Health-related quality of life, psychological well-being and physical activity in patients with mild-to-moderate ascending aortic dilation - a cross-sectional case-control study.
Nilsson F, Lindenberger M, et al. • BMC cardiovascular disorders • 2026
In this population-based cohort, no statistically significant differences in HRQoL, psychological well-being, and physical activity were observed between subjects with mild to moderate ascending aortic dilation and matched controls.
Key Findings
Results
No statistically significant differences in health-related quality of life were observed between patients with mild-to-moderate ascending aortic dilation and matched controls.
Study drew from the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) in Linköping (n = 5053 total).
67 cases (ascending aortic dilation ≥ 40 mm) and 50 age- and sex-matched controls completed the questionnaires.
HRQoL was assessed using validated questionnaire forms.
Cases and controls were identified from a general population-based cohort, not a clinical referral population.
Results
Anxiety and depression scores were comparable between patients with ascending aortic dilation and controls.
Anxiety comparison yielded p = 0.228 and depression comparison yielded p = 0.307, neither reaching statistical significance.
No significant correlations were identified between aortic diameter and perceived stress, anxiety, or depression.
Perceived stress also did not differ significantly between cases and controls (p = 0.096).
Psychological well-being was assessed using validated forms.
Results
Physical activity and physical capacity did not differ significantly between cases and controls.
Physical capacity comparison: p = 0.173.
Physical activity comparison: p = 0.471.
Both physical capacity and physical activity were assessed using validated forms.
Neither measure reached the conventional threshold for statistical significance.
Results
Cases with ascending aortic dilation demonstrated a trend toward higher sedentary behaviour compared to controls, though this did not reach statistical significance.
Cases demonstrated a higher mean rank than controls for sedentary behaviour (62 vs. 52).
The p-value for sedentary behaviour was 0.062, marginally exceeding the conventional threshold for significance.
Group comparisons were made using independent t-tests or Mann-Whitney U tests.
The authors noted this trend despite the overall lack of significant differences in physical activity levels.
Results
No significant correlations were found between aortic diameter and psychological measures including perceived stress, anxiety, or depression.
Spearman's rank correlation was used for correlation analyses.
Aortic diameter was examined as a continuous variable in relation to psychological outcomes.
This finding suggests that larger dilation within the mild-to-moderate range does not correspond to greater psychological burden.
The study design was cross-sectional and case-control.
Discussion
The authors acknowledged that small differences between groups cannot be excluded due to the small sample size.
Only 67 cases and 50 controls completed questionnaires from a pool of 5053 SCAPIS participants.
The authors stated: 'given the small sample size, small differences between groups cannot be excluded.'
The study was cross-sectional in design, limiting causal inference.
The authors concluded that 'balanced management strategies that promote safe physical activity, psychological well-being and HRQoL remain important in this population.'
What This Means
This research suggests that people who have mild-to-moderate enlargement (dilation) of the main artery leaving the heart — a condition that requires long-term medical monitoring due to risks like aortic dissection — do not appear to experience significantly worse quality of life, anxiety, depression, or stress compared to similar people without this condition. The study recruited participants from a large Swedish population health study and compared 67 people with aortic dilation to 50 age- and sex-matched people without the condition, finding no statistically meaningful differences across a range of psychological and physical activity measures.
One noteworthy trend was that people with aortic dilation tended to sit more (higher sedentary behavior scores) than controls, though this difference just missed the standard cutoff for statistical significance. Additionally, the size of the aortic dilation itself did not correlate with how stressed, anxious, or depressed someone felt, suggesting that knowing about — and living with — this condition in its milder forms may not translate into measurable psychological harm at the population level.
This research matters because it provides early evidence that patients with mild-to-moderate aortic dilation, when identified through general population screening rather than clinical referral, may cope reasonably well psychologically. However, the study was relatively small, so subtle differences in well-being could have been missed. The authors emphasize that healthcare approaches should still support safe physical activity and emotional well-being for these patients, as these remain important aspects of long-term care.
Nilsson F, Lindenberger M, Borg S, Kylhammar D, Dyverfeldt P, Hammaréus F, et al.. (2026). Health-related quality of life, psychological well-being and physical activity in patients with mild-to-moderate ascending aortic dilation - a cross-sectional case-control study.. BMC cardiovascular disorders. https://doi.org/10.1186/s12872-026-06616-9