Observational study of regional aortic size referenced to body size: production of a cardiovascular magnetic resonance nomogram

Abstract

BackgroundCardiovascular magnetic resonance (CMR) is regarded as the gold standard for clinical assessment of the aorta, but normal dimensions are usually referenced to echocardiographic and computed tomography data and no large CMR normal reference range exists. As a result we aimed to 1) produce a normal CMR reference range of aortic diameters and 2) investigate the relationship between regional aortic size and body surface area (BSA) in a large group of healthy subjects with no vascular risk factors.Methods447 subjects (208 male, aged 19–70 years) without identifiable cardiac risk factors (BMI range 15.7–52.6 kg/m2) underwent CMR at 1.5 T to determine aortic diameter at three levels: the ascending aorta (Ao) and proximal descending aorta (PDA) at the level of the pulmonary artery, and the abdominal aorta (DDA), at a level 12 cm distal to the PDA. In addition, 201 of these subjects had aortic root imaging, allowing for measurements at the level of the aortic valve annulus (AV), aortic sinuses and sinotubular junction (STJ).ResultsNormal diameters (mean ±2 SD) were; AV annulus male(♂) 24.4 ± 5.4, female (♀) 21.0 ± 3.6 mm, aortic sinus♂32.4 ± 7.7, ♀27.6 ± 5.8 mm, ST-junction ♂25.0 ± 7.4, ♀21.8 ± 5.4 mm, Ao ♂26.7 ± 7.7, ♀25.5 ± 7.4 mm, PDA ♂20.6 ± 5.6, +18.9 ± 4.0 mm, DDA ♂17.6 ± 5.1, ♀16.4 ± 4.0 mm. Aortic root and thoracic aortic diameters increased at all levels measured with BSA. No gender difference was seen in the degree of dilatation with increasing BSA (p > 0.5 for all analyses).ConclusionAcross both genders, increasing body size is characterized by a modest degree of aortic dilatation, even in the absence of traditional cardiovascular risk factors.

Fluoroscopy-free Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for controlling life threatening postpartum hemorrhage

“…Recently in Norway, a 15 mm diameter PTS-X balloon has been used in a few REBOA cases, which only require a 6 French introducer. Our experience is that in a hypovolemic PPH patient, a 15 mm balloon is sufficient to occlude or partially occlude the infra-renal aorta [26], and in this way stabilize the hemodynamic emergency situation.…”

Age‐related changes in aortic 3D blood flow velocities and wall shear stress: Implications for the identification of altered hemodynamics in patients with aortic valve disease

“…Ideally, 3D velocity and 3D WSS atlases created in this study were not only stratified for age, but for gender as well. However, the limited number of subjects did not allow for the investigation of the influence of gender, as has been performed in aortic diameter nomograms . Future work will consist of analyses such as those presented here of 4D flow MRI data acquired in women.…”

Elevated Blood Pressure in Preterm-Born Offspring Associates With a Distinct Antiangiogenic State and Microvascular Abnormalities in Adult Life

“…24 Cardiovascular magnetic resonance on a Siemens 1.5T Sonata scanner was used to quantify cardiac mass and function, 5 as well as thoracic and abdominal aortic size. 3,[5][6][7]26 …”