Reference Ranges for Ascending Aorta Dimensions in Iranian Adults Assessed by 2D Echocardiography: Effect of Sex, Age, and Anthropometric Factors.

Background: Determining the normal ranges of the aortic dimension is essential in various populations. In this study, we aim to define the normal ranges for the sinus of Valsalva (SoV), the sinotubular junction (STJ), and the ascending aorta (AA) diameters using the Imam Khomeini Hospital Complex (IKHC) data registry of Iranian adults. Methods: This study was conducted on 2269 adult participants with left ventricular ejection fraction (LVEF) of more than 50%. Echocardiographic measurements were taken at the SoV, STJ, and AA levels. Subjects with any valvular stenosis and more than moderate insufficiency were excluded. Results: The normal range of SoV was found to be 24.5-38.9 mm in males and 21.7-34.9 mm in females. Additionally, the STJ diameters ranged from 19.7 to 32.5 mm and 18.0 to 29.6 mm in males and females, respectively. The AA measurements showed significant differences between sexes, ranging from 23.74 to 38.02 mm in males and 21.45 to 36.53 mm in females. Results also indicated that for every 10-year increase in age, the diameters of SoV, STJ, and AA increased by approximately 1.0, 0.8, and 1.6 mm, respectively. Conclusion: This study provided detailed echocardiographic reference values for aortic dimensions in the Iranian population and compared them across various age groups, genders, and body mass index (BMI) categories. Also, the findings emphasize the impact of aging on aortic values. The limited external validity of our single-center, hospital-based study suggests that future multicenter research is necessary to confirm our findings and improve their generalizability.