Normal Values of Thoracic Aorta Dimensions by Echocardiography. The MATEAR (Measurement of Thoracic Aorta by Echocardiography in Argentina) Registry

Iván Constantin, Juan Benger, Federico Asch, Celeste Carrero, Silvia Makhoul, Sergio Baratta, Rodrigo Bagnatti, Federico Cintora

Abstract


Background: Differences in the thoracic aorta diameters have been found according to sex, age and body surface area. However,the results are very heterogeneous.Objectives: The aim of this study was to establish the normal thoracic aortic diameters (AoD) by transthoracic echocardiography inour population and to analyze the influence of anthropometric, demographic and ethnic variables.Methods: A national, prospective and multicenter registry was performed including 1,000 healthy adults (mean age: 38.3±12.7years, 553 women, 56.7% of Caucasian origin and 38.3% Native Americans). Aortic measurements were made at 6 levels followingcurrent recommendations: aortic annulus, aortic sinuses, sinotubular junction, proximal ascending aorta, aortic arch and proximaldescending aorta.Results: The 95th percentile of all absolute AoD was below 3.80 cm; AoD indexed by height was 2.08 cm/m and 2.11 cm/m2 indexedby body surface area (BSA). The global analysis showed a positive and significant correlation of all AoD with BSA and height, aswell as with age, except for the aortic annulus which did not change over time. In individuals with increased body mass index, BSAdid not correlate with AoD. Women had lower AoD in all segments and in the aortic root, even after indexing it by height. NativeAmerican subjects had lower absolute and indexed AoD than Caucasian ones at all aortic levels (p <0.01), except for the proximaldescending aorta, which showed no significant differences.Conclusions: Demographic, anthropometric and ethnic variables were significant determinants of aortic dimensions at all levels, sothey must be taken into account for interpretation.

References


Roman MJ, Devereux RB, Niles NW, Hochreiter C, Kligfield P, Sato N, et al. Aortic root dilatation as a cause of isolated, severe aortic regurgitation. Prevalence, clinical and echocardiographic patterns, and relation to left ventricular hypertrophy and function. Ann Intern Med 1987;106:800-7. 10.7326/0003-4819-106-6-800

Asch FM, Yuriditsky E, Prakash SK, Roman MJ, Weinsaft JW,

Weissman G, et al. The Need for Standardized Methods for Measuring the Aorta: Multimodality Core Lab Experience From the Gen-TAC Registry. JACC Cardiovasc Imaging 2016;9:219-26. 10.1016/j.jcmg.2015.06.023

American College of C, American Heart Association Task Force on Practice G, Society of Cardiovascular A, Bonow RO, Carabello BA,Chatterjee K, et al. ACC/AHA 2006 guidelines for the management ofpatients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines

(writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by theSociety for Cardiovascular Angiography and Interventions and the Society

of Thoracic Surgeons. J Am Coll Cardiol 2006;48(3):e1-148.

Davies JE, Sundt TM. Surgery insight: the dilated ascending aorta-indications for surgical intervention. Nat Clin Pract Cardiovasc Med 2007;4:330-9. 10.1038/ncpcardio0885

Kim SY, Martin N, Hsia EC, Pyeritz RE, Albert DA. Managementof aortic disease in Marfan Syndrome: a decision analysis. Arch Intern Med 2005;165:749-55.10.1001/archinte.165.7.749

Roman MJ, Devereux RB, Kramer-Fox R, O’Loughlin J. Twodimensional echocardiographic aortic root dimensions in normal children and adults. Am J Cardiol 1989;64:507-12. 10.1016/0002-9149(89)90430-X

Goldstein SA, Evangelista A, Abbara S, Arai A, Asch FM, Badano LP, et al. Multimodality imaging of diseases of the thoracic aorta in adults: from the American Society of Echocardiography and the European association of cardiovascular imaging: endorsed by the society

of cardiovascular computed tomography and society for cardiovascular magnetic resonance. J Am Soc Echocardiogr 2015;28:119-82. 10.1016/j.echo.2014.11.015

Devereux RB, de Simone G, Arnett DK, Best LG, Boerwinkle E, Howard BV, et al. Normal limits in relation to age, body size and gender of two-dimensional echocardiographic aortic root dimensions in persons >/=15 years of age. Am J Cardiol 2012;110:1189-9410.1016/j.amjcard.2012.05.063

Campens L, Demulier L, De Groote K, Vandekerckhove K, De WolfD, Roman MJ, et al. Reference values for echocardiographic assessment of the diameter of the aortic root and ascending aorta spanning all age categories. Am J Cardiol 2014;114:914-20. 10.1016/j.amjcard.2014.06.024

Saura D, Dulgheru R, Caballero L, Bernard A, Kou S, Gonjilashvili N, et al. Two-dimensional transthoracic echocardiographic normal reference ranges for proximal aorta dimensions: resultsfrom the EACVI NORRE study. Eur Heart J Cardiovasc Imaging 2017;18:167-79. 10.1093/ehjci/jew053

Muraru D, Maffessanti F, Kocabay G, Peluso D, Dal Bianco L,Piasentini E et al. Ascending aorta diameters measured by echocardiographyusing both leading edge-to-leading edge and inner edge to-inner edge conventions in healthy volunteers. Eur Heart J Cardiovasc Imaging 2014;15:415-22. 10.1093/ehjci/jet173

Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015;28:1-39 e14. 10.1016/j.echo.2014.10.003

4ta Encuesta Nacional de Factores de Riesgo 2018. Secretaría de Gobierno de Salud Argentina. Republica Argentina. 2018.

Pham MH, Ballegaard C, de Knegt MC, Sigvardsen PE, Sørgaard MH, Fuchs A, et al. Normal values of aortic dimensions assessed by multidetector computed tomography in the Copenhagen General Population Study. Eur Heart J Cardiovasc Imaging 2019;20:939-48.10.1093/ehjci/jez012

Bella JN, MacCluer JW, Roman MJ, Almasy L, North KE,

Welty TK, et al. Genetic influences on aortic root size in American Indians: the Strong Heart Study. Arterioscler Thromb Vasc Biol 2002;22:1008-11. 10.1161/01.ATV.0000017473.78775.F6

Wang Y-L, Wang Q-L, Wang L, Wu Y-B, Wang Z-B, Cameron J, et al. Body surface area as a key determinant of aortic root and arch dimensions in a population-based study. Exp Ther Med 2013;5:406-10. 10.3892/etm.2012.839


Refbacks

  • There are currently no refbacks.
Bookmark and Share


Licencia Creative Commons
The documents published in this journal are under the licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.

Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar