Abstract 13757: Dilated Ascending Aorta in Hypertrophic Cardiomyopathy: Incidence and Predictors
Background: In many hypertrophic cardiomyopathy (HCM) patients, we observed that the proximal ascending aorta (AA) is dilated. We sought to determine the frequency & potential predictors of dilated AA in HCM patients.
Methods: We studied 267 consecutive HCM patients, ≥18 years (68% men) that underwent clinical, echo and contrast-enhanced cardiac magnetic resonance (CMR) assessment at a single center. Maximal (resting or provocable) left ventricular outflow tract gradient (LVOTG) was recorded on echo; LV mass recorded on CMR. True short-axis proximal AA (also aortic root) dimensions were measured using multiple CMR sequences. Expected aortic root dimensions, based on age, gender & height were calculated using the following formula: 1.519 + (age [years] х 0.010) + (height [cm] х 0.010)-(gender [1=man, 2=woman] х 0.247). If difference between actual & expected measurement was more than the product of 1.96 x 0.215 (standard error of mean for above equation), the root was considered dilated.
Results: There were 49% hypertensives, 82% on betablockers & 28% on calcium blockers. Mean LV ejection fraction, LVOTG, LV thickness, LV mass, aortic root & AA dimensions were 63±5%, 105±51 mm Hg, 2±0.5 cm, 207±71 g, 3.1±0.5 cm & 3.2±0.5 cm, while 0.7% had ≥II+ aortic regurgitation. Dilated proximal AA was seen in 36 (14%) patients. After adjustment for age, gender & height, dilated AA was seen in 20 (8%) patients. Logistic regression analysis demonstrating the predictors of dilated AA (absolute as well as adjusted dimensions) are shown in Figures a-b.
Conclusions: Dilation of proximal AA is frequently seen in HCM patients, & attention to AA should be paid during HCM evaluation. Hypertension is an independent predictor of dilated AA. Whether AA dilation represents a concomitant aortopathy or a secondary adaptive phenomenon remains to be elucidated.
Author Disclosures: F. Asfahan: None. N.G. Smedira: None. A. Dhillon: None. M. THamilarasan: None. B. Lytle: None. H. Lever: None. M.Y. Desai: None.
- © 2014 by American Heart Association, Inc.