Left ventricular morphology and function in mild to moderate ascending aortic dilation: a Swedish population-based case-control study

Sammanfattning

Background Mild to moderate dilation of the ascending aorta is a common finding in the general population and is associated with increased cardiovascular risk. However, its relationship with left ventricular morphology and function in individuals without overt cardiac disease is not fully understood. The aim of this study was to investigate the association between ascending aortic dilation and left ventricular morphology and function in a middle-aged general population. Methods In this population-based, cross-sectional study from the ASCending Aorta study (AscA) within Swedish CArdioPulmonary bioImage Study (SCAPIS), individuals with ascending aortic dilation (≥ 40 mm, n = 74) were compared with age- and sex-matched controls (n = 146) using transthoracic echocardiography for evaluation of left ventricular morphology and function. Results Individuals with aortic dilation had larger left ventricular end-diastolic volume (p = 0.024), although indexed volumes were similar between groups, and left ventricular mass did not differ. Ejection fraction and global longitudinal strain were preserved and did not differ between groups, whereas left ventricular mechanical dispersion was increased (p = 0.001).Regarding diastolic function, differences were limited to a lower E/A ratio (p = 0.016) and higher A-wave velocity (p = 0.049). Aortic dilation was also associated with a higher prevalence of aortic regurgitation (p < 0.001). In multivariable linear regression, aortic diameter was independently associated with greater left ventricular mechanical dispersion (p = 0.026) and with lower E/A ratio (p = 0.002), but not with left ventricular volume after adjustment for aortic valve disease. Conclusion Ascending aortic dilation was independently associated with increased left ventricular mechanical dispersion and subtle alterations in diastolic function, but global systolic function was preserved