University of Oulu

Kauhanen, S.P., Saari, P., Jaakkola, P. et al. High prevalence of ascending aortic dilatation in a consecutive coronary CT angiography patient population. Eur Radiol 30, 1079–1087 (2020).

High prevalence of ascending aortic dilatation in a consecutive coronary CT angiography patient population

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Author: Kauhanen, S. Petteri1,2; Saari, Petri2; Jaakkola, Pekka3;
Organizations: 1Doctoral Programme of Clinical Research, University of Eastern Finland, Kuopio, Finland
2Department of Clinical Radiology, Clinical Imaging Center, Kuopio University Hospital, PO Box 100, Puijonlaaksontie 2, 70029, Kuopio, KYS, Finland
3Department of Heart and Thoracic Surgery, Heart Center, Kuopio University Hospital, Kuopio, Finland
4School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland
5Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
6Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: Springer Nature, 2020
Publish Date: 2020-04-27


Objectives: To clarify the prevalence and risk factors of ascending aortic (AA) dilatation according to ESC 2014 guidelines.

Methods: This study included 1000 consecutive patients scheduled for diagnostic coronary artery computed tomographic angiography. AA diameter was retrospectively measured in 3 planes: sinus valsalva, sinotubular junction, and tubular part. The threshold for AA dilatation was set to > 40 mm which has been suggested as an upper normal limit for AA diameter in ESC 2014 guidelines on aortic diseases. Aortic size index (ASI) using the ratio between aortic diameter and body surface area (BSA) was applied as a comparative measurement. The threshold for AA dilatation was set to the upper limit of normal distribution exceeding two standard deviations (95%). Risk factors for AA dilatation were collected from medical records.

Results: The patients’ mean age was 52.9 ± 9.8 years (66.5% women). The prevalence of AA dilatation was 23.0% in the overall study population (52.5% males) and 15.1% in the subgroup of patients with no coronary artery disease or bicuspid (BAV)/mechanical aortic valve (n = 365). According to the normal-distributed ASI values, the threshold for sinus valsalva was defined as 23.2 mm/m2 and for tubular part 22.2 mm/m2 in the subgroup. Higher BSA was associated with larger AA dimensions (r = 0.407, p < 0.001). Male gender (p < 0.001), BAV (p < 0.001), hypertension (p = 0.009) in males, and smoking (p < 0.001) appeared as risk factors for AA dilatation.

Conclusions: The prevalence of AA dilatation is high with current ESC guidelines for normal AA dimension, especially in males. Body size is strongly associated with AA dimensions; it would be more reliable to use BSA-adjusted AA diameters for the definition of AA dilatation.

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Series: European radiology
ISSN: 0938-7994
ISSN-E: 1432-1084
ISSN-L: 0938-7994
Volume: 30
Pages: 1079 - 1087
DOI: 10.1007/s00330-019-06433-z
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: Open access funding provided by University of Eastern Finland (UEF) including Kuopio University Hospital. This study has received funding from Oiva Vaittinen Will Grant, Aarne Koskelo Foundation, Finnish Society of Angiology, Radiological Society of Finland, Northern Savonia Foundation of the Finnish Cultural Foundation, Finnish Foundation of Cardiovascular Research, and Ida Montin Foundation.
Copyright information: © The Author(s) 2019. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.