Normal Values of Aortic Root Dimensions in Healthy Adults

Vriz, Olga; Aboyans, Victor; D’Andrea, Antonello; Ferrara, Francesco; Acri, Edvige; Limongelli, Giuseppe; Corte, Alessandro Della; Driussi, Caterina; Bettio, Manola; Pluchinotta, Francesca Romana; Citro, Rodolfo; Russo, Maria Giovanna; Isselbacher, Eric M.; Bossone, Eduardo

doi:10.1016/j.amjcard.2014.06.028

Cited by 84 publications

(77 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly Muraru and colleagues showed how end‐diastolic values using the inner edge convention were significantly lower than those calculated by the leading edge technique. However, indexed values, even calculated with different techniques showed quite reproducible intervals as reported in Table …”

Section: Resultsmentioning

confidence: 91%

“…This number should be multiplied for the number of races evaluated . Using a more liberal criterion, the total number could be reduced to 1440, and up to 1200 if only five age groups are evaluated . On the basis of these criteria, only three studies had a sufficient sample size (2952, 3431 and 1612 respectively), and three were close to this target (849,1043 and 1142 healthy subjects, respectively) …”

Section: Resultsmentioning

confidence: 99%

“…Other studies included subjects with no cardiovascular disease but known systemic disorders. Lastly, most of the studies had retrospective design with few exceptions …”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Strengths and Limitations of Current Adult Nomograms for the Aorta Obtained by Noninvasive Cardiovascular Imaging

et al. 2016

View full text Add to dashboard Cite

Normalized measurements for the evaluation of aortic disease severity are preferred to the adoption of generic cutoff values. The purpose of this review is to evaluate the strengths and limitations of currently available aortic nomograms by echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI). A literature search was conducted accessing the National Library of Medicine using the keywords normal values, aorta, echocardiography, CT, and MRI. Addition of these keywords further refined the results: reference values, nomograms, aortic arch, and adults. Thirty studies were included in the final analysis. Despite the strengths noted in the recent investigations, multiple methodological and numerical limitations emerged. The numerical limitations included sample size limitation in most of the studies (only few investigations consisted of >800 subjects and many had 70-300), lack of aortic arch measurements, and paucity of data for non-Caucasian subjects. Methodological limitations consisted of lack of standardization in measurements (systole vs. diastole, internal vs. external border, axial vs. orthogonal planes), heterogeneity and data normalization issues (various age intervals used, body size often not evaluated, data expressed as observed values rather than estimated values by z-score), and study design issues. The designs were mostly retrospective with poorly defined inclusion and exclusion criteria. The nomograms presented range of normality with significant differences, but also with some reproducible pattern. Despite recent advances, multiple methodological or numerical limitations exist in adult nomograms for the aorta. Comprehensive nomograms of aortic dimensions at multiple levels including the aortic arch for different imaging techniques, involving a wide sample size, and using standardized methodology for measurements and data normalization are warranted. The availability of robust nomograms may encourage the use of personalized rather than generic cutoff values.

show abstract

Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Strengths and Limitations of Current Adult Nomograms for the Aorta Obtained by Noninvasive Cardiovascular Imaging

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The only study that measured the aorta in the 4 planes of 2D echocardiogram was that by D'Andrea et al 17 In our study, 5 measures were performed: one in M-mode at an intermediate point between the valve plane and the aortic sinuses in accordance with the standards of the American Society of Echocardiography 12 and 4 in 2D (AoA, AoSV, AoSJ, and AoPx) following the recommendations of Roman et al 3 The raw and corrected mean values of the aorta in all planes were within the normal range for the general population. 3,12,18 The smaller size of the aorta was found at the AoA level, with 21.6±2.7 mm in women and 25.5±3.3 mm in men; this is likely because of the fact that it is part of the fibrous skeleton of the heart and probably suffers less remodeling with training. 1 The largest dimension was found at the AoSV level, with values of 27.2±2.8 mm and 31.6±3.6 mm in women and men, respectively, probably because of the increase of elastic fibers in the ascending part of the AoSV, in contrast to AoSJ, which has a greater presence of collagen type I, with greater tensile strength.…”

Section: Discussionmentioning

confidence: 99%

Reference Values of Aortic Root in Male and Female White Elite Athletes According to Sport

