Appraisal of transthoracic echocardiography for opportunistic screening of abdominal aortic aneurysm

Abstract

Abdominal aortic aneurysm is a life threatening disease. Most of the patients diagnosed incidentally because of the asymptomatic nature of this disease. This study aimed to determine the frequency of abdominal aortic aneurysm and evaluate the value of opportunistic screening during transthoracic echocardiography. A total of 5138 patients referred for echocardiographic evaluation for any reason were screened for abdominal aortic aneurysm between November 2014 to July 2019. The aneurysm was defined as an abdominal aorta with a diameter greater than 30 mm, or segmental dilatation of more than 50% of its size in non-dilated parts. The overall frequency of abdominal aortic aneurysm was 2.2% (n = 109) in the study population. Male sex ( P < .001), older age ( P < .001), presence of diastolic dysfunction ( P = .036), hypertension ( P < .001), coronary artery disease ( P < .001), and hyperlipidemia ( P < .001) were associated with abdominal aortic aneurysm. Patients with aneurysm had significantly increased diameters of the aortic trunk ( P < .001) and ascending aorta ( P < .001), significantly thicker interventricular septum ( P < .001) and posterior wall ( P < .001), significantly increased end-diastolic diameter ( P < .001) and enlarged left atrium ( P < .001), and significantly decreased ejection fraction ( P < .001). The mostly met criteria for screening abdominal aortic aneurysm in international guidelines was the age of the patients. Based on the results of this study, screening patients over 60 years of age who undergo a transthoracic echocardiography for any reason would be beneficial to detect an asymptomatic abdominal aortic aneurysm in Turkish population.