Increased Proximal Aortic Diameter is Associated With Risk of Cardiovascular Events and All-Cause Mortality in Blacks The Jackson Heart Study

• Published in: Journal of the American Heart Association Vol. 6; no. 6
• Main Authors: Kamimura, Daisuke, Suzuki, Takeki, Musani, Solomon K, Hall, Michael E, Samdarshi, Tandaw E, Correa, Adolfo, Fox, Ervin R
• Format: Journal Article
• Language: English
• Published: England John Wiley and Sons Inc 21.06.2017; Wiley
• Subjects: Adult; African Americans; Aged; aorta; Aorta - diagnostic imaging; Aorta - pathology; Aorta - physiopathology; Blacks; Cardiovascular Diseases - diagnostic imaging; Cardiovascular Diseases - ethnology; Cardiovascular Diseases - mortality; Cardiovascular Diseases - physiopathology; cardiovascular events; Cause of Death; Chi-Square Distribution; Dilatation, Pathologic; Disease-Free Survival; echocardiogram; Echocardiography; Female; Humans; Jackson Heart Study; Kaplan-Meier Estimate; Male; Middle Aged; Mississippi - epidemiology; Original Research; Predictive Value of Tests; Proportional Hazards Models; Prospective Studies; Risk Assessment; Risk Factors; Time Factors; Jackson Heart Study; cardiovascular events; aorta; Blacks; echocardiogram
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.116.005005

Enlargement of the proximal aorta is associated with aortic wall tissue remodeling, including fragmentation of the elastin fibers, increased synthesis of collagen, and calcification, all of which are associated with aortic wall stiffening. We hypothesized that the proximal aortic diameter (AoD) is associated with cardiovascular events in a community-based cohort of blacks. We investigated the associations between AoD and cardiovascular events among 3018 black participants (mean age, 55.9 years; 69% women) without past history of cardiovascular disease in the Jackson Heart Study. AoD was measured using echocardiography at the level of the sinuses of Valsalva at end diastole. Cardiovascular event was defined as incident myocardial infarction, fatal coronary artery disease, stroke, or heart failure hospitalization. Cox proportional hazards regression models were used to evaluate the association between baseline AoD and cardiovascular events. Over a median follow-up of 8.3 years, there were 258 cardiovascular events (incident rate, 10.5 per 1000 person-years). After adjustment for traditional risk factors, increased AoD was significantly associated with cardiovascular events (hazard ratio per 1-cm increase, 1.72; 95% CI, 1.10-2.69; <0.05). Participants in the top AoD quintile had a higher incidence of cardiovascular events compared to those not in the top quintile (hazard ratio, 1.47; 95% CI, 1.11-1.94; <0.005) after adjustment for risk factors. Greater AoD was associated with an increased risk of cardiovascular events in a community-based cohort of blacks. AoD may be useful as a predictor of incident cardiovascular events and further investigation is warranted.