{"id":"75800eade1a7","type":"article","url":"https://hartvaat.nl/2026/01/23/etnische-verschillen-in-aortadiameters-indiase-versus-nederlandse-patienten-amst/","title":"Etnische verschillen in aortadiameters: Indiase versus Nederlandse patiënten (Amsterdam UMC)","title_en":"Ethnic variation in thoracic aortic dimensions in the general population: a comparison between Indian and Dutch populations","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Open Heart","doi":"http://openheart.bmj.com/cgi/content/short/13/1/e003808?rss=1","source_url":"https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003808?rss=1","authors":["Bacour","N.","Idhrees","M.","Samraj","J.","Grewal","S.","Velayudhan","B.","Busra Celik","N.","Zafar","M.","Elefteriades","J. A.","Grewal","N."],"significance":6,"published":"2026-01-23","source_date":"2026-01-23","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/bloedsuikerdoelen-cardiovasculair/","https://hartvaat.nl/kennis/antistolling/doac-versus-vka-keuze/"],"congress":"","summary_en":"Guidelines use absolute diameter thresholds for aortic surgery, largely based on Western cohorts. This retrospective study compared aortic diameters of Indian (SIMS Hospital) and Dutch patients (Amsterdam UMC) who underwent CT in 2022 (3,692 patients: 2,000 Indian, 1,692 Dutch) at five anatomical locations. Indian patients had a larger aortic root (33.9 vs 31.5 mm), but Dutch patients had significantly larger diameters of the ascending aorta (33.1 vs 30.5 mm), aortic arch, descending aorta and abdominal aorta. These differences persisted after adjustment for age, sex, height and comorbidity. There is thus substantial ethnic-geographic variation in aortic diameters — raising questions about applying current (Western) surgical thresholds to Indian patients and arguing for individualised, indexed risk assessment.","created":"2026-07-03T10:32:27Z","updated":"2026-07-03T13:31:24Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Richtlijnen hanteren absolute diameterdrempels voor het opereren van de aorta, grotendeels gebaseerd op westerse cohorten. Deze retrospectieve studie vergeleek de aortadiameters van Indiase (SIMS Hospital) en Nederlandse patiënten (Amsterdam UMC) die in 2022 een CT ondergingen (3.692 patiënten: 2.000 Indiaas, 1.692 Nederlands), op vijf anatomische locaties. Indiase patiënten hadden een grotere aortawortel (33,9 vs. 31,5 mm), maar Nederlandse patiënten hadden significant grotere diameters van de aorta ascendens (33,1 vs. 30,5 mm), de aortaboog, de aorta descendens en de abdominale aorta. Deze verschillen bleven bestaan na correctie voor leeftijd, geslacht, lengte en comorbiditeit. Er bestaat dus aanzienlijke etnisch-geografische variatie in aortadiameters — wat vragen oproept over het toepassen van de huidige (westerse) operatiedrempels op Indiase patiënten en pleit voor geïndividualiseerde, geïndexeerde risicobeoordeling.","abstract_original":"<sec><st>Background</st>\n<p>Aortic dimensions are critical for assessing the risk of acute aortic complications and guiding surgical interventions. Current guidelines define absolute diameter thresholds based largely on Western cohorts, while data on Indian patients remain limited. To address this gap, our study provides a direct, large-scale comparison of aortic diameters between Indian and Dutch individuals to determine whether existing geometry-based surgical guidelines are equally applicable across populations.</p>\n</sec>\n<sec><st>Methods</st>\n<p>In this retrospective cohort study, we analysed all consecutive patients who underwent CT imaging between January and December 2022 at SIMS Hospital (India) and Amsterdam University Medical Center (Netherlands). Aortic diameters were measured at five predefined anatomical locations: aortic root, ascending aorta, aortic arch, descending aorta and abdominal aorta. Multivariable linear regression models were used, adjusting for age, sex, height and comorbidities.</p>\n</sec>\n<sec><st>Results</st>\n<p>A total of 3692 patients were included (2000 Indian and 1692 Dutch). Indian patients had a larger aortic root (33.9 &plusmn; 4.6 mm vs 31.5 &plusmn; 5.4 mm; p&lt;0.001), whereas Dutch patients had significantly larger diameters of the ascending aorta (33.1 &plusmn; 5.4 mm vs 30.5 &plusmn; 4.3 mm; p&lt;0.001), aortic arch (29.8 &plusmn; 4.5 mm vs 26.4 &plusmn; 3.7 mm; p&lt;0.001), descending aorta (26.7 &plusmn; 4.2 mm vs 23.0 &plusmn; 3.9 mm; p&lt;0.001) and abdominal aorta (23.1 &plusmn; 5.0 mm vs 21.3 &plusmn; 3.4 mm; p&lt;0.001). These differences persisted after adjustment for age, sex, height and comorbidities.</p>\n</sec>\n<sec><st>Conclusions</st>\n<p>In this first global comparison of ascending aortic dimensions between Indian and Dutch patients, we demonstrate substantial geographic heterogeneity. These findings highlight concerns about applying current surgical thresholds to Indian patients with aortopathy and emphasise the need for individualised risk assessment and treatment strategies in this population. Future guidelines should consider population-specific differences in India and incorporate indexed measurements to optimise personalised surgical decision-making.</p>\n</sec>"}