title: Influence of left ventricular geometry and function on aortic annular dimensions as assessed with multi-detector row computed tomography: implications for transcatheter aortic valve implantation.
abstract: OBJECTIVE
  Evaluate changes in aortic annular dimensions in relation to severe aortic stenosis (AS) and left ventricular (LV) dysfunction.
  
  
  RESULTS
  Mean aortic annular diameters and geometries were compared between 90 severe AS patients and 111 controls by multi-detector row computed tomography (MDCT). All severe AS patients were also dichotomized into two groups based on the presence of preserved (≥ 50%) or impaired (<50%) LV ejection fraction (EF). The influence of LV geometry and function on changes in aortic annular dimensions was examined. Patients with severe AS had similar aortic annular dimensions and geometries compared with controls even after correcting for baseline differences in age and body surface area (BSA). However, severe AS patients with LV dysfunction (LVEF <50%) had significantly larger mean aortic annular diameter (26.4 ± 1.9 vs. 24.5 ± 2.1 mm, P < 0.001) compared with patients with preserved LVEF. The presence of LV dysfunction, male gender, and larger BSA were independent determinants of a larger aortic annulus on MDCT.
  
  
  CONCLUSIONS
  In severe AS patients, the presence of LV dysfunction, not the presence of severe AS, was an independent determinant of a larger aortic annular diameter.
authors.affiliation: Department of Cardiology,  Princess Alexandra Hospital, University of Queensland,  Australia.
authors.forename: Arnold C T
authors.initials: AC
authors.lastname: Ng
authors.forename: Kai-Hang
authors.initials: KH
authors.lastname: Yiu
authors.forename: See Hooi
authors.initials: SH
authors.lastname: Ewe
authors.forename: Frank
authors.initials: F
authors.lastname: van der Kley
authors.forename: Matteo
authors.initials: M
authors.lastname: Bertini
authors.forename: Arend
authors.initials: A
authors.lastname: de Weger
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Dominic Y
authors.initials: DY
authors.lastname: Leung
authors.forename: Joanne D
authors.initials: JD
authors.lastname: Schuijf
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Victoria
authors.initials: V
authors.lastname: Delgado
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000473:pathology*; D001021:Aortic Valve / Q000473:pathology* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D006328:Cardiac Catheterization / Q000379:methods; D004452:Echocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000473:pathology* / Q000503:physiopathology