Bossone Eduardo, Yuriditsky Eugene, Desale Sameer, Ferrara Francesco, Vriz Olga, Asch Federico M
Cava de Tirreni and Amalfi Coast Hospital, University of Salerno, Salerno, Italy.
MedStar Washington Hospital Center, Washington, District of Columbia.
J Am Soc Echocardiogr. 2016 Feb;29(2):166-72. doi: 10.1016/j.echo.2015.09.010. Epub 2015 Oct 23.
There is a lack of uniformity across echocardiographic society guidelines as to how the diameter of the ascending aorta is to be measured. The aims of this study were to compare measurements done using the diastolic leading edge-to-leading edge and systolic inner edge-to-inner edge (SIE) techniques in a large cohort of healthy adult individuals and to report the normal values for adults using the SIE technique.
Aortic diameters obtained according to the two guideline recommendations at the aortic annuls, sinuses of Valsalva, sinotubular junction, and ascending aorta in 1,148 healthy adult volunteers were compared. Bland-Altman analysis, paired t tests, and intraclass correlation coefficients were evaluated at each segment. SIE values are reported as normative data, according to age, gender, and body surface area.
The diastolic leading edge-to-leading edge convention yielded smaller diameters (compared with SIE) at the aortic annulus and ascending aorta and larger diameters at the sinus of Valsalva and sinotubular junction (P < .001 for all). There was excellent correlation between these techniques, with intraclass correlation coefficients of 0.88 to 0.96. Interobserver variability was minimal and similar for both techniques. Using the SIE technique, diameters were larger for men and increased with age and larger body surface area.
Although there was a statistically significant difference in aortic diameter measures between the two conventions used, this difference was very small and correlations were excellent, suggesting that the difference has no clinical significance. The authors recommend that a standard convention be adopted within the American Society of Echocardiography and across all professional cardiovascular imaging societies for consistency and improved communication.
在超声心动图学会指南中，关于如何测量升主动脉直径缺乏一致性。本研究的目的是在一大群健康成年个体中比较使用舒张期末前沿到前沿和收缩期内缘到内缘（SIE）技术所做的测量，并报告使用SIE技术的成年人正常值。
比较了1148名健康成年志愿者在主动脉瓣环、主动脉窦、窦管交界和升主动脉处根据两种指南建议获得的主动脉直径。在每个节段评估Bland-Altman分析、配对t检验和组内相关系数。根据年龄、性别和体表面积报告SIE值作为规范数据。
舒张期末前沿到前沿的方法在主动脉瓣环和升主动脉处产生的直径较小（与SIE相比），而在主动脉窦和窦管交界处产生的直径较大（所有P<0.001）。这些技术之间具有极好的相关性，组内相关系数为0.88至0.96。观察者间的变异性最小，两种技术相似。使用SIE技术，男性的直径较大，并且随着年龄和体表面积的增加而增加。
尽管所使用的两种方法在主动脉直径测量上存在统计学上的显著差异，但这种差异非常小且相关性极好，表明该差异无临床意义。作者建议美国超声心动图学会以及所有专业心血管成像学会采用标准方法，以确保一致性并改善沟通。
