Transthoracic echocardiographic reference values of the aortic root: results from the Hamburg City Health Study

Wenzel, Jan‐Per; Nikorowitsch, Julius; Senftinger, Juliana; Sinning, Christoph; Theissen, Matthias; Petersen, Johannes; Reichenspurner, Hermann; Girdauskas, Evaldas

doi:10.1007/s10554-021-02354-5

Cited by 6 publications

(5 citation statements)

References 29 publications

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“…In normal children and adult population, Roman et al 11 found that Ao-asc was most strongly influenced by age, whereas BSA was the most important independent determinant of Ao-a and Ao-s. Of note, the impact of age on Ao-a size in a normal population was paradoxical and varied among populations. Apart from no correlation of Ao-a measurement with age in the NORRE study, consistent growth in aortic dimensions with aging was observed irrespective of whether or not it was indexed with BSA, which was in agreement with previous studies, 15–18 showing that Ao-a grew slower than aortic dimensions at other measurement levels. Noteworthy, the Ao-asc dimension had the strongest positive correlation with age, which was in agreement with the results of Roman’s study 11 .…”

Section: Discussionsupporting

confidence: 91%

Comparisons of Two-dimensional Echocardiographic Aortic Dimensions Between Chinese, Japanese, and Europeans

Lin

Lü

et al. 2023

Journal of Thoracic Imaging

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Purpose: We aimed to investigate the impacts of age, gender, and race on aortic dimensions in healthy adults. Methods: We analyzed data from 3 large population-based sample studies, including Chinese Echocardiographic Measurements in Normal Chinese Adults, Japanese the Normal Values for Echocardiographic Measurements Project, and European Normal Reference Ranges for Echocardiography, to compare the two-dimensional echocardiography-derived aortic diameters at different levels and to explore the effects of age, gender, and race on aortic measurements. We also compared the values corrected by body surface area (BSA) or height. Results: The results are as follows: (1) Aortic diameters showed positive correlations with age (r=0.12-0.42, P<0.05), and there were significant inter-age group differences before and after indexing to BSA (P<0.05); (2) Men had greater measurements of aortic diameters than women, with the differences being the same when indexed to height. However, indexing to BSA reversed the differences; (3) The aortic diameters at annulus (Ao-a) and sinus (Ao-s) levels were very close with minor differences between the Chinese and Japanese regardless of whether BSA was used for correction; and (4) The aortic measurements at Ao-s and proximal ascending aorta (Ao-asc) levels in the Chinese were significantly lower than in the Europeans for both genders, with the differences remaining the same even after indexing to BSA or height (P<0.05). Conclusion: Aortic dimensions vary with age and gender, and there are significant differences between races or ethnicities even when stratified by gender and age. The indexation by BSA or height cannot eliminate these differences. Therefore, age-specific, gender-specific, race-specific, and nationality-specific reference values may be more appropriate at present for clinical practice to avoid misdiagnosis and misclassification of aortic dilation.

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Section: Discussionsupporting

confidence: 91%

Comparisons of Two-dimensional Echocardiographic Aortic Dimensions Between Chinese, Japanese, and Europeans

Lin

Lü

et al. 2023

Journal of Thoracic Imaging

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“…These are the main reasons why the 2018 European Society of Cardiology/ European Society of Hypertension (ESC/ESH) guidelines did not include aortic diameter among the markers of cardiac damage to be considered in hypertensive patients [5]. Furthermore, although it is well known that ascending, thoracic and abdominal aortic diameters increase with aging [11,12], a limited knowledge exists on the prevalence, correlates and time-related changes of aortic dilatation [3][4][5][6][7][8][9][10][11][12][13][14][15]. In the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, echocardiographic and clinical data (including office ambulatory and home blood pressure, BP) have been collected at the start and after 10 and 25 years in an Italian population sample with an average initial age of 42 years.…”

