Association of Aortic Root Dilation from Early Adulthood to Middle Age with Cardiac Structure and Function: The CARDIA Study

Chike C. Nwabuo, Henrique T. Moreira, Henrique D. Vasconcellos, Bharath Ambale-Venkatesh, Kihei Yoneyama, Yoshiaki Ohyama, Ravi K. Sharma, Anderson C. Armstrong, Mohammed R. Ostovaneh, Cora E. Lewis, Kiang Liu, Pamela J. Schreiner, Kofo O. Ogunyankin, Samuel S. Gidding, João A.C. Lima

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background The human aorta dilates with advancing age. However, the association between progressive aortic dilation with aging and cardiac remodeling has not been established in studies of community-dwelling adults. The aim of this study was to test the hypothesis that there would be a relationship between aortic size increase over the early adult life span with left ventricular (LV) structural remodeling and subclinical LV dysfunction in middle age, even in the absence of overt cardiovascular and valvular disease. Methods Included were Coronary Artery Risk Development in Young Adults study participants (N = 2,933) aged 23 to 35 years with available transthoracic echocardiographic measurements during 20 years of follow-up. Multivariate linear regression models assessed sex-specific associations between 20-year change in aortic root diameter with LV structure and function. Results Larger aortic root diameter at 20-year follow-up was associated with greater LV mass (2.77 vs 2.18 g/mm in men and women, respectively, P <.001). In longitudinal analyses, increase in aortic root diameter over 20-year follow-up was associated with a greater 20-year increase in LV mass and ratio of LV mass to LV end-diastolic volume ratio in both sexes. In women but not in men, increased aortic root diameter over 20 years was associated with increased left atrial dimension, impaired E/E′ and impaired early diastolic longitudinal and circumferential strain rates assessed by speckle-tracking echocardiography. Conclusions Progressive increase in aortic root diameter from early adulthood to middle age was associated with increased LV mass and LV concentric remodeling in both sexes and impaired diastolic function predominantly in women.

Original languageEnglish (US)
Pages (from-to)1172-1179
Number of pages8
JournalJournal of the American Society of Echocardiography
Volume30
Issue number12
DOIs
StatePublished - Dec 2017

Bibliographical note

Funding Information:
The Coronary Artery Risk Development in Young Adults study is supported by contracts HHSN268201300025C, HHSN268201300026C, HHSN268201300027C, HHSN268201300028C, HHSN268201300029C, and HHSN268200900041C from the National Heart, Lung, and Blood Institute; the Intramural Research Program of the National Institute on Aging; and an intra-agency agreement between the National Institute on Aging and the National Heart, Lung, and Blood Institute (AG0005).

Publisher Copyright:
© 2017 American Society of Echocardiography

Keywords

  • Aging
  • Aorta
  • Cardiac remodeling
  • Diastolic function
  • Left ventricle
  • Systolic function

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