Meel Ruchika, Blair Kelly
Division of Cardiology, Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, 2193, South Africa.
Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Echo Res Pract. 2023 Feb 15;10(1):2. doi: 10.1186/s44156-023-00016-x.
There is limited data regarding reference ranges for aortic dimensions in African populations. This study aims to establish normal reference ranges for echocardiographic dimensions and circumferential strain (CS) of the proximal thoracic aorta in a healthy sub-Saharan African population.
This was a secondary analysis of data from a prospective cross-sectional study of 88 participants conducted at Chris Hani Baragwanath Hospital (2017-2019). Aortic measurements were obtained as per the 2015 American Society of Echocardiography guidelines using a Philips iE33 system. Circumferential Strain was measured using Philips QLAB version 11.0 software offline semi-automated analysis of speckle-based strain 2-D speckle-tracking software (Amsterdam, The Netherlands).
Mean age was 37.22 ± 10.79 years (41% male). The mean diameter at the aortic annulus, sinuses, sino-tubular junction (STJ) and ascending aorta (AAO) were 19.11 ± 2.38 mm, 27.40 ± 6.11 mm, 25.32 ± 3.52 mm and 25.36 ± 3.38 mm, respectively. Males had larger absolute and indexed aortic diameters at all levels when compared to females. The mean aorta CS was 11.97 ± 5.05%. There was no significant difference in CS based on gender (12.19 ± 5.04% vs 11.51 ± 5.02%, P = 0.267). On multivariate linear regression analysis, male sex was the most significant predictor of increased diameter at the level of the aortic annulus (r = 0.17, P = 0.014), body surface area was the most significant predictor at the sinuses (r = 0.17, P = 0.014) and AAO (r = 0.30, P < 0.001), while age was the most significant predictor at the STJ (r = 0.27, P = 0.004). There was a negative correlation between age and aortic CS (r = - 0.12, P < 0.001). The most important predictor of aorta CS was age, on multivariate analysis (r = - 0.19, P = 0.024).
This study provides normal reference ranges for dimensions of the proximal aorta and circumferential strain (CS) in a sub-Saharan African population according to age, sex, and body habitus. It serves as a platform for future larger studies and allows for risk stratification of cardiovascular disease in an African population.
关于非洲人群主动脉尺寸参考范围的数据有限。本研究旨在建立撒哈拉以南非洲健康人群胸主动脉近端超声心动图尺寸和圆周应变（CS）的正常参考范围。
这是对在克里斯·哈尼·巴拉干纳特医院进行的一项针对88名参与者的前瞻性横断面研究（2017 - 2019年）数据的二次分析。根据2015年美国超声心动图学会指南，使用飞利浦iE33系统进行主动脉测量。使用飞利浦QLAB 11.0版软件对基于斑点的应变二维斑点追踪软件（荷兰阿姆斯特丹）进行离线半自动分析来测量圆周应变。
平均年龄为37.22±10.79岁（41%为男性）。主动脉瓣环、窦部、窦管交界（STJ）和升主动脉（AAO）的平均直径分别为19.11±2.38毫米、27.40±6.11毫米、25.32±3.52毫米和25.36±3.38毫米。与女性相比，男性在所有水平的主动脉绝对直径和指数直径都更大。主动脉平均CS为11.97±5.05%。基于性别的CS无显著差异（12.19±5.04%对11.51±5.02%，P = 0.267）。在多变量线性回归分析中，男性是主动脉瓣环水平直径增加的最显著预测因素（r = 0.17，P = 0.014），体表面积是窦部（r = 0.17，P = 0.014）和AAO（r = 0.30，P < 0.001）的最显著预测因素，而年龄是STJ的最显著预测因素（r = 0.27，P = 0.004）。年龄与主动脉CS呈负相关（r = - 0.12，P < 0.001）。在多变量分析中，年龄是主动脉CS的最重要预测因素（r = - 0.19，P = 0.024）。
本研究提供了撒哈拉以南非洲人群根据年龄、性别和身体状况的胸主动脉近端尺寸和圆周应变（CS）的正常参考范围。它为未来更大规模的研究提供了一个平台，并有助于对非洲人群的心血管疾病进行风险分层。
