J Cardiovasc Imaging.  2019 Jan;27(1):11-21. 10.4250/jcvi.2019.27.e3.

Gender Related Association between Arterial Stiffness and Aortic Root Geometry

  • 1Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea. jooheezo@hanmail.net
  • 2Department of Biostatistics, Boramae Medical Center, Seoul, Korea.


The gender-related change in aortic morphology by arterial stiffness has not been well studied. This study was performed to investigate the association between brachial-ankle pulse wave velocity (baPWV) and aortic root size according to gender.
A total of 263 consecutive subjects (63.2 ± 10.6 years, 71.1% men) without overt cardiovascular disease who underwent both baPWV measurement and transthoracic echocardiography on the same day were retrospectively analyzed. The diameters of the aortic annulus (AN), sinus of Valsalva (SV), sinotubular junction (STJ), and ascending aorta (AA) were measured using 2-dimensional echocardiography.
The body surface area (BSA)-corrected diameters of AN, SV, STJ, and AA were significantly higher in women than in men. Univariable analyses showed that baPWV was significantly correlated with SV/BSA and STJ/BSA in men, and with SV/BSA, STJ/BSA, and AA/BSA in women (p < 0.05 for each). In men, however, these associations disappeared in multiple linear regression models after controlling for potential confounders (p > 0.05 for each). In women, the associations of baPWV with diameters of STJ/BSA (β = 0.407, p < 0.001) and AA/BSA (β = 0.391, p = 0.005) remained significant in the same multivariate models. Women-specific correlation between aortic root size and baPWV was also similarly demonstrated in age-matched analyses (n = 61 in each gender).
Among Korean adult without overt cardiovascular disease, the association between increased arterial stiffness and aortic root dilatation is stronger in women than in men.


Aortic geometry; Arterial stiffness; Gender difference; Pulse wave velocity
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