Background

Accurate measurements of the aortic annulus and root are important for guiding therapeutic decisions regarding the need for aortic surgery. Current echocardiographic guidelines for identification of aortic root dilatation are limited because current normative values were derived predominantly from white individuals in narrow age ranges, and based partially on M-mode measurements. Using data from the World Alliance Societies of Echocardiography study, the authors sought to establish normal ranges of aortic dimensions across sexes, races, and a wide range of ages.

Methods

Adult individuals free of heart, lung, and kidney disease were prospectively enrolled from 15 countries, with even distributions among sexes and age groups: young (18–40 years), middle aged (41–65 years) and old (>65 years). Transthoracic two-dimensional echocardiograms of 1,585 subjects (mean age, 47 ± 17 years; 50.4% men; mean body surface area [BSA], 1.77 ± 0.22 m²) were analyzed in a core laboratory following American Society of Echocardiography guidelines. Measurements, indexed separately by BSA and by height, included the aortic annulus, sinuses of Valsalva, and sinotubular junction. Differences among age, sex, and racial groups were evaluated using unpaired two-tailed Student's t tests.

Results

All aortic root dimensions were larger in men compared with women. After indexing to BSA, all measured dimensions were significantly larger in women, whereas men continued to show larger dimensions after indexing to height. Of note, the upper limits of normal for all aortic dimensions were lower across all age groups, compared with the guidelines. Aortic dimensions were larger in older age groups in both sexes, a trend that persisted regardless of BSA or height adjustment. Last, differences in aortic dimensions were also observed according to race: Asians had the smallest nonindexed aortic dimensions at all levels.

Conclusions

There are significant differences in aortic dimensions according to sex, age, and race. Thus, current guideline-recommended normal ranges may need to be adjusted to account for these differences.

中文翻译：

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根据年龄、性别和种族的主动脉根部大小的正常值：世界超声心动图协会联盟的研究结果

背景

主动脉环和根部的准确测量对于指导有关主动脉手术需求的治疗决策非常重要。当前用于识别主动脉根部扩张的超声心动图指南是有限的，因为当前的标准值主要来自狭窄年龄范围的白人个体，并且部分基于 M 模式测量。作者利用世界超声心动图联盟协会研究的数据，试图确定不同性别、种族和不同年龄的主动脉尺寸的正常范围。

方法

前瞻性招募来自 15 个国家的无心、肺、肾疾病的成人，性别和年龄组分布均匀：青年（18-40 岁）、中年（41-65 岁）和老年（>65 岁） 。根据美国超声心动图协会指南，在核心实验室对 1,585 名受试者（平均年龄，47 ± 17 岁；50.4% 男性；平均体表面积 [BSA]，1.77 ± 0.22 m 2 ）的经胸二维超声心动图进行了分析^。测量结果分别按 BSA 和高度进行索引，包括主动脉环、瓦氏窦和窦管交界处。使用不配对的双尾学生t检验评估年龄、性别和种族群体之间的差异。

结果

与女性相比，男性的主动脉根部尺寸更大。在对 BSA 进行索引后，女性的所有测量尺寸均显着增大，而男性在对身高进行索引后继续显示出更大的尺寸。值得注意的是，与指南相比，所有年龄组的所有主动脉尺寸的正常上限均较低。无论男女，老年组的主动脉尺寸都较大，无论 BSA 或身高调整如何，这一趋势都持续存在。最后，还根据种族观察到主动脉尺寸的差异：亚洲人在所有级别上的非指数主动脉尺寸最小。

结论

根据性别、年龄和种族的不同，主动脉尺寸存在显着差异。因此，当前指南推荐的正常范围可能需要调整以解决这些差异。