Aortic root dilatation in hypertensive patients: A multicenter survey in echocardiographic practice

Abstract

Background and aim. Aortic root dilatation (ARD) is a cardiovascular phenotype of adverse prognostic value; its prevalence has been mostly investigated in population-based samples and selected hypertensive cohorts. Data from clinical practice are rather scant. Thus, we examined the prevalence and correlates of ARD in a large sample of hypertensive patients referred by general practitioners for a routine echocardiographic examination. Methods. A total of 2229 untreated and treated hypertensive subjects (mean age 62 years) referred to 17 outpatient echocardiographic laboratories across Italy for detection of hypertensive subclinical cardiac damage were included in the study. ARD was defined by aortic diameter exceeding 3.7 cm in women and 3.9 cm in men. Results. ARD was found in 263 patients, with an overall prevalence of 11.8% (16.9% in men and 6.2% in women, p < 0.05). In multivariate regression analyses, body surface area (BSA), left ventricular (LV) mass and age were in ranking order the most important correlates of aortic root size in the whole population study as well as in men. In women, LV mass and its derivative indexes were the most important independent variables associated to aortic root size. Conclusions. This multicenter nationwide survey indicates that ARD is a frequent cardiovascular phenotype in hypertensives referred to echo-labs for detection of hypertensive organ damage. BSA, LV mass and age are the most important correlates of this phenotype. The hierarchical order of these factors differs between genders, LV mass being the strongest independent variable in women.

Key Words::

• Aortic root dilatation
• hypertension
• left ventricular mass

Conflict of interest: None. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Appendix: List of investigators

Bonanomi C, Settimi E, Danzi GB, Division of Cardiology, Fondazione Ospedale Maggiore Policlinico, Milano; Capra A, Scanziani E, Giannattasio C, Trocino G, Casati A, Department of Clinical Medicine and Prevention, Clinica Medica, University of Milano-Bicocca, Milan, and Division of Cardiology, Ospedale San Gerardo, Monza, Italy; Chiappa L, Paggi A, Morganti A, Chair of Internal Medicine and Hypertension Center, Ospedale S. Giuseppe, Italy; Degli Esposti D, Bacchelli S, Department of Internal Medicine, Aging and Kidney diseases, University Hospital of Bologna, Bologna, Italy; Ganau A, Oppo A, Cattedra di Malattie dell'Apparato Cardiovascolari, Università di Sassari, Italy; Grandi AM, Nicolini E, Mongiardi C, Department of Clinical Medicine, University of Insubria, Varese, Italy; Lonati L, Branzi G, Parati G, Division of Cardiology, Istituto Auxologico Italiano IRCCS Milan, Italy; Longo M, Valerio C, Marconi M, Centro Trasfusionale e di Immunoematologia Fondazione Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, IRCCS Milano; Macca G, Division of Clinical Cardiology San Carlo Hospital, Paderno Dugnano, Italy; Milan A, Avenatti E, Veglio F, Department of Medicine and Experimental Oncology, Division of Internal Medicine, University of Torino, Torino, Italy; Muiesan ML, Salvetti M, Paini A, Galbassini G, Monteduro C, Department of Medical and Surgical Sciences, Clinica Medica, University of Brescia, Brescia, Italy; Negri F, Giudici V, Valerio C, Re A, Cuspidi C, Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milan, and Clinical Research Unit, Istituto Auxologico Italiano, Meda, Italy; Pellizzoli S, Robustelli F, Division of Cardiology, Hospital of Morbegno, Italy; Rao MAE, Iovino GL, Arcucci O, De Luca N, Department of Clinical Medicine and Cardiovascolar Sciences, Università degli Studi “Federico II”, Napoli, Italy; Tocci G, Ciavarella M, Volpe M, Division of Cardiology, II Faculty of Medicine, University of Rome La Sapienza, Sant’Andrea Hospital, Rome; Vaccarella A, Servizio di Cardiologia-Presidio Operativo e di Ricerca di Casatenovo I.N.R.C.A-IRCCS, Italy; Veglia MG, Division of Cardiology, Hospital Madonna delle Grazie, Matera, Italy.