Poutanen Tuija, Tikanoja Tero, Sairanen Heikki, Jokinen Eero
Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland.
Clin Physiol Funct Imaging. 2003 Jul;23(4):224-9. doi: 10.1046/j.1475-097x.2003.00501.x.
Knowledge of normal aortic dimensions is important while evaluating children with aortic root dilatation.
The purpose of the study was to create normal values for aortic dimensions with two-dimensional echocardiography and for aortic flow velocities with Doppler echocardiography in healthy children and young adults.
One hundred and sixty-eight healthy children were studied by a single observer using digitized two-dimensional (2DE) and Doppler echocardiography.
The 2DE measurements were obtained at the level of aortic annulus, sinus, sinotubular junction, before the origin of innominate artery, before and after the origin of left carotid artery, after left subclavian artery and descending aorta at the level of the diaphragm. Doppler measurements were made from ascending aorta and from descending aorta.
For the analysis the subjects were divided into five groups according to body surface area (BSA): 0.5-0.75 m2, 0.75-1.0 m2, 1.0-1.25 m2, 1.25-1.5 m2 and over 1.5 m2. Aortic dimensions normalized to BSA were greater in smaller children at all levels. All diameters correlated closely with age, BSA, height and weight (for each r>0.75, P<0.001). The best predictor of aortic dimensions was BSA with r values over 0.84 for all estimates (P<0.001). The diameters of ascending and descending aorta were similar in both genders when indexed to BSA. Flow velocities in descending aorta were greater than those measured in ascending aorta (P<0.001 for all measurements). There were significant inverse correlations with heart rate and velocity time integral in ascending and descending aorta (r=-0.32 and -0.53, P<0.001, respectively).
The presented aortic dimensions at eight levels from the valve annulus to the descending thoracic aorta by 2DE in conjunction with Doppler measurements of ascending and descending aorta in 168 healthy subjects will serve as reference data for further studies and clinical use in patients with various cardiac abnormalities.
在评估患有主动脉根部扩张的儿童时，了解正常主动脉尺寸很重要。
本研究的目的是通过二维超声心动图建立健康儿童和年轻成人主动脉尺寸的正常值，并通过多普勒超声心动图建立主动脉血流速度的正常值。
由一名观察者使用数字化二维（2DE）和多普勒超声心动图对168名健康儿童进行研究。
二维测量在主动脉瓣环、窦部、窦管交界、无名动脉起始前、左颈动脉起始前后、左锁骨下动脉后以及膈肌水平的降主动脉处进行。多普勒测量在升主动脉和降主动脉进行。
为进行分析，根据体表面积（BSA）将受试者分为五组：0.5 - 0.75平方米、0.75 - 1.0平方米、1.0 - 1.25平方米、1.25 - 1.5平方米和超过1.5平方米。在所有水平上，按体表面积归一化的主动脉尺寸在较小儿童中更大。所有直径与年龄、体表面积、身高和体重密切相关（每个r>0.75，P<0.001）。主动脉尺寸的最佳预测指标是体表面积，所有估计值的r值均超过0.84（P<0.001）。按体表面积指数化后，升主动脉和降主动脉的直径在两性中相似。降主动脉中的血流速度大于升主动脉中测量的血流速度（所有测量值P<0.001）。升主动脉和降主动脉中的血流速度与心率和速度时间积分呈显著负相关（r分别为-0.32和-0.53，P<0.001）。
本研究通过二维超声心动图在168名健康受试者中呈现了从瓣环到胸段降主动脉的八个水平的主动脉尺寸，并结合升主动脉和降主动脉的多普勒测量，将作为进一步研究和临床应用于各种心脏异常患者的参考数据。
