title: The association between wedging of the aorta and cardiac structural anatomy as revealed using multidetector-row computed tomography.
abstract: The aortic root is wedged within the cardiac base. The precise extent of aortic wedging, however, and its influence on the surrounding cardiac structures, has not been systematically investigated. We analysed 100 consecutive patients, who underwent coronary arterial computed tomographic angiography. We assessed the extent of aortic wedging by measuring the vertical distance between the non-adjacent aortic sinus and the inferior epicardium. A shorter distance indicates deeper aortic wedging. We assessed the tilt angle and diameter of the ascending aorta, the relative heights of the left atrial roof and the oval fossa, the shape of the proximal right coronary artery, the angle of the aorta relative to the left ventricular axis, and the lung volume. The mean extent of wedging was 42.7 ± 9.8 mm. Multivariate analysis revealed that ageing, male gender, increased body mass index, patients without cardiomyopathy, the extent of tilting and dilation of the ascending aorta, and lung volume were all independent predictors for deeper aortic wedging (R2= 0.7400, P < 0.0001). The extent of wedging was additionally correlated with a relatively high left atrial roof (R2= 0.1394, P < 0.0001) and oval fossa (R2= 0.1713, P < 0.0001), the shepherd's crook shape of the proximal right coronary artery (R2= 0.2376, P < 0.0001), and the narrowness of the angulation of the root relative to the left ventricular axis (R2= 0.2544, P < 0.0001). In conclusion, ageing, male gender, obesity, background cardiac disease, aortic tilting and dilation, and lung volume are all correlated with the extent of wedging of the aortic root within the cardiac base.
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Shumpei
authors.identifier: http://orcid.org/0000-0002-5803-7135
authors.initials: S
authors.lastname: Mori
authors.affiliation: Institute of Genetic Medicine, Newcastle University, Newcastle-upon-Tyne, UK.
authors.forename: Robert H
authors.identifier: http://orcid.org/0000-0001-5163-9021
authors.initials: RH
authors.lastname: Anderson
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Takaya
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Toba
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ito
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Sei
authors.initials: S
authors.lastname: Fujiwara
authors.affiliation: Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nishii
authors.affiliation: Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Atsushi K
authors.initials: AK
authors.lastname: Kono
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Ken-Ichi
authors.initials: KI
authors.lastname: Hirata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology; D001011:Aorta / Q000000981:diagnostic imaging* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies
keywords: aortic elongation; aortic root; aortic wedging; cardiac structural anatomy; computed tomography