Section: Introductionmentioning

confidence: 99%

New-onset aortic dilatation in the population: a quarter-century follow-up

et al. 2022

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Background Aortic size tends to increase with aging but the extent of this dynamic process has not been evaluated in long-term longitudinal population-based studies. We investigated the incidence of new-onset aortic root (AR) dilatation and its principal correlates among middle-aged adults over a 25-year time period. Methods A total of 471 participants with measurable echocardiographic parameters at baseline and after a 25-year follow-up were included in the analysis. Sex-specific upper limits of normality for absolute AR diameter, AR diameter indexed to body surface area (BSA) and to height were derived from healthy normotensive PAMELA participants. Results New AR dilatation occurred in 7.4% (AR/BSA), 9.1% (AR/height) and 14.6% (absolute AR), respectively. According to the AR/height index, the risk of new dilation was similar in men and women. As for echocardiographic parameters, baseline AR diameter emerged as a key predictor of AR dilation, regardless of the diagnostic criteria and the 10-year change in LVMI was positively associated to new AR/height dilatation. No significant relationship was observed between baseline office and ambulatory systolic/diastolic blood pressure or their changes over time with incident AR dilatation. Baseline and the 25-year change in 24-h pulse pressure were negatively related to new AR dilatation. Conclusions The incidence of AR dilatation from mid to late adulthood occurs in a small but clinically relevant fraction of participants and is unaffected by both office and out-office BP. It is significant related to baseline AR diameter and to the 25-year change in LVMI. Our data suggest that echocardiography performed in middle-aged individuals of both sexes may identify those at increased risk of future AR dilatation; moreover, preventing LVH may reduce the risk of progressive AR enlargement. Graphical abstract

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“…Diameters obtained by both conventions such as DLE, with inclusion of anterior aortic wall thickness, and SIE, with systolic expansion of aorta size, have similar diameter values. In a large cohort with 1687 healthy adult subjects, end-diastolic measurements correlated strongly with midsystolic measurements in men and in women for all aortic root diameters [16] Bossone et al [7] compared aortic measurements using the DLE and SIE conventions in a large cohort of healthy adult individuals and reported normal values by SIE. In that study, the maximum diameter at the level of the sinuses of Valsalva was significantly greater by the DLE method (0.21 ± 1.35 mm; p < 0.001).…”

Section: Discussionmentioning

confidence: 95%

Are Aortic Root and Ascending Aorta Diameters Measured by the Pediatric versus the Adult American Society of Echocardiography Guidelines Interchangeable?

Servato

Teixidó-Turà

Sabaté-Rotés

et al. 2021

JCM

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Ascending aorta diameters have important clinical value in the diagnosis, follow-up, and surgical indication of many aortic diseases. However, there is no uniformity among experts regarding ascending aorta diameter quantification by echocardiography. The aim of this study was to compare maximum aortic root and ascending aorta diameters determined by the diastolic leading edge (DLE) and the systolic inner edge (SIE) conventions in adult and pediatric patients with inherited cardiovascular diseases. Transthoracic echocardiograms were performed in 328 consecutive patients (260 adults and 68 children). Aorta diameters were measured twice at the root and ascending aorta by the DLE convention following the 2015 American Society of Echocardiography (ASE) adult guidelines and the SIE convention following the 2010 ASE pediatric guidelines. Comparison of the diameters measured by the two conventions in the overall population showed a non-significant underestimation of the diameter measured by the SIE convention at root level of 0.28 mm (CI −1.36; 1.93) and at tubular ascending aorta level of 0.17 mm (CI −1.69; 2.03). Intraobserver and interobserver variability were excellent. Maximum aorta diameter measured by the leading edge convention in end-diastole and the inner edge convention in mid-systole had similar values to a mild non-significant underestimation of the inner-to-inner method that permits them to be interchangeable when used in clinical practice.

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Transthoracic echocardiographic reference values of the aortic root: results from the Hamburg City Health Study

Cited by 6 publications

References 29 publications

Comparisons of Two-dimensional Echocardiographic Aortic Dimensions Between Chinese, Japanese, and Europeans

Comparisons of Two-dimensional Echocardiographic Aortic Dimensions Between Chinese, Japanese, and Europeans

New-onset aortic dilatation in the population: a quarter-century follow-up

Are Aortic Root and Ascending Aorta Diameters Measured by the Pediatric versus the Adult American Society of Echocardiography Guidelines Interchangeable?

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