Document Detail


Nomograms for aortic root diameters in children using two-dimensional echocardiography.
MedLine Citation:
PMID:  20211339     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The evaluation of aortic root dilation is of major importance for the diagnosis and follow-up of patients with diverse diseases, including the Marfan syndrome. However, we noted that the available nomograms suggested a lower aortic root dilation rate in adults (75%) than in children (90%), when the opposite would have been expected. To establish new nomograms, we selected a population of 353 normal children. We took transthoracic echocardiographic measurements of the aortic root diameters at the level of the aortic annulus, sinuses of Valsalva, sinotubular junction, and ascending aorta according to the American Society of Echocardiography recommendations. All diameters correlated well with the height, weight, body surface area, and age (r = 0.75 to 0.84, p <0.0001). Covariance analysis adjusting for body surface area showed slightly larger diameters at the level of the sinuses of Valsalva in male children than in female children (+1 mm, p = 0.0002). Equations and derived nomograms were developed, giving the upper limit of normal (allowing simple recognition of aortic dilation) and the Z score (allowing fine quantification of dilation and differentiation of normal growth from pathologic dilation) for all 4 aortic root diameters (ie, aortic annulus, sinuses of Valsalva, sinotubular junction, and proximal ascending aorta) according to body surface area and gender. We applied the nomograms to 282 children with confirmed Marfan syndrome, of whom 65.2% presented with dilation of the sinuses of Valsalva. In conclusion, we propose equations to calculate the upper limit of normal and Z-score for aortic root diameters measured by 2-dimensional echocardiography, which should be useful tools for the diagnosis and follow-up of aortic root aneurysms in children.
Authors:
Mathieu Gautier; Delphine Detaint; Christophe Fermanian; Philippe Aegerter; Gabriel Delorme; Florence Arnoult; Olivier Milleron; Fran?ois Raoux; Chantal Stheneur; Catherine Boileau; Alec Vahanian; Guillaume Jondeau
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-09     Completed Date:  2010-03-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  888-94     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Centre de R?f?rence pour le Syndrome de Marfan et Apparent?s, H?pital Bichat, AP-HP, Paris, France; Service de Cardiologie, H?pital Bichat, AP-HP, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aorta / pathology,  ultrasonography*
Body Mass Index
Body Surface Area
Child
Child, Preschool
Dilatation, Pathologic / ultrasonography
Echocardiography*
Female
Humans
Male
Nomograms*
Reference Values
Sinus of Valsalva / ultrasonography

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