title: Aortic stenosis severity is not a risk factor for poststenotic dilatation of the ascending aorta.
abstract: BACKGROUND
  Dilatation of the ascending aorta in aortic stenosis may be partly explained by intrinsic wall structure changes, but the relative contribution of altered hemodynamics is unclear. The aim of this study was to assess the association between ascending aortic dimensions and valve stenosis severity.
  
  
  RESULTS
  An analysis of echocardiographic examinations was conducted in 296 patients with aortic stenosis (179 males, mean age 71 years), 57 with bicuspid and 239 with tricuspid aortic valve, mean transaortic gradient 43+/-20 mmHg, and not more than moderate aortic regurgitation. Aortic dimensions at the level of annulus, sinuses of Valsalva, sinotubular junction and proximal ascending aorta were measured. Only height (p<0.001), degree of aortic regurgitation (p<0.01) and presence of bicuspid aortic valve (p<0.001) were independent predictors of ascending aortic dimensions.
  
  
  CONCLUSIONS
  An independent association between aortic pressure gradients and proximal ascending aortic dimensions was not observed in patients with bicuspid or tricuspid aortic valve stenosis. Therefore, the poststenotic dilatation of the ascending aorta is not explained by aortic stenosis severity itself. Possible nonhemodynamic causes deserve detailed study at the time of diagnosis.
authors.affiliation: First Department of Medicine, Charles University of Prague, School of Medicine Hospital, Pilsen, Czech Republic. linhartkaterina@atlas.cz
authors.forename: Katerina
authors.initials: K
authors.lastname: Linhartová
authors.forename: Václav
authors.initials: V
authors.lastname: Beránek
authors.forename: Frantisek
authors.initials: F
authors.lastname: Sefrna
authors.forename: Iveta
authors.initials: I
authors.lastname: Hanisová
authors.forename: Gabriela
authors.initials: G
authors.lastname: Sterbáková
authors.forename: Markéta
authors.initials: M
authors.lastname: Pesková
mesh_terms: D000368:Aged; D001011:Aorta / Q000473:pathology* / Q000503:physiopathology*; D001022:Aortic Valve Insufficiency / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000473:pathology* / Q000503:physiopathology; D001794:Blood Pressure; D004108:Dilatation, Pathologic / Q000473:pathology / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000503:physiopathology; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014264:Tricuspid Valve Stenosis / Q000473:pathology / Q000503:physiopathology