P2785Persons with dilated aorta ascendens - who are they?

Background Dilation of the ascending aorta (AscA) may result in life-threatening events. However, it often remains asymptomatic and undiagnosed until the catastrophic complication occurs. The prevalence of dilated AscA in the general population is largely unknown. It is also unclear whether traditional cardiovascular risk factors are associated with dilated AscA. Purpose The aim was to study the prevalence of dilated AscA and its determinants with focus on cardiovascular risk factors in a middle-aged population. Methods Five thousand subjects from the Swedish CardioPulmonary BioImage Study (SCAPIS), aged 50–65 years, underwent transthoracic echocardiography (echo) and coronary CT angiography. Subjects with dilated AscA (diameter ≥40 mm) were identified. Two age- and gender-matched controls with normal AscA diameter were selected per case. Presence of carotid artery plaques was determined by duplex ultrasound. Results Seventy one cases (16 women, 55 men) and 142 controls were included. In cases, echo and CT measurements were 42 (41–43) and 42 (41–45) mm, respectively. Body surface area-adjusted AscA diameters were higher in female than in male cases, 22,7 (21,9–23,6) vs 20,2 (19,0–20,8) mm/m2 (p<0,001), see Figure. Bicuspid aortic valves and mild aortic regurditation were more common in cases than in controls (12% vs 0% and 30% vs 11%). The use of antihypertensive drugs was higher among cases, 47% vs 32%, p=0.035. There were no differences in body size, smoking status, diabetes, history of cardiovascular disease or presence of carotid plaques between cases and controls. Conclusions The prevalence of dilated AscA was 1.4% in a Swedish middle-aged population. Dilated AscA was associated with male sex, aortic valve pathology and antihypertensive medication. Whether dilated AscA is associated with impaired regulation of blood pressure and vascular function deserves further investigation. Also, data raise the intriguing question that a 40 mm cut-off value may not be appropriate for the diagnosis in women.