Comparative assessment of ascending aortic aneurysms in Marfan patients using ECG-gated computerized tomographic angiography versus trans-thoracic echocardiography

Amsallem, Myriam; Ou, Phalla; Milleron, Olivier; Henry–Feugeas, Marie-Cécile; Détaint, Delphine; Arnoult, Florence; Vahanian, Alec; Jondeau, Guillaume

doi:10.1016/j.ijcard.2015.01.086

Cited by 24 publications

(12 citation statements)

References 21 publications

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“…Expectedly, the difference between echocardiographic leading-edge diameter and MRA-derived outer diameters (~ 7 mm) was higher and clinically more relevant than the difference from MRA-derived inner diameters (~ 1 mm). The remaining small difference between MRA-derived inner-to-inner diameters and echocardiographic leading-edge diameters is explained by the different angle of incidence and imaging modalities [31]. Taken together, MRA-derived inner-to-inner measurements show a smaller variance and higher agreement with echocardiographic measurements than outer-to-outer measurements.…”

Section: Discussionmentioning

confidence: 86%

Reliability of non-contrast magnetic resonance angiography-derived aortic diameters in Marfan patients: comparison of inner vs. outer vessel wall measurements

Weinrich

Avanesov

Lenz

et al. 2020

Int J Cardiovasc Imaging

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Aortic diameter measurements play a crucial role for the indication of aortic root surgery in Marfan patients. However, for magnetic resonance angiography (MRA)-derived measurements, there is no consensus on whether the aortic wall should be included or excluded in the aortic diameter. The purpose of this retrospective study was to compare the reliability of noncontrast bright blood MRA aortic inner-to-inner and outer-to-outer edge measurements in patients with Marfan syndrome. Forty Marfan patients underwent ECG-gated balanced steady-state free-precession MRA of the aorta at 1.5 T. Two readers independently performed inner and outer measurements at different aortic levels. They rated the image quality of the delineation of both inner and outer vessel wall edges on a four-point scale. MRA-derived diameters of the sinuses of Valsalva were compared with echocardiography-derived diameters. Aortic vessel wall delineation score was rated higher at all levels for inner than for outer vessel walls (p < 0.001). Inter-and intraobserver variances of aortic measurements were smaller for inner-to-inner measurements at the sinuses of Valsalva, sinotubular junction and ascending aorta (p < 0.03). There was a difference of 1.1 ± 2.3 mm for inner MRA measurements (p = 0.014) and 6.9 ± 3.1 mm for outer MRA measurements (p < 0.001) when compared to echocardiographic leading-edge measurements. Inner-to-inner vessel wall diameter measurements in non-contrast bright blood MRA provide more reliable diameters when compared to outer-to-outer vessel wall measurements of the aortic root. Therefore, we propose to rely on inner rather than outer aortic wall measurements in non-contrast-MRA when monitoring aortic diameters in patients with Marfan syndrome.

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Section: Discussionmentioning

confidence: 86%

Reliability of non-contrast magnetic resonance angiography-derived aortic diameters in Marfan patients: comparison of inner vs. outer vessel wall measurements

Weinrich

Avanesov

Lenz

et al. 2020

Int J Cardiovasc Imaging

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“…Deben registrarse los diámetros a nivel del anillo, senos de Valsalva, unión senotubular, aorta ascendente tubular y arco aórtico. El diámetro máximo de la raíz debe tomarse de seno a seno, en lugar del diámetro máximo de seno a comisura, ya que esta medida se correlaciona mejor con los diámetros máxi-mos en el plano largo de borde exterior a borde exterior medidos por ecocardiografía 54,55 . Véase la tabla de recomendaciones sobre las indicaciones de cirugía en la insuficiencia aórtica grave y en la enfermedad de la raíz aórtica para su definición.…”

Section: Tomografía Computarizada Y Resonancia Magnética Cardiacaunclassified

Guía ESC/EACTS 2017 sobre el tratamiento de las valvulopatías

Baumgartner¹,

Falk²,

Bax³

et al. 2018

Revista Española de Cardiología

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“…Despite the relatively small population size, we were able to detect statistically significant differences in tortuosity values both in the case-control comparison and in the analysis of severity groups, which underscores the robustness of the applied tortuosity metrics. Furthermore, our study population is comparable in size to previous human MFS studies [34,35].…”

Section: Limitationsmentioning

confidence: 60%

Increased visceral arterial tortuosity in Marfan syndrome

Ágg

Szilveszter

Daradics

et al. 2020

Orphanet J Rare Dis

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Background: Clinical evidence suggests that the currently recommended approach to estimate the risk of aortic dissection in Marfan syndrome (MFS) is not reliable enough. Therefore, we investigated the possible role of visceral arterial tortuosity in the risk stratification. Methods and results: Splenic and renal arteries of 37 MFS patients and 74 age and gender matched control subjects were segmented using CT angiography imaging. To measure tortuosity, distance metric (DM), sum of angles metric (SOAM), inflection count metric (ICM), and the ratio of ICM and SOAM (ICM/SOAM) were calculated. DM of the splenic, right and left renal artery was significantly higher in MFS patients than in controls (2.44 [1.92-2.80] vs. 1.75 [1.57-2.18] p < 0.001; 1.16 [1.10-1.28] vs. 1.11 [1.07-1.15] p = 0.011; 1.40 [1.29-1.70] vs. 1.13 [1.09-1.23] p < 0.001, respectively). A similar tendency for ICM and an opposite tendency for SOAM were observed. ICM/SOAM was significantly higher in the MFS group compared to controls in case of all three arteries (73.35 [62.26-93.63] vs. 50.91 [43.19-65.62] p < 0.001; 26.52 [20.69-30.24] vs. 19.95 [16.47-22.95] p < 0.001; 22.81 [18.64-30.96] vs. 18.38 [15.29-21.46] p < 0.001, respectively). MFS patients who underwent aortic root replacement had increased right and left renal DM and ICM/SOAM compared to MFS patients without surgery. Conclusion:To our knowledge this is the first demonstration of increased arterial tortuosity in MFS on visceral arteries. Visceral arterial tortuosity, dominated by curves of lower frequency but higher amplitude according to the observed opposite tendency between the DM and SOAM metrics, could be a possible new predictor of serious manifestations of MFS.

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Comparative assessment of ascending aortic aneurysms in Marfan patients using ECG-gated computerized tomographic angiography versus trans-thoracic echocardiography

Cited by 24 publications

References 21 publications

Reliability of non-contrast magnetic resonance angiography-derived aortic diameters in Marfan patients: comparison of inner vs. outer vessel wall measurements

Reliability of non-contrast magnetic resonance angiography-derived aortic diameters in Marfan patients: comparison of inner vs. outer vessel wall measurements

Guía ESC/EACTS 2017 sobre el tratamiento de las valvulopatías

Increased visceral arterial tortuosity in Marfan syndrome

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