Servato Maria Luz, Teixidó-Turá Gisela, Sabate-Rotes Anna, Galian-Gay Laura, Gutiérrez Laura, Valente Filipa, Fernandez-Galera Ruben, Casas Guillem, López-Sainz Angela, González-Alujas M Teresa, Sao-Aviles Augusto, Ferreira Ignacio, Rodríguez-Palomares Jose, Evangelista Arturo
Department of Cardiology, University Hospital Vall d'Hebron, CIBERCV, 08035 Barcelona, Spain.
Department of Pediatric Cardiology, University Hospital Vall d'Hebron, CIBERCV, 08035 Barcelona, Spain.
J Clin Med. 2021 Nov 14;10(22):5290. doi: 10.3390/jcm10225290.
Ascending aorta diameters have important clinical value in the diagnosis, follow-up, and surgical indication of many aortic diseases. However, there is no uniformity among experts regarding ascending aorta diameter quantification by echocardiography. The aim of this study was to compare maximum aortic root and ascending aorta diameters determined by the diastolic leading edge (DLE) and the systolic inner edge (SIE) conventions in adult and pediatric patients with inherited cardiovascular diseases. Transthoracic echocardiograms were performed in 328 consecutive patients (260 adults and 68 children). Aorta diameters were measured twice at the root and ascending aorta by the DLE convention following the 2015 American Society of Echocardiography (ASE) adult guidelines and the SIE convention following the 2010 ASE pediatric guidelines. Comparison of the diameters measured by the two conventions in the overall population showed a non-significant underestimation of the diameter measured by the SIE convention at root level of 0.28 mm (CI -1.36; 1.93) and at tubular ascending aorta level of 0.17 mm (CI -1.69; 2.03). Intraobserver and interobserver variability were excellent. Maximum aorta diameter measured by the leading edge convention in end-diastole and the inner edge convention in mid-systole had similar values to a mild non-significant underestimation of the inner-to-inner method that permits them to be interchangeable when used in clinical practice.
升主动脉直径在多种主动脉疾病的诊断、随访及手术指征方面具有重要临床价值。然而，在通过超声心动图对升主动脉直径进行量化方面，专家们尚未达成统一意见。本研究的目的是比较采用舒张期末前缘（DLE）和收缩期内缘（SIE）标准测定的成年和儿童遗传性心血管疾病患者的主动脉根部及升主动脉最大直径。对328例连续患者（260例成人和68例儿童）进行了经胸超声心动图检查。根据2015年美国超声心动图学会（ASE）成人指南，采用DLE标准在主动脉根部和升主动脉处测量主动脉直径两次；根据2010年ASE儿童指南，采用SIE标准测量。在总体人群中，比较两种标准测量的直径发现，SIE标准在主动脉根部水平测量的直径低估0.28 mm（可信区间-1.36；1.93），在升主动脉管状部水平低估0.17 mm（可信区间-1.69；2.03），差异无统计学意义。观察者内和观察者间的变异性良好。舒张期末采用前缘标准测量的主动脉最大直径和收缩中期采用内缘标准测量的主动脉最大直径具有相似的值，内对内测量方法轻度低估且差异无统计学意义，这使得它们在临床实践中可相互替代。
