Impact of methodology and the use of allometric scaling on the echocardiographic assessment of the aortic root and arch: a study by the Research and Audit Sub-Committee of the British Society of Echocardiography

Echo Research and Practice - 2014
David Oxborough, Saqib Ghani, Allan Harkness, Guy Lloyd, William E. Moody, Liam Ring, Julie Sandoval, Roxy Senior, Nabeel Sheikh, Martin Stout1, Victor Utomi, James Willis, Abbas Zaidi, Richard P. Steeds
1Cardiology Department, University Hospital South Manchester , Manchester , UK.

Tóm tắt

The aim of the study is to establish the impact of 2D echocardiographic methods on absolute values for aortic root dimensions and to describe any allometric relationship to body size. We adopted a nationwide cross-sectional prospective multicentre design using images obtained from studies utilising control groups or where specific normality was being assessed. A total of 248 participants were enrolled with no history of cardiovascular disease, diabetes, hypertension or abnormal findings on echocardiography. Aortic root dimensions were measured at the annulus, the sinus of Valsalva, the sinotubular junction, the proximal ascending aorta and the aortic arch using the inner edge and leading edge methods in both diastole and systole by 2D echocardiography. All dimensions were scaled allometrically to body surface area (BSA), height and pulmonary artery diameter. For all parameters with the exception of the aortic annulus, dimensions were significantly larger in systole (P<0.05). All aortic root and arch measurements were significantly larger when measured using the leading edge method compared with the inner edge method (P<0.05). Allometric scaling provided a b exponent of BSA0.6 in order to achieve size independence. Similarly, ratio scaling to height in subjects under the age of 40 years also produced size independence. In conclusion, the largest aortic dimensions occur in systole while using the leading edge method. Reproducibility of measurement, however, is better when assessing aortic dimensions in diastole. There is an allometric relationship to BSA and, therefore, allometric scaling in the order of BSA0.6 provides a size-independent index that is not influenced by the age or gender.

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Tài liệu tham khảo

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1916, A formula to estimate the approximate surface area if height and weight be known, Archives of Internal Medicine, 17, 863

1969, Discussion of calculation of power function with special reference to respiratory metabolism in fish, Journal of the Fisheries Research Board of Canada, 26, 2643, 10.1139/f69-256

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2008, Assessment of the thoracic aorta by multidetector computed tomography: age- and sex-specific reference values in adults without evident cardiovascular disease, Journal of Cardiovascular Computed Tomography, 2, 298, 10.1016/j.jcct.2008.08.002

2013, Assessment of aortic dimensions in patients with marfan syndrome: intraindividual comparison of contrast-enhanced and non-contrast magnetic resonance angiography with echocardiography, International Journal of Cardiology, 167, 190, 10.1016/j.ijcard.2011.12.041

2010, Nonograms for aortic root diameters in children using two-dimensional echocardiography, American Journal of Cardiology, 105, 888, 10.1016/j.amjcard.2009.11.040

2005, Normative angiographic data relating to the aorta and pulmonary trunk in children and adolescents, Cardiology in the Young, 15, 119, 10.1017/S1047951105000272

2012, Multimodality imaging of aortic dimensions: a comparison of transthoracic echocardiography with multidetector row computed tomography, Echocardiography, 29, 735, 10.1111/j.1540-8175.2012.01666.x

2008, The bicuspid aortic valve: an integrated phenotype classification of leaflet morphology and aortic root shape, Heart, 94, 1634, 10.1136/hrt.2007.132092

2010, ACF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for diagnosis and management of patients with thoracic aortic disease: executive summary, Journal of the American College of Cardiology, 55, 1509, 10.1016/j.jacc.2010.02.010

2013, Assessment of aortic dimensions in patients with marfan syndrome: intraindividual comparison of contrast-enhanced and non-contrast magnetic resonance angiography with echocardiography, International Journal of Cardiology, 167, 190, 10.1016/j.ijcard.2011.12.041

1989, Two-dimensional aortic root in dimensions in normal children and adults, American Journal of Cardiology, 64, 507, 10.1016/0002-9149(89)90430-X

2013, Comparative measurement of aortic root by transthoracic echocardiography in normal Korean population based on two different guidelines, Cardiovascular Ultrasound, 11, 28, 10.1186/1476-7120-11-28

1999, ACT sign of chronic pulmonary arterial hypertension: the ratio of main pulmonary artery to aortic diameter, Journal of Thoracic Imaging, 14, 270, 10.1097/00005382-199910000-00007

2005, Normative angiographic data relating to the aorta and pulmonary trunk in children and adolescents, Cardiology in the Young, 15, 119, 10.1017/S1047951105000272

1998, Modeling the influence of body size and composition on M-mode echocardiographic dimensions, American Journal of Physiology, 274, 701

2012, Normal limits in relation to age, body size and gender of two-dimensional echocardiographic aortic root dimensions in persons >15 years of age, American Journal of Cardiology, 110, 1189, 10.1016/j.amjcard.2012.05.063

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Echo Research and Practice

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