Daniel Saura1, Raluca Dulgheru2, Luis Caballero1, Anne Bernard2,3, Seisyou Kou4, Natalia Gonjilashvili5, George D Athanassopoulos6, Daniele Barone7, Monica Baroni8, Nuno Cardim9, Andreas Hagendorff10, Krasimira Hristova11, Teresa Lopez12, Gonzalo de la Morena1, Bogdan A Popescu13, Martin Penicka14, Tolga Ozyigit15, Jose David Rodrigo Carbonero16, Nico Van De Veire17, Ralph Stephan Von Bardeleben18, Dragos Vinereanu19, Jose Luis Zamorano20, Ann-Stephan Gori2, Bernard Cosyns21,22, Erwan Donal23, Gilbert Habib24,25, Karima Addetia26, Roberto M Lang26, Luigi P Badano27, Patrizio Lancellotti28,29. 1. Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain. 2. University of Liège hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium. 3. CHU Tours, France et Université de Tours, Tours, France. 4. Department of Cardiology, St Marianna University, School of Medicine, Kawasaki, Japan. 5. Echocardiography Laboratory of Adult Cardiology Department of the JO ANN Medical Center, Tbilisi, Georgia. 6. Noninvasive Diagnostics Department, Onassis Cardiac Surgery Center, Athens, Greece. 7. Laboratory of Cardiovascular Ecography-Cardiology Dpt, S. Andrea Hospital, La Spezia, Italy. 8. Laboratorio Di Ecocardiografia Adulti, Fondazione Toscana 'G.Monasterio', Ospedale Del Cuore, Massa, Italy. 9. Hospital da Luz - Echocardiography laboratory, Lisbon, Portugal. 10. Echokardiographie-Labore des Universitätsklinikums AöR, Department of Cardiology-Angiology, University of Leipzig, Leipzig, Germany. 11. Department of Noninvasive Functional Diagnostic and Imaging, University National Heart Hospital, Sofia, Bulgaria. 12. Cardiology Department, La Paz hospital, Madrid, Spain. 13. 'Carol Davila' University of Medicine and Pharmacy - Euroecolab, Institute of Cardiovascular Diseases, Bucharest, Romania. 14. Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium. 15. VKV Amerikan Hastanesi, Kardiyoloji Bölümü, Istanbul, Turkey. 16. Laboratorio de Ecocardiografia Hospital de Cruces-Barakaldo, Barakaldo, Spain. 17. Echocardiography Unit, AZ Maria Middelares Gent, Gent, Belgium. 18. Medical Department Cardiology, Universitätsmedizin of the Johannes Gutenberg-University Mainz, Mainz, Germany. 19. Cardiovascular Research Unit, University and Emergency Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania. 20. University Hospital Ramón y Cajal, Madrid, Spain. 21. CHVZ (Centrum voor Hart en Vaatziekten) - Universitair ziekenhuis Brussel, Brussel, Belgium. 22. ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Brussels, Belgium. 23. CIC-IT U 804, CHU Rennes, Université Rennes 1, Service de Cardiologie, CHU RENNES, France. 24. Aix-Marseille Université, Marseille 13005, France. 25. Department of Cardiology, APHM, La Timone Hospital, Marseille 13005, France. 26. Department of Medicine, University of Chicago Medical Center, IL, USA. 27. Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, School of Medicine, Padova, Italy. 28. University of Liège hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium plancellotti@chu.ulg.ac.be. 29. Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy.
Abstract
AIMS: To report normal reference ranges for echocardiographic dimensions of the proximal aorta obtained in a large group of healthy volunteers recruited using state-of-the-art cardiac ultrasound equipment, considering different measurement conventions, and taking into account gender, age, and body size of individuals. METHODS AND RESULTS: A total of 704 (mean age: 46.0 ± 13.5 years) healthy volunteers (310 men and 394 women) were prospectively recruited from the collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. A comprehensive echocardiographic examination was obtained in all subjects following pre-defined protocols. Aortic dimensions were obtained in systole and diastole, following both the leading-edge to leading-edge and the inner-edge to inner-edge conventions. Diameters were measured at four levels: ventricular-arterial junction, sinuses of Valsalva, sino-tubular junction, and proximal tubular ascending aorta. Measures of aortic root in the short-axis view following the orientation of each of the three sinuses were also performed. Men had significantly larger body sizes when compared with women, and showed larger aortic dimensions independently of the measurement method used. Dimensions indexed by height and body surface area are provided, and stratification by age ranges is also displayed. In multivariable analysis, the independent predictors of aortic dimensions were age, gender, and height or body surface area. CONCLUSION: The NORRE study provides normal values of proximal aorta dimensions as assessed by echocardiography. Reference ranges for different anatomical levels using different (i) measurement conventions and (ii) at different times of the cardiac cycle (i.e. mid-systole and end-diastole) are provided. Age, gender, and body size were significant determinants of aortic dimensions. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: To report normal reference ranges for echocardiographic dimensions of the proximal aorta obtained in a large group of healthy volunteers recruited using state-of-the-art cardiac ultrasound equipment, considering different measurement conventions, and taking into account gender, age, and body size of individuals. METHODS AND RESULTS: A total of 704 (mean age: 46.0 ± 13.5 years) healthy volunteers (310 men and 394 women) were prospectively recruited from the collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. A comprehensive echocardiographic examination was obtained in all subjects following pre-defined protocols. Aortic dimensions were obtained in systole and diastole, following both the leading-edge to leading-edge and the inner-edge to inner-edge conventions. Diameters were measured at four levels: ventricular-arterial junction, sinuses of Valsalva, sino-tubular junction, and proximal tubular ascending aorta. Measures of aortic root in the short-axis view following the orientation of each of the three sinuses were also performed. Men had significantly larger body sizes when compared with women, and showed larger aortic dimensions independently of the measurement method used. Dimensions indexed by height and body surface area are provided, and stratification by age ranges is also displayed. In multivariable analysis, the independent predictors of aortic dimensions were age, gender, and height or body surface area. CONCLUSION: The NORRE study provides normal values of proximal aorta dimensions as assessed by echocardiography. Reference ranges for different anatomical levels using different (i) measurement conventions and (ii) at different times of the cardiac cycle (i.e. mid-systole and end-diastole) are provided. Age, gender, and body size were significant determinants of aortic dimensions. Published on behalf of the European Society of Cardiology. All rights reserved.
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