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Distorted assessment of left atrial size by echocardiography in patients with increased aortic root diameter
The Egyptian Heart Journal ( IF 1.4 ) Pub Date : 2021-06-26 , DOI: 10.1186/s43044-021-00177-2
Abdullah Kaplan 1, 2 , Raffaele Altara 3, 4, 5 , Marco Manca 6 , Hacı Murat Gunes 2 , Alessandro Cataliotti 3, 4 , George W Booz 7 , Fouad A Zouein 1
Affiliation  

Left atrial (LA) size is frequently assessed by posterior-anterior linear measurement of LA (LAD P-A) in the parasternal long axis to expedite examination. Aging, changes in body surface area, and several cardiovascular pathologies can affect aortic root (AoR) size, thereby affecting LA anatomical shape. We hypothesized that AoR dilatation influences LAD P-A and consequently correct assessment of LA size. We tested our hypothesis in a study of 70 patients with AoR diameter ranging from 2.7 to 4.8 cm. LA size assessed in parasternal long axis view as LAD P-A was compared to that with LA width and length acquired in the apical two and four chamber view. Simpson’s method of discs was used as standard measurement to assess LA volume. We observed that LAD P-A in the parasternal long axis decreases when AoR diameter increases. Thus, the increase in LA size assessed in parasternal long axis did not correlate with the increase of LA volume. Further analysis revealed that a significant positive correlation was observed when LAV was plotted as a function of LAD P-A only for those with a normal size AoR. In contrast, LA volume increase correlated with LA diameters assessed in the apical two and four chamber view regardless of AoR size. Our study documents that increases in AoR impact on the linear measurement of LA, resulting in an underestimated LAD P-A. LA size ought to be calculated from the apical two and four chambers view parameters, especially in patients with AoR dilatation.

中文翻译:

超声心动图对主动脉根部直径增大患者左心房大小的扭曲评估

左心房 (LA) 大小经常通过胸骨旁长轴的后-前线性测量 (LAD PA) 进行评估,以加快检查。衰老、体表面积的变化和几种心血管疾病都会影响主动脉根 (AoR) 的大小,从而影响 LA 的解剖形状。我们假设 AoR 扩张会影响 LAD PA,从而影响对 LA 大小的正确评估。我们在一项对 70 名 AoR 直径范围为 2.7 至 4.8 厘米的患者的研究中检验了我们的假设。在胸骨旁长轴视图中评估的 LA 大小作为 LAD PA 与在心尖二腔和四腔视图中获得的 LA 宽度和长度进行比较。Simpson 的椎间盘方法被用作评估 LA 体积的标准测量方法。我们观察到当 AoR 直径增加时,胸骨旁长轴上的 LAD PA 减少。因此,在胸骨旁长轴评估的 LA 大小的增加与 LA 体积的增加无关。进一步的分析表明,当 LAV 被绘制为 LAD PA 的函数时,仅对于那些具有正常 AoR 大小的人,观察到显着的正相关。相比之下,无论 AoR 大小如何,LA 体积增加都与在心尖二腔和四腔视图中评估的 LA 直径相关。我们的研究记录了 AoR 增加对 LA 线性测量的影响,导致 LAD PA 被低估。LA 大小应根据心尖二腔和四腔切面参数计算,尤其是 AoR 扩张的患者。进一步的分析表明,当 LAV 被绘制为 LAD PA 的函数时,观察到显着的正相关性,仅适用于具有正常大小 AoR 的人。相比之下,无论 AoR 大小如何,LA 体积增加都与在心尖二腔和四腔视图中评估的 LA 直径相关。我们的研究记录了 AoR 增加对 LA 线性测量的影响,导致低估了 LAD PA。LA 大小应根据心尖二腔和四腔切面参数计算,尤其是 AoR 扩张的患者。进一步的分析表明,当 LAV 被绘制为 LAD PA 的函数时,观察到显着的正相关性,仅适用于具有正常大小 AoR 的人。相比之下,无论 AoR 大小如何,LA 体积增加都与在心尖二腔和四腔视图中评估的 LA 直径相关。我们的研究记录了 AoR 增加对 LA 线性测量的影响,导致低估了 LAD PA。LA 大小应根据心尖二腔和四腔切面参数计算,尤其是 AoR 扩张的患者。
更新日期:2021-06-28
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