| Background:Obesity is an independent risk factor for cardiovascular disease,and with the aortic root as an important site connecting the heart and systemic blood vessels,the relationship between its morphological changes and obesity is not clear.Body mass index(BMI)is the most widely used index for the diagnosis of overweight and obesity,and its relationship with the aortic root diameter(ARD)index and aortic root dilation also needs to be studied.Objective:To investigate the relationship between BMI and aortic root diameter index and aortic root dilation in patients with a primary diagnosis of coronary heart disease(CHD),and the influence of obesity on aortic root dilation was further explored.Methods:The clinical data of 511 patients with a primary diagnosis of CHD hospitalized in the Shandong Provincial Hospital from July 1,2021 to June 30,2022 were collected retrospectively,and the patients were divided into normal BMI group(n=129),overweight group(n=238)and obesity group(n=143)according to BMI.The differences in general data,laboratory data and cardiac ultrasound data were compared between the patient groups.Pearson,Spearman and partial correlation analyses were used to analyze the association of ARD,aortic root diameter/height(ARD/H)with BMI and other clinical variables.The relationship between BMI and ARD and ARD/H was further explored by multifactor linear regression analysis,and the relationship between BMI、obesity and aortic root dilation was explored by logistic regression analysis.Results:1.There were statistical differences in age,body weight,BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),the proportion of patients with hypertension,proportion of patients with fatty liver,fasting blood glucose,glycated hemoglobin,triglycerides,high-density lipoprotein cholesterol(HDL-c)between three groups.2.There was a statistical difference in ARD between the three groups,with the ARD in the obesity group greater than the normal BMI and overweight group.In addition,statistical differences were also observed between the three groups with respect to left atrial diameter,right ventricular diameter,intraventricular septal thickness,left ventricular diameter,left ventricular posterior wall thickness,right atrial diameter and left ventricular mass.3.ARD and ARD/H were linearly associated with BMI(the correlation coefficients were respectively 0.187 and 0.137,P<0.05).4.After adjusting for age,sex,and body surface area(BSA),ARD and ARD/H were positively correlated with BMI,hypertension,DBP,and MAP,and negatively correlated with total cholesterol(TC)and HDL-c.5.The multivariate linear regression analysis including age,sex,BSA,BMI,hypertension,DBP,MAP,CHOL and HDL-c showed that each 10 kg/m2 increase in BMI showed a 0.25cm increase in ARD and 0.15cm/m in ARD/H.6.The multivariate logistic regression analysis including BMI showed that the risk of aortic root dilation increased with the increase of BMI(OR=1.205,95%CI 1.071-1.355,P=0.002);The multivariate logistic regression analysis including obesity status showed obesity(OR=3.680,95%CI 1.658-8.168,P=0.001)increased the risk of aortic root dilation.In addition,this study also found that male gender and hypertension increased the risk of aortic root dilation,and the risk of aortic root dilation is also increased with the increase of BSA and age.7.The ROC area under the curve of BMI predicting aortic root dilation was 0.595(95%CI 0.544-0.646).Conclusion:1.In patients with a primary diagnosis of CHD,BMI is an independent risk factor for increased ARD,increased ARD/H,and aortic root dilation.2.Obesity is an independent risk factor for aortic root dilation in patients with a primary diagnosis of CHD.3.Male gender,hypertension,increased BSA,and increased age were also independent risk factors for aortic root dilation. |
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