital San Diego. Seventy (37 male) members of the US national volleyball team. Athletes underwent evaluation that included medical and family histories, targeted physical examinations specifically focusing on abnormalities present in Marfan syndrome (MFS), and transthoracic echocardiograms. Cardiac chamber and great artery size, valve function, and coronary artery origins were assessed. Three male athletes (8%) had an aortic sinus diameter ≥4 cm, one of whom also had an ascending aorta >4 cm. Two female athletes (6%) had aortic sinus diameter ≥3.4 cm, and another had an ascending aorta of 3.4 cm. There were no other intracardiac or arterial abnormalities. Individual musculoskeletal characteristics of MFS were common among the athletes but not more frequent or numerous in those with aortic dilation. The prevalence of aortic root dilation in this population of athletes was higher than what has previously been reported in other similar populations. Further study is needed to determine whether these represent pathological changes or normal variations in tall athletes. This study adds to the existing knowledge base of athlete's heart, with specific attention to aortic dimensions in elite volleyball players. The data are relevant to similar athletes' medical care and to preparticipation cardiac screening in general.

Echocardiographic aortic root dilatation in hypertensive patients: a systematic review and meta-analysis.

The risk of thoracic aortic dissection is strictly related to the diameter of the ascending aorta. Arterial hypertension represents a major risk factor for the development of aortic dissection and is thought to be directly involved in the pathogenesis of aortic aneurysms. Recent studies have suggested a high prevalence of aortic root enlargement in the hypertensive population, but evidence of a direct link between blood pressure values and size of the aortic root has been inconclusive so far. The aim of the current study was to evaluate prevalence of aortic root dilatation (ARD) in the hypertensive population and to assess the correlates of this condition. Medical literature was reviewed to identify articles assessing prevalence of echocardiographic ARD in hypertensive patients. A total of eight studies including 10 791 hypertensive patients were considered. Prevalence of ARD in the pooled population was 9.1% with a marked difference between men and women (12.7 vs. 4.5%; odds ratio 3.15; 95% confidence interval 2.68-3.71). Hypertensive patients with ARD and those with normal aortic root size had similar office blood pressure values, but the former were older and had a significantly higher left-ventricular mass (0.52 SDs, 95% confidence interval 0.41-0.63). ARD is a common phenotype in hypertensive patients, with men showing a markedly higher susceptibility, but office blood pressure values do not appear to be directly associated with aortic root diameter.

Abstract 9937: Comparison of Aortic Root Dimensions using Multi Slice Computer Tomography and 2D Transthoracic Echocardiography. CARDIA Study

Introduction: Multislice computer tomography (MSCT) is the gold standard for measuring aortic root dimensions; however, in clinical practice 2D transthoracic echocardiography (2DTE) is commonly used to diagnose and monitor aortic root diseases. Limited data exist on the accuracy of the 2DTE approach. We assessed the agreement between MSCT and 2DTE dimensions of the aortic root in middle-aged adults free of clinical aortic diseases who were part of the ongoing Coronary Artery Risk Development in Young Adults (CARDIA) Study. Methods: 2DTE and MSCT were used to measure the aortic root dimensions in 1197 CARDIA participants. The MSCT aortic root dimension was measured on non-contrast enhanced images using 0.5-0.6mm slices reformatted to provide true cross sections perpendicular to the vessel centerline, 3 D Slicer® (planimetered: [ROI pixel count multiplied by unit pixel area]) while the 2DTE aortic root diameter was measured by leading-edge to leading-edge approach [MM mode, Parasternal long axis with aorta and left atrium in view] and the area obtained using π r2. Correlation coefficient and Bland Altman plots were used to assess the agreement between the 2 approaches. Results: Mean age 49.9 ±3.6 yrs, BMI 30.5 ±7.1 kg/m2, LDL-C 110.3 ±33.5 mg/dL, HDL-C 57.3 ±17.4 mg/dL, 52.9% blacks, 45.6% males, 11.1% diabetics, 39.3% former/current smokers and 35.4% had hypertension. Prevalence of aortic root dilation (&gt;4cm) was 1.7% by MSCT and 2.1% by 2DTE. The mean aortic root diameter and area by 2DTE and 3 D slicer® were 3.07 ±0.42 cm and 3.02± 0.33 cm; 8.3± 1.7 cm2 and 7.5 ±2.1 cm2 respectively. The aortic root diameters/ areas by the 2 approaches had a Pearson correlation coefficient of 0.67. In the Bland Altman analysis the bias and limits of agreement for aortic root diameter and area were -0.15 and -0.80 to 0.48 cm; -0.57 and -3.8 to 2.7cm2 respectively. The sensitivity, specificity, PPV and NPV of 2DTE for diagnosing aortic root dilation were 0.43 (0.22 to 0.66), 0.98 (0.976 to 0.991), 0.33 (0.17 to 0.54) and 0.99 (0.982 to 0.995) respectively. Conclusions: The accuracy of 2DTE for aortic root dimensions shows moderate agreement with the MSCT suggesting that there will often be disagreement between these 2 approaches which would have significant clinical and cost implications.

