Research Group, Council of Echocardiography and Vascular Doppler Oscar Orías, Sociedad Argentina de Cardiología, Buenos Aires, Argentina.
Advisory, Research Group, Council of Echocardiography and Vascular Doppler Oscar Orías, Sociedad Argentina de Cardiología, Buenos Aires, Argentina.
Arch Cardiol Mex. 2023;93(2):139-148. doi: 10.24875/ACM.22000017.
Patient's body size is a significant determinant of aortic dimensions. Overweight and obesity underestimate aortic dilatation when indexing diameters by body surface area (BSA). We compared the indexation of aortic dimensions by height and BSA in subjects with and without overweight to determine the upper normal limit (UNL).
The MATEAR study was a prospective, observational, and multicenter study (53 echocardiography laboratories in Argentina). We included 879 healthy adult individuals (mean age: 39.7 ± 11.4 years, 399 men) without hypertension, bicuspid aortic valve, aortic aneurysm, or genetic aortopathies. Echocardiograms were acquired and proximal aorta measured at the sinus of Valsalva (SV), sinotubular junction (STJ), and ascending aorta (AA) levels (EACVI/ASE guidelines). We compared absolute and indexed aortic diameters by height and BSA between groups (men with body mass index [BMI] < 25 and BMI ≥ 25, women with BMI < 25 and BMI ≥ 25).
Indexing of aortic diameters by BSA showed significantly lower values in overweight and obese subjects compared to normal weight in their respective gender (for women: SV 1.75 cm/m in BMI < 25 vs. 1.52 cm/m in BMI between 25 and 29.9 vs. 1.41 cm/m in BMI ≥ 30; at the STJ: 1.53 cm/m vs 1.37 cm/m vs. 1.25 cm/m; and at the AA: 1.63 cm/m vs. 1.50 cm/m vs. 1.37 cm/m; all p < 0.0001 and for men, all p < 0.0001). These differences disappeared when indexing by height in both gender groups (all p = NS).
While indexing aortic diameters by BSA in obese and overweight subjects underestimate aortic dilation, the use of aortic height index (AHI) yields a similar UNL for individuals with normal weight, overweight, and obesity. Therefore, AHI could be used regardless of their weight.
患者的体型是主动脉尺寸的重要决定因素。当通过体表面积 (BSA) 对直径进行索引时，超重和肥胖会低估主动脉扩张。我们比较了超重和非超重患者的身高和 BSA 对主动脉尺寸的索引，以确定上限正常范围 (UNL)。
MATEAR 研究是一项前瞻性、观察性和多中心研究（阿根廷 53 个超声心动图实验室）。我们纳入了 879 名无高血压、二叶式主动脉瓣、主动脉瘤或遗传性主动脉疾病的健康成年个体（平均年龄：39.7 ± 11.4 岁，399 名男性）。获取超声心动图并根据 EACVI/ASE 指南在窦部（SV）、窦管交界（STJ）和升主动脉（AA）水平测量近端主动脉（EACVI/ASE 指南）。我们比较了各组（男性 BMI<25 和 BMI≥25，女性 BMI<25 和 BMI≥25）中身高和 BSA 对主动脉直径的绝对和指数化值。
与正常体重的相应性别相比，超重和肥胖患者的 BSA 指数化主动脉直径值明显较低（对于女性：SV 1.75 cm/m 在 BMI<25 与 BMI 在 25-29.9 之间 1.52 cm/m 与 BMI≥30 之间 1.41 cm/m；在 STJ：1.53 cm/m 与 1.37 cm/m 与 1.25 cm/m；在 AA：1.63 cm/m 与 1.50 cm/m 与 1.37 cm/m；所有 p<0.0001，对于男性，所有 p<0.0001）。当在两性组中通过身高进行索引时，这些差异消失（所有 p=NS）。
虽然在超重和肥胖患者中，BSA 指数化主动脉直径会低估主动脉扩张，但使用主动脉高度指数 (AHI) 可以为体重正常、超重和肥胖的个体提供相似的 UNL。因此，无论体重如何，都可以使用 AHI。
