Progressive increase in ascending aortic diameter across the menopausal transition: A longitudinal study using AI-based automated measurement from chest radiographs

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Menopausal transition (n=4427). Intervention: Menopausal transition vs. Premenopause. Primary outcome: Maximum ascending aortic diameter.

Q: What does this research mean for the field?

Ascending aortic diameter progressively increases across the menopausal transition independently of age and traditional cardiovascular risk factors, with structural changes detectable even before menopause onset. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Yoonyoung Jang; Yoosoo Chang; Jeonggyu Kang; Seungho Ryu

doi:10.1016/j.maturitas.2026.109117

September 12, 2026MaturitasOpen Access

Progressive increase in ascending aortic diameter across the menopausal transition: A longitudinal study using AI-based automated measurement from chest radiographs

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Key result

Menopausal transition linked to a ~1 mm increase in maximum ascending aortic diameter.

n=4,427

Why the study?

Despite the menopausal transition being a critical period of accelerating CVD risk, structural remodeling of the thoracic ascending aorta during this phase remains poorly characterized.

Key Points

To examine longitudinal structural changes in ascending aortic diameter across menopausal stages using deep learning-assisted measurements from routine chest radiographs.
Analyzed 4,427 Korean women who were premenopausal at baseline (mean age 40.2 ± 3.9 years) across a median follow-up of 7.3 years.
Quantified maximum ascending aortic diameter from posteroanterior chest radiographs using validated deep learning software, staging menopause via STRAW+10 criteria.
Employed linear mixed-effects models to assess aortic changes adjusted for age and cardiovascular risk factors, stratified by PREVENT 10-year CVD risk score.
Age-adjusted maximum ascending aortic diameter increased across menopausal stages, expanding from 2.901 cm at premenopause to 2.991 cm at postmenopause.
The progressive increase in ascending aortic diameter remained statistically significant after adjusting for traditional cardiovascular disease risk factors.
Aortic expansion patterns varied significantly by PREVENT 10-year CVD risk score, with late-transition increases detected even in the lowest three risk quartiles.

Study Design

Type

Cohort (n=4,427)

PICO

P

Population

4,427 Korean women who were premenopausal at baseline, followed for a median of 7.3 years to assess longitudinal aortic changes.

E

Exposure / Comparator

Menopausal transition vs Premenopause

O

Primary Outcome

Maximum ascending aortic diameter

Main Result

Absolute Event Rate: 2.991% vs 2.901%

Implication

Longitudinal study reveals progressive ascending aortic enlargement across the menopausal transition in women, indicating early structural vascular remodeling before menopause onset.

Abstract

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Discussion

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Cite This Study

Jang et al. (2026) conducted a cohort in Menopausal transition (n=4,427). Menopausal transition vs. Premenopause was evaluated on Maximum ascending aortic diameter. The menopausal transition was associated with a progressive increase in age-adjusted maximum ascending aortic diameter, from 2.901 cm in premenopause to 2.991 cm in postmenopause.

synapsesocial.com/papers/6aa7b15d79e9260bc85aad54 https://doi.org/10.1016/j.maturitas.2026.109117

View Full Paper

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Progressive increase in ascending aortic diameter across the menopausal transition: A longitudinal study using AI-based automated measurement from chest radiographs

Key Points

Study Design

PICO

Main Result

Implication

Abstract

Discussion

Cite This Study

Progressive increase in ascending aortic diameter across the menopausal transition: A longitudinal study using AI-based automated measurement from chest radiographs

Key Points

Study Design

PICO

Main Result

Implication

Abstract

Discussion

Cite This Study

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