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The study included the first 10,000 participants of the population-based Hamburg City Health Study (HCHS) of whom 8259 subjects, aged 62.23\u2009\u00b1\u20098.46\u00a0years (51.3% females), enrolled 2016\u20132018, provided echocardiographic data. 69 subjects with bicuspid valves and 23 subjects with moderate\/severe aortic stenosis were excluded. Aortic root dimensions were measured using state-of-the-art cardiac ultrasound, including the aortic annulus, sinus of Valsalva, sinotubular junction (STJ), and ascending aorta, in diastole and systole. The distribution of AR was: 932 (11.4%) mild, 208 (2.5%) moderate, and 20 (0.24%) severe. Patients with moderate or severe AR were predominantly male at advanced age who had hypertension, coronary artery disease, atrial fibrillation, and renal dysfunction. Increasing AR severity correlated with higher absolute and indexed aortic root diameters (e.g., end-diastolic sinus of Valsalva for no-mild-moderate-severe AR in mm\u2009\u00b1\u2009standard deviation: 34.06\u2009\u00b1\u20093.81; 35.65\u2009\u00b1\u20094.13; 36.13\u2009\u00b1\u20094.74; 39.67\u2009\u00b1\u20094.61; p\u2009&lt;\u20090.001). In binary logistic regression analysis, all aortic root components showed significant associations with moderate\/severe AR. Mid-systolic STJ showed the strongest association with moderate\/severe AR (OR 1.33, 95% confidence interval 1.25\u20131.43, p\u2009&lt;\u20090.001). AR was prevalent in 14.2%, of whom 2.8% showed moderate\/severe AR. All assessed aortic root diameters correlated with the prevalence and severity of AR. STJ diameter had the strongest association with moderate\/severe AR possibly reflecting the pathophysiological impact of an increasingly dilated STJ in the context of an ageing aorta.<\/jats:p>","DOI":"10.1007\/s10554-021-02337-6","type":"journal-article","created":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T05:02:46Z","timestamp":1625634166000},"page":"3439-3449","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Aortic root dimensions as a correlate for aortic regurgitation\u2019s severity"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6302-8671","authenticated-orcid":false,"given":"Jan-Per","family":"Wenzel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elina","family":"Petersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius","family":"Nikorowitsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilo","family":"K\u00f6lbel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Reichenspurner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Blankenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evaldas","family":"Girdauskas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,7]]},"reference":[{"issue":"6","key":"2337_CR1","doi-asserted-by":"publisher","first-page":"800","DOI":"10.7326\/0003-4819-106-6-800","volume":"106","author":"MJ Roman","year":"1987","unstructured":"Roman MJ, Devereux RB, Niles NW, Hochreiter C, Kligfield P, Sato N, Spitzer MC, Borer JS (1987) Aortic root dilatation as a cause of isolated, severe aortic regurgitation Prevalence, clinical and echocardiographic patterns, and relation to left ventricular hypertrophy and function. 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SB reports honoraria from Abbott, Siemens, Thermo Fisher, and Roche, outside of the submitted work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The authors do hereby declare that their study complies with the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors do hereby declare that all illustrations and figures in the manuscript are entirely original and do not require reprint permission.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Illustrations and figures"}}]}}