Aortic root dilatation in essential hypertension

Aortic root dilatation (ARD) and arterial hypertension represent two important risk factors for aortic dissection: prevalence of observed ARD is increasing - up to 12% in the latest available reports. A recently published work tested on a good number of healthy individuals new reference ranges for aortic root dimensions, suggesting new reference values with corrections for age, gender, height (pHeight) or body surface area (pBSA). The aim of the study was to evaluate the prevalence of ARD in hypertensive patients using various criteria. A total of 1076 untreated and treated essential hypertensive patients (mean age, 52.5 ± 2 years) were considered for this analysis. We measured proximal aortic diameters using ultrasound imaging (echocardiography). ARD was defined in three ways. First, when the observed aortic diameter was larger than that predicted for age, sex, and BSA (pBSA), second when larger than predicted by height (pHeight), and third when the aortic diameter to BSA ratio (ASi) was at least 2.1 cm/m. A total of 237 patients (22% of the study population) showed at least one among the three different criteria defining aortic dilatation. Prevalence of ARD, considering singularly each one of the criteria, varied between 12.8% (pBSA) and 16.9% (pHeight). Our study demonstrated a prevalence of ARD higher than previously reported. Our data suggest, therefore, the necessity of a correct choice of the diagnostic criterion that has to be applied in the single patient for definition of ARD. In particular, using the criterion pHeight in obese patients, we may avoid underdiagnosis of this condition.

Avaliação ecocardiográfica da dilatação da raiz da aorta em doentes adultos operados a tetralogia de Fallot

IntroductionTransthoracic echocardiography is an important tool after tetralogy of Fallot repair, of which aortic root dilatation is a recognized complication. In this study we aimed to assess its prevalence and potential predictors. MethodsWe consecutively assessed adult patients by transthoracic echocardiography after tetralogy of Fallot repair, and divided them into two groups based on the maximum internal aortic diameter at the sinuses of Valsalva in parasternal long-axis view: group 1 with aortic root dilatation (≥38 mm) and group 2 without dilatation (<38 mm). ResultsA total of 53 patients were included, mean age 32±10 years, with a mean time since surgery of 23±7 years. An aortopulmonary shunt had been performed prior to complete repair in 25 patients, and a transannular patch was used in 19 patients. Aortic root measurement was possible in all patients. Aortic root dilatation was identified in eight patients (15%), all male. Male gender (p=0.001), body surface area (1.93±0.10 vs. 1.70±0.20 m2, p=0.03) and increased left ventricular end-diastolic diameter (p=0.005) were predictors of aortic root dilatation. None of the surgical variables studied were predictors of aortic root dilatation. ConclusionsThe prevalence of aortic root dilatation in this cohort was low and male gender was a predictor of its occurrence. The type of repair and time to surgery did not influence its occurrence.Quantification of aortic root diameter is possible by transthoracic echocardiography; we suggest indexing it to body surface area in clinical practice.

Echocardiographic assessment of aortic root dilatation in adult patients after tetralogy of Fallot repair

IntroductionTransthoracic echocardiography is an important tool after tetralogy of Fallot repair, of which aortic root dilatation is a recognized complication. In this study we aimed to assess its prevalence and potential predictors. MethodsWe consecutively assessed adult patients by transthoracic echocardiography after tetralogy of Fallot repair, and divided them into two groups based on the maximum internal aortic diameter at the sinuses of Valsalva in parasternal long-axis view: group 1 with aortic root dilatation (≥38 mm) and group 2 without dilatation (<38 mm). ResultsA total of 53 patients were included, mean age 32±10 years, with a mean time since surgery of 23±7 years. An aortopulmonary shunt had been performed prior to complete repair in 25 patients, and a transannular patch was used in 19 patients. Aortic root measurement was possible in all patients. Aortic root dilatation was identified in eight patients (15%), all male. Male gender (p=0.001), body surface area (1.93±0.10 vs. 1.70±0.20 m2, p=0.003) and increased left ventricular end-diastolic diameter (p=0.005) were predictors of aortic root dilatation. None of the surgical variables studied were predictors of aortic root dilatation. ConclusionsThe prevalence of aortic root dilatation in this cohort was low and male gender was a predictor of its occurrence. The type of repair and time to surgery did not influence its occurrence.Quantification of aortic root diameter is possible by transthoracic echocardiography; we suggest indexing it to body surface area in clinical practice.

