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- Title
Aortic Root Remodeling as an Indicator for Diastolic Dysfunction and Normative Ranges in Asians: Comparison and Validation with Multidetector Computed Tomography.
- Authors
Liu, Lawrence Yu-min; Yun, Chun-Ho; Kuo, Jen-Yuan; Lai, Yau-Huei; Sung, Kuo-Tzu; Yuan, Po-Jung; Tsai, Jui-Peng; Huang, Wen-Hung; Lin, Yueh-Hung; Hung, Ta-Chuan; Chen, Ying-Ju; Su, Cheng-Huang; Tsai, Cheng-Ting; Yeh, Hung-I; Hung, Chung-Lieh
- Abstract
Background: The aortic root diameter (AoD) has been shown to be a marker of cardiovascular risk and heart failure (HF). Data regarding the normal reference ranges in Asians and their correlates with diastolic dysfunction using contemporary guidelines remain largely unexplored. Methods: Among 5343 consecutive population-based asymptomatic Asians with echocardiography evaluations for aortic root diameter (without/with indexing, presented as AoD/AoDi) were related to cardiac structure/function and N-terminal pro-brain B-type natriuretic peptide (Nt-ProBNP), with 245 participants compared with multidetector computed tomography (MDCT)-based aortic root geometry. Results: Advanced age, hypertension, higher diastolic blood pressure, and lower body fat all contributed to greater AoD/AoDi. The highest correlation between echo-based aortic diameter and the MDCT-derived measures was found at the level of the aortic sinuses of Valsalva (r = 0.80, p < 0.001). Age- and sex-stratified normative ranges of AoD/AoDi were provided in 3646 healthy participants. Multivariate linear regressions showed that AoDi was associated with a higher NT-proBNP, more unfavorable left ventricular (LV) remodeling, worsened LV systolic annular velocity (TDI-s′), a higher probability of presenting with LV hypertrophy, and abnormal LV diastolic indices except tricuspid regurgitation velocity by contemporary diastolic dysfunction (DD) criteria (all p < 0.05). AoDi superimposed on key clinical variables significantly expanded C-statistic from 0.71 to 0.84 (p for ∆AUROC: < 0.001). These associations were broadly weaker for AoD. Conclusion: In our large asymptomatic Asian population, echocardiography-defined aortic root dilation was associated with aging and hypertension and were correlated modestly with computed tomography measures. A larger indexed aortic diameter appeared to be a useful indicator in identifying baseline abnormal diastolic dysfunction.
- Subjects
MULTIDETECTOR computed tomography; ASIANS; SINUS of valsalva; COMPUTED tomography; HYPERTENSION
- Publication
Diagnostics (2075-4418), 2020, Vol 10, Issue 9, p712
- ISSN
2075-4418
- Publication type
Article
- DOI
10.3390/diagnostics10090712