Aortic root dilatation in the children and young adults: prevalence, determinants, and association with target organ damage

Aortic root dilatation is associated with increased cardiovascular risk in hypertensive adults. In the young, few data have been published evaluating the cardiovascular organ damage that may be present in patients with aortic dilatation. The objective was to evaluate the prevalence of proximal aorta dilatation, its possible determinants, and its relation with target organ damage in young subjects. The aorta was measured at the level of the sinus of valsalva and at its proximal ascending aorta (pAA) in a total of 177 young subjects (11-35 years). Linear regression analysis was used to assess the association between aortic size, clinical, and hemodynamic parameters. Prevalence of pAA and sinus of valsalva dilatation was 10.2% and 8.7%, respectively. No significant differences in prevalence were found in hypertensive, diabetic and obese subjects; aortic enlargement was less frequent in African-Americans. Age, sex, and central pulse pressure were the most important determinants of aortic size. Left ventricular mass was increased in patients with aortic enlargement, and aortic size showed an inverse relation with indices of local distensibility. The prevalence of aortic dilatation among young patients is high (10%). As in adults, age and body surface area are the main determinants of aortic size. Dilatation of the ascending aorta is associated with an increased left ventricular mass, as in adults, but not with increased arterial stiffness. Local distensibility is reduced in patients with pAA enlargement.