106 THE PREVALENCE OF AORTIC ROOT DILATION IN HIGHLY TRAINED ATHLETES: 'THE BRITISH EXPERIENCE'

Introduction Studies suggest there is an increased prevalence of aortic root dilation highly trained competitive athletes. It is unclear whether this is a benign feature of ‘athlete9s heart9 or an indication of a pathological condition. However, distinguishing between the two may be important in the prevention of exercise related sudden cardiac death. This study sought to investigate the prevalence of aortic root dilation in British competitive athletes. Methods Between 2004 and 2012, 1165 athletes (63% male, 81% Caucasian, mean age 20.9±6.0 years, range 14–35 years) underwent echocardiography. Aortic root dimensions, measured at sinus of valsalva level, were analysed to ESC guidelines and were compared to current Bathesda recommendations of ≥40 mm for both male and female athletes. Results were compared to 415 healthy controls (57% male, 60% Caucasian, mean age 22.1±6.4 years, range 14–35 years) and 50 patients with Marfan syndrome (54% male, 88% Caucasian, mean age 35.6±12.6 years, range 18–68 years). Results Male athletes and controls demonstrated a similar prevalence of aortic root dimension (27.9±4.2 mm, range: 17–52 mm vs 27.9±4.0 mm, range: 19 ¨C 38 mm; p=1.000). However, seven male athletes (1.0%) had an aortic root ≥40 mm, compared to 0% male controls (p 0.2053). Male Marfan patients demonstrated a higher prevalence of aortic root dilation than male athletes (40.9 mm±4.6 mm; p Female athletes demonstrated a similar prevalence of aortic root dimension to female controls (26.1±3.3 mm vs 25.8±3.6; p 03207). One female athlete (0.2%) had an aortic root ≥ 40 mm compared to 0% female controls (p=1.000). Female Marfan patients had a higher prevalence of aortic root dilation than female athletes (36.8±4.7 mm vs 26.1±3.3 mm; p On longitudinal follow up of 5 years, none of the athletes with aortic dilation alone required surgical intervention. Conclusions Athletes exhibited a similar prevalence of aortic root dilation to healthy controls and there is no statistically significant evidence to suggest aortic root dilation is a feature of ‘athlete9s heart9. However, Marfan9s patients were found to have a far greater proportion of pathologically wide aortic of ≥40 mm. The study would benefit from further longitudinal evaluation.

Aortic Root Dilatation in African Hypertensives Subjects: Frequency of Occurrence and Associations: A Multicentre Echocardiographic Survey

Aortic Root Dilatation in African Hypertensives Subjects: Frequency of Occurrence and Associations: A Multicentre Echocardiographic Survey Anecdotal reports suggest that hypertension is associated with an increased predisposition to aortic root dilatation (ARD). Reports on epidemiology of ARD and demographic or clinical associations among African hypertensive subjects are scarce. This study aimed to describe the prevalence of ARD among Nigerian hypertensive subjects.

Prevelance of aortic root dilation in patients with cta of the aorta

To investigate the prevalence of aortic root dilation in patients who underwent CT angiography of the thoracic aorta. In 95 patients, 64-slice multislice computed tomography was performed for evaluation of the thoracic aorta. Measurements of the annulus, sinuses of valsalva (SOV), sinotubular junction (STJ), and maximum ascending aorta (AAo) were made by double oblique multiplanar reformation (MPR). For the AAo, STJ, and SOV, dilation was defined as greater than 40 mm; for annulus, the dilation criterion was greater than 27 mm. Overall, 52 patients were diagnosed with a dilated AAo. Of those patients with dilated AAo, 28 patients had a dilated annulus, 27 patients had dilated SOV, and 11 patients had STJ dilation. Forty-three patients presented with normal AAo; 12 patients had annulus dilation; 12 patients had SOV dilation; and 4 patients had STJ dilation. In patients with dilated AAo, 38% also had a dilated annulus, 52% showed SOV dilation, and 21% presented with STJ dilation, compared to 28% annulus dilation, 28% SOV dilation, and 9% STJ dilation in patients with an AAo of normal caliber. Our data indicate a higher prevalence of aortic root dilation among patients with dilated AAo.

Aortopathy Is Prevalent in Relatives of Bicuspid Aortic Valve Patients

This study aimed to determine the prevalence of dilation and abnormal elastic properties of aortic root in first-degree relatives (FDRs) of bicuspid aortic valve (BAV) patients. Evidence indicates that BAV is a genetic disorder. Although FDRs of affected individuals have an increased prevalence of BAV, their risk of aortic root abnormalities is unknown. We studied dimensions as well as the elastic properties of the ascending aorta in 48 FDRs with morphologically normal tricuspid aortic valves, 54 BAV patients, and 45 control subjects using 2-dimensional echocardiography. The prevalence of aortic root dilation was 32% in FDRs and 53% in BAV patients, whereas all control subjects showed normal aortic dimensions (p < 0.001). The FDRs and BAVs had significantly lower aortic distensibility (1.7 +/- 1.4 x 10(-3) mm Hg and 1.4 +/- 2.0 x 10(-3) mm Hg vs. 2.5 +/- 1.6 x 10(-3) mm Hg, p < 0.001) and greater aortic stiffness index (26.7 +/- 25.8 and 55.9 +/- 76.8 vs. 18.7 +/- 40.1, p = 0.001) compared with control subjects. This difference remained significant in subjects without aortic root dilation or hypertension (p = 0.002 and p = 0.004, respectively). The aortic root is functionally abnormal and dilation is common (32%) in first-degree relatives of patients with BAV. Screening of FDRs by transthoracic 2-dimensional echocardiography should be considered for detection of aortic valve malformation and dilated ascending aorta.