Boraita

Heras

Morales

et al. 2016

Circ: Cardiovascular Imaging

View full text Add to dashboard Cite

Background-There is limited information regarding the aortic root upper physiological limits in all planes in elite athletes according to static and dynamic cardiovascular demands and sex. Methods and Results-A cross-sectional study was performed in 3281 healthy elite athletes (2039 men and 1242 women) aged 23.1±5.7 years, with body surface area of 1.9±0.2 m 2 and 8.9±4.9 years and 19.2±9.6 hours/week of training. Maximum end-diastolic aortic root diameters were measured in the parasternal long axis by 2-dimensional echocardiography. Age, left ventricular mass, and body surface area were the main predictors of aortic dimensions. Raw values were greater in males than in females (P<0.0001) at all aortic root levels. Dimensions corrected by body surface area were higher in men than in women at the aortic annulus (13.1±1.7 versus 12.9±1.7 mm/m 2 ; P=0.007), without significant differences at the sinus of Valsalva (16.3±1.9 versus 16.3±1.9 mm/m 2 ; P=0.797), and were smaller in men at the sinotubular junction (13.6±1.8 versus 13.8±1.8 mm/m 2 ; P=0.008) and the proximal ascending aorta (13.8±1.9 versus 14.1±1.9 mm/m 2 ; P=0.001). Only 1.8% of men and 1.5% of women had values >40 mm and 34 mm, respectively. Raw and corrected aortic measures at all levels were significantly greater in sports, with a high dynamic component in both sexes, except for corrected values of the sinotubular junction in women. Conclusions-Aortic root dimensions in healthy elite athletes are within the established limits for the general population.This study describes the normal dimensions for healthy elite athletes classified according to sex and dynamic and static components of their sports. (Circ Cardiovasc Imaging. 2016;9:e005292.

show abstract

“…Almost all studies presented data as mean values (plus or minus standard deviation) normalised by gender, age groups and at times indexed by body surface area (BSA) (15)(16)(17)(18)(19)(20)(21)(22)(23)(34)(35)(36)38,50,58,59,61,90,91). A few studies used percentile (35,72,(76)(77)(78)80) and one study employed z scores (41) that are commonly used in the pediatric age group. The relative scarce and inconstant relationship between parameters of body size (age, weight, BSA) producing low R2 (18,82) may explain the choice to employ mean values (plus or minus standard) instead of computing z scores, that theoretically should be preferred (6,8,9).…”

Section: How To Normalize and To Express Normalized Datamentioning

confidence: 99%

Adult echocardiographic nomograms: overview, critical review and creation of a software for automatic, fast and easy calculation of normal values

Cantinotti¹,

Giordano²,

Paterni³

et al. 2017

J. Thorac. Dis.

View full text Add to dashboard Cite

There is a crescent interest on normal adult echocardiographic values and the introduction of new deformation imaging and 3D parameters pose the issue of normative data. A multitude of nomograms has been recently published, however data are often fragmentary, difficult to find, and their strengths/ limitations have been never evaluated. Aims: (I) to provide a review of current echocardiographic nomograms; (II) to generate a tool for easy and fast access to these data. A literature search was conducted accessing the National Library of Medicine using the keywords: 2D/3D echocardiography, strain, left/ right ventricle, atrial, mitral/tricuspid valve, aorta, reference values/nomograms/normal values. Adding the following keywords, the results were further refined: range/intervals, myocardial velocity, strain rate and speckle tracking. Forty one published studies were included. Our study reveals that for several of 2D/3D parameters sufficient normative data exist, however, a few limitations still persist. For some basic parameters (i.e., mitral/tricuspid/pulmonary valves, great vessels) and for 3D valves data are scarce. There is a lack of studies evaluating ethnic differences. Data have been generally expressed as mean values normalised for gender and age instead of computing models incorporating different variables (age/gender/body sizes) to calculate z scores. To summarize results a software (Echocardio-Normal Values) who automatically calculate range of normality for a broad range of echocardiographic measurements according to age/gender/weight/ height, has been generated. We provide an up-to-date and critical review of strengths/limitation of current adult echocardiographic nomograms. Furthermore we generated a software for automatic, easy and fast access to multiple echocardiographic normative data.

show abstract

Normal Values of Aortic Root Dimensions in Healthy Adults

Cited by 84 publications

References 17 publications

Strengths and Limitations of Current Adult Nomograms for the Aorta Obtained by Noninvasive Cardiovascular Imaging

Strengths and Limitations of Current Adult Nomograms for the Aorta Obtained by Noninvasive Cardiovascular Imaging

Reference Values of Aortic Root in Male and Female White Elite Athletes According to Sport

Adult echocardiographic nomograms: overview, critical review and creation of a software for automatic, fast and easy calculation of normal values

Contact Info

Product

Resources

About