Aortic Cross-Sectional Area/Height Ratio and Outcomes in Patients With a Trileaflet Aortic Valve and a Dilated Aorta
Authors' conclusion
In patients with dilated aortic root and trileaflet aortic valve, a ratio of aortic root area to height provides independent and improved stratification for prediction of death.
Study context
- Population
- Patients with dilated aortic root (≥4 cm) and trileaflet aortic valve with echocardiography and gated CT or MR angiography, 2003–2007
- Participants
- 771 patients
- Exposure
- Aortic root area/height ratio ≥10 cm²/m vs <10 cm²/m
- Outcome
- All-cause death
- Follow-up
- 7.8 years (IQR, 6.6-8.9)
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Hazard ratio (95% CI)P value
Aortic root area/height ratiomultivariable Cox
4.04(2.69–6.231)
P < 0.01Aortic surgerymultivariable Cox; improved survival
0.47(0.27–0.81)
P < 0.01- Overall deaths
- 130 (17%)
- Ratio ≥10 cm²/m prevalence
- 24%
Observational data: associations, not effects.
Further findings
Death, surgical vs nonsurgical
P < 0.01
- Death, surgical vs nonsurgical — Underwent aortic surgery (76% within 1 year)
- 280 (36%)
Incremental prognostic value of ratio ≥10 cm²/m added to clinical model (longer-term mortality)
- C-statistic 0.57 (95% CI, 0.35-0.77) to 0.65 (95% CI, 0.52-0.73)
- P < 0.01
- Net reclassification index 0.17 (95% CI, 0.02-0.31) to 0.23 (95% CI, 0.04-0.34)
- P < 0.01
Aortic root diameter 4.5–5.5 cm (subgroup, n=327)
- Abnormal aortic root area/height ratio
- 44%
- Died, among those with abnormal ratio
- 78%
In-hospital postoperative mortality
- In-hospital postoperative mortality
- 1%
Original publication
Aortic Cross-Sectional Area/Height Ratio and Outcomes in Patients With a Trileaflet Aortic Valve and a Dilated Aorta. Circulation. Published 21 October 2016. doi:10.
Summarised from the published abstract; every number is checked against it