Ansari Ayub, Syed Kazi, Baig Mirza, Tanbour Yazan, Baghdadi Abdullah, Ansari Aisha, Nada Ayman
Radiology, Kansas City University of Medicine and Biosciences, Santa Clara, USA.
Radiology, Kansas City University of Medicine and Biosciences, Kansas City, USA.
Cureus. 2024 Dec 31;16(12):e76703. doi: 10.7759/cureus.76703. eCollection 2024 Dec.
Ethnic differences may substantially influence the morphological characteristics of the ascending aorta, with potential implications for clinical assessment and management of aortic dilatation. This systematic review evaluated the impact of ethnicity on ascending aorta diameter and dilatation rates, highlighting the need for more tailored, ethnicity-specific care in cardiovascular practice. We identified 11 studies that measured ascending aorta dimensions using transthoracic echocardiography (TTE), computed tomography (CT), or magnetic resonance imaging (MRI). Most investigations focused on Asian, Caucasian, African American, and Hispanic populations. Data extraction revealed notable variability in baseline aortic diameters across ethnic groups. Some studies found no significant differences between Asian and Caucasian participants, whereas others reported consistently larger diameters in Chinese ethnicities compared to Caucasians and smaller diameters in African American groups. One investigation, for instance, showed that Chinese participants had ascending aorta diameters approximately 1.5 mm larger than their Caucasian counterparts. Dilatation rates also diverged: one study observed that non-White race was linked to earlier or more rapid aortic root dilation in younger populations. At the same time, another reported that Vietnamese individuals had nearly twice the annual growth rate of ascending aorta dilatation when compared to other ethnicities. Available data on prevalence varied, with some studies suggesting ascending aorta dilatation ranged from about 1.2% to 7.5% in Caucasians, 0.9% to 6.4% in African Americans, and 0.8% to 5.9% in Asians. These findings potentiate the role of ethnicity in shaping aortic dimensions, possibly through a combination of genetic predisposition, environmental factors, and lifestyle influences. Incorporating ethnic background into risk stratification may improve the accuracy of clinical assessments and help guide personalized management strategies for ascending aorta dilatation. Future research should address heterogeneity in measurement techniques, more consistently defining ethnic groups, and explore long-term outcomes to clarify whether these observed morphological differences translate into variations in morbidity and mortality.
种族差异可能会极大地影响升主动脉的形态特征，这对主动脉扩张的临床评估和管理具有潜在影响。本系统评价评估了种族对升主动脉直径和扩张率的影响，强调了在心血管实践中需要更具针对性、针对特定种族的护理。我们确定了11项使用经胸超声心动图（TTE）、计算机断层扫描（CT）或磁共振成像（MRI）测量升主动脉尺寸的研究。大多数调查集中在亚洲人、白种人、非裔美国人和西班牙裔人群。数据提取显示不同种族之间基线主动脉直径存在显著差异。一些研究发现亚洲和白种人参与者之间没有显著差异，而其他研究报告称，与白种人相比，中国种族的直径始终更大，非裔美国人群体的直径更小。例如，一项调查显示，中国参与者的升主动脉直径比白种人对应者大约大1.5毫米。扩张率也存在差异：一项研究观察到，非白人种族与年轻人群中更早或更快的主动脉根部扩张有关。与此同时，另一项研究报告称，与其他种族相比，越南人的升主动脉扩张年增长率几乎是两倍。关于患病率的现有数据各不相同，一些研究表明，白种人的升主动脉扩张率约为1.2%至7.5%，非裔美国人为0.9%至6.4%，亚洲人为0.8%至5.9%。这些发现增强了种族在塑造主动脉尺寸方面的作用，可能是通过遗传易感性、环境因素和生活方式影响的综合作用。将种族背景纳入风险分层可能会提高临床评估的准确性，并有助于指导升主动脉扩张的个性化管理策略。未来的研究应解决测量技术的异质性问题，更一致地定义种族群体，并探索长期结果，以澄清这些观察到的形态差异是否转化为发病率和死亡率的差异。
