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Aortic and vascular disease
Original research article
Aortic sinus diameter in middle age is associated with body size in young adulthood
  1. Jussi A Hernesniemi1,2,
  2. Jarkko Heiskanen3,
  3. Saku Ruohonen3,
  4. Noora Kartiosuo3,
  5. Nina Hutri-Kähönen4,
  6. Mika Kähönen5,
  7. Eero Jokinen6,
  8. Päivi Tossavainen7,8,
  9. Merja Kallio7,8,
  10. Tomi Laitinen9,
  11. Terho Lehtimäki2,
  12. Jorma S A Viikari10,11,
  13. Markus Juonala10,11,
  14. Olli T Raitakari3,12
  1. 1 Department of Cardiology, Tays Heart Hospital, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
  2. 2 Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
  3. 3 Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
  4. 4 Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland
  5. 5 Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland
  6. 6 Children’s Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
  7. 7 Department of Pediatrics, University of Oulu, Oulu, Finland
  8. 8 PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland
  9. 9 Department of Clinical Physiology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
  10. 10 Department of Medicine, University of Turku, Turku, Finland
  11. 11 Division of Medicine, Turku University Hospital, Turku, Finland
  12. 12 Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
  1. Correspondence to Dr Jussi A Hernesniemi, Department of Cardiology, University of Tampere, Biokatu 6, Tampere 33520, Finland; jussi.hernesniemi{at}uta.fi

Abstract

Objective Aortic sinus dilatation can lead to aortic valve regurgitation or even aortic dissection. Our objective was to examine the association between body surface area (BSA) measures from childhood to middle age and aortic sinus diameter in middle age. Understanding the relation of these two clarifies how aortic size is normally determined.

Methods Cardiovascular Risk in Young Finns Study is a longitudinal study with follow-up of over 31 years (1980–2011). The study comprises information of body composition from multiple time points of 1950 subjects with cardiac ultrasound measurements made in 2011. The association between BSA in different ages and aortic sinus diameter in middle age was analysed by linear regression modelling adjusted with age, sex and diastolic blood pressure. Missing BSA values were derived for each life year (ages 3–33 years) from subject-specific curves for body weight and height estimated from longitudinal measurements using mixed model regression splines.

Results BSA estimates in early 20s are most strongly associated with aortic sinus diameter in middle age. Top association was observed at age 23 years with one SD increase in estimated BSA corresponding to 1.04 mm (0.87–1.21 mm) increase in aortic diameter. Increase in body weight beyond early 20s does not associate with aortic sinus diameter, and the association between middle age BSA and aortic size is substantially weaker (0.74 mm increase (0.58–0.89 mm)). These results were confirmed in a subpopulation using only measured data.

Conclusion The association between aortic sinus diameter and BSA is stronger when considering BSA in young adulthood compared with BSA in middle age.

  • echocardiography
  • aortic aneurysm
  • epidemiology

https://doi.org/10.1136/heartjnl-2017-312136

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    Footnotes

    • Contributors JAH, SR, TeL, OTR and JSAV planned the present study. JAH, JH, SR, NK, N-HK, EJ, PT, MK, ToL, TeL and MJ conducted the study. All authors have been involved in reporting the study (ie, drafting the work or revising it critically for important intellectual content). JAH is responsible for the data analysis, while OTR is responsible of the overall content of the work. All authors have given their final approval for the manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Local ethics committees at all recruiting study centres have approved the study protocol.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The data of the present study are not publicly available for sharing without the approval the monitoring board and full anonymisation.