Background: A few prior studies have demonstrated the increased prevalence of dilated ascending aorta in patients with hypertrophic cardiomyopathy (HCM). There are no studies evaluating the relative association of HCM with sinus of Valsalva (SV) versus mid ascending aorta (MAA). In addition, the mechanism behind aortic dilation in HCM is unclear, as to whether it is acquired or genetically mediated.

Methods: Echocardiography reports of patients (n= 65,843; 46.5% male), referred to tertiary care center from January 2011 to November 2014 with adequate data on aortic parameters (diameter of SV/MAA) were reviewed. Electronic medical records were queried to obtain patients with HCM using ICD 9 codes. Aortic dilation was defined based on American Society of Echocardiography guidelines published in 2015. The records were evaluated for presence of genetic studies.

Results:Of the 65,843 patients, 553 HCM patients were identified, out of which 48% were men. The mean age was similar in both HCM and general population (63.7±16.5 vs. 64.3 ±17.3, p=0.384). The mean diameter of SV (3.21 ±0.51 vs. 3.08±0.46; p =

Conclusions: These data suggest that HCM is associated with increased prevalence of dilated SV, but not MAA. The lower odds of dilated aorta in HCM patients who were gene positive, suggest that this association may not be genetically mediated. Further studies are required to identify the pathophysiology behind this association.