title: Hemodynamic Correlates of Abnormal Aortic Root Dimension in an Adult Population: The Strong Heart Study.
abstract: BACKGROUND
  We evaluated the relationship of aortic root dimension (ARD) with flow output and both peripheral and central blood pressure, using multivariable equations predicting ideal sex-specific ARD at a given age and body height.
  
  
  RESULTS
  We measured echocardiographic diastolic ARD at the sinuses of Valsalva in 3160 adults (aged 42±16 years, 61% women) from the fourth examination of the Strong Heart Study who were free of prevalent coronary heart disease, and we compared measured data with the theoretical predicted value to calculate a z score. Central blood pressure was estimated by applanation tonometry of the radial artery in 2319 participants. ARD z scores were divided into tertiles representing small, normal, and large ARD. Participants with large ARD exhibited greater prevalence of central obesity and higher levels of inflammatory markers and lipids (0.05<P<0.0001). Stroke volume, heart rate, and both cuff and central diastolic blood pressure were progressively greater from small to large ARD (all P<0.0001). Pulse pressure was higher in small ARD (P<0.0001). In multivariable analysis, ARD z score was related positively to stroke volume, either cuff or central diastolic blood pressure, and negatively to pulse pressure. Large ARD was also independently correlated to higher waist circumference and percentages of neutrophils and plasminogen activator inhibitor-1 (all P<0.01).
  
  
  CONCLUSIONS
  Aortic root dilatation is associated with high diastolic blood pressure, high stroke volume, central fat distribution, and inflammatory status. In contrast, at a given diastolic blood pressure and stroke volume, aortic root dilatation is associated with lower pulse pressure and systolic blood pressure.
authors.affiliation: Hypertension Research Center, Federico II University, Naples, Italy (G.S., M.D.M., R.I.) Department of Translational Medical Sciences, Federico II University, Naples, Italy (G.S., M.D.M., R.I.) Department of Medicine, Weill-Cornell Medical College, New York, NY (G.S., M.J.R., R.B.D.).
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Simone
authors.affiliation: Department of Medicine, Weill-Cornell Medical College, New York, NY (G.S., M.J.R., R.B.D.).
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Roman
authors.affiliation: Hypertension Research Center, Federico II University, Naples, Italy (G.S., M.D.M., R.I.) Department of Translational Medical Sciences, Federico II University, Naples, Italy (G.S., M.D.M., R.I.).
authors.forename: Marina
authors.initials: M
authors.lastname: De Marco
authors.affiliation: Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY (J.N.B.).
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Bella
authors.affiliation: Hypertension Research Center, Federico II University, Naples, Italy (G.S., M.D.M., R.I.) Department of Translational Medical Sciences, Federico II University, Naples, Italy (G.S., M.D.M., R.I.).
authors.forename: Raffaele
authors.initials: R
authors.lastname: Izzo
authors.affiliation: Center for American Indian Health Research, University of Oklahoma, Oklahoma City, OK (E.T.L.).
authors.forename: Elisa T
authors.initials: ET
authors.lastname: Lee
authors.affiliation: Department of Medicine, Weill-Cornell Medical College, New York, NY (G.S., M.J.R., R.B.D.).
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology*; D001794:Blood Pressure; D001827:Body Height; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004108:Dilatation, Pathologic; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000208:ethnology / Q000503:physiopathology; D007198:Indians, North American; D007249:Inflammation / Q000208:ethnology / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008365:Manometry; D008875:Middle Aged; D008955:Models, Cardiovascular; D015999:Multivariate Analysis; D009765:Obesity / Q000208:ethnology / Q000503:physiopathology; D012307:Risk Factors; D012850:Sinus of Valsalva / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013318:Stroke Volume; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: aortic root dilatation; applanation tonometry; blood pressure; inflammation; neutrophil count; pulse pressure; stroke volume