Gender-related changes in aortic geometry throughout life

Aortic geometry changes throughout life are not well defined. This investigation delineates aortic geometry across the adult age spectrum and determines the gender-related influence of aging on aortic morphometry. Contrast-enhanced computed tomography scans of all aortic segments in 195 subjects (94 women, 101 men, average age 57 +/- 20 years) free of vascular disease were analysed. Lengths and diameters of each aortic segment as well as width, height and tortuosity of the thoracic aorta were compared between both genders. Aortic diameters and lengths were larger in men than women (P < 0.001); however, after adjustment for body surface area (BSA), the ascending aorta and aortic arch revealed greater diameters in women than in men (P = 0.001 and P = 0.011, respectively). All aortic segment dimensions increased in a similar pattern with age for both genders, except the ascending aorta diameter, which increased +3.4% (P < 0.001) per decade in women and +2.6% (P < 0.001) per decade in men. Owing to more dynamic ascending aortic growth in women, absolute diameters were similar in both genders at an older age (> 70 years old: 3.4 +/- 0.3 vs 3.5 +/- 0.3 cm, P = 0.241). Female gender is associated with smaller aortic dimensions, but only at a young age. The dynamics of aortic growth throughout life are greater in women than in men. Gender-related changes in aortic geometry provide a hypothesis for the predominance of aortic dissection in young male patients, which normalizes between genders with increasing age.