Dataset Information

Accuracy of aortic annulus measurements by three-dimensional transesophageal echocardiography and predictive value for thoracic aorta aneurysm in patients with aortic regurgitation.

ABSTRACT:

Background

Accurate assessment of the aortic annulus (AA) dimension and judgment of thoracic aorta aneurysm is crucial for patients with aortic regurgitation (AR) before surgery. The aim of this study was to evaluate the accuracy and reproducibility of three-dimensional transesophageal echocardiography (3D-TEE) methods for AA measurement and explore the predictive value of the AA dimensions obtained by 3D-TEE for high-risk thoracic aorta aneurysms using the gold standard of multi-slice computed tomography (MSCT).

Methods

3D-TEE was performed on 111 patients with pure moderate-to-severe AR, and MSCT examination was conducted simultaneously. AA dimensions were obtained using reconstruction software for these two imaging techniques. Thoracic aortic diameters at standard anatomic landmarks were also measured by MSCT. All patients were divided into two groups depending on the presence of high-risk thoracic aorta aneurysms.

Results

Compared to MSCT, 3D-TEE overestimated all AA parameters. However, no statistically significant differences were found in the average bias between methods (minimum diameter: 26.07±3.57 vs. 25.88±3.68 mm, P=0.52; maximum diameter: 32.30±2.68 vs. 31.78±4.06 mm, P=0.11; area: 669.76±155.19 vs. 660.05±168.28 mm², P=0.44; perimeter: 93.52±10.42 vs. 92.26±11.71 mm, P=0.12). 3D-TEE demonstrated good correlations with MSCT measurement for AA minimum diameter, maximum diameter, area, and perimeter (r=0.63, 0.64, 0.74, 0.69, P<0.05 for all). According to the multivariate logistic regression analysis, the AA minimum diameter obtained by 3D-TEE was the best predictor for the presence of high-risk thoracic aorta aneurysms. The sensitivity and specificity for prediction were 84.6% and 63.9%, respectively, for an AA minimum diameter ≥25.74 mm (AUC: 0.759, 95% CI: 0.668-0.850).

Conclusions

AA measurements obtained by the 3D-TEE method are feasible and reliable for patients with pure AR. The AA minimum diameter measured by 3D-TEE can effectively predict the presence of high-risk thoracic aorta aneurysms.

SUBMITTER: Meng Q

PROVIDER: S-EPMC9929374 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Accuracy of aortic annulus measurements by three-dimensional transesophageal echocardiography and predictive value for thoracic aorta aneurysm in patients with aortic regurgitation.

Meng Qinglong Q Chen Yuan Y Wang Dandan D Tao Jia J Wang Hao H

Quantitative imaging in medicine and surgery 20221211 2

<h4>Background</h4>Accurate assessment of the aortic annulus (AA) dimension and judgment of thoracic aorta aneurysm is crucial for patients with aortic regurgitation (AR) before surgery. The aim of this study was to evaluate the accuracy and reproducibility of three-dimensional transesophageal echocardiography (3D-TEE) methods for AA measurement and explore the predictive value of the AA dimensions obtained by 3D-TEE for high-risk thoracic aorta aneurysms using the gold standard of multi-slice c ...[more]

PMID: 36819254

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Project description:IntroductionIn patients with ascending aortic (AA) aneurysms, prosthetic graft replacement yields benefit but risk for complications in the descending aorta persists. Longitudinal impact of AA grafts on native descending aortic physiology is poorly understood.MethodsTransthoracic echocardiograms (echo) in patients undergoing AA elective surgical grafting were analyzed: Descending aortic deformation indices included global circumferential strain (GCS), time to peak (TTP) strain, and fractional area change (FAC). Computed tomography (CT) was used to assess aortic wall thickness and calcification.Results46 patients undergoing AA grafting were studied; 65% had congenital or genetically-associated AA (30% bicuspid valve, 22% Marfan, 13% other): After grafting (6.4±7.5 months), native descending aortic distension increased, irrespective of whether assessed based on circumferential strain or area-based methods (both p<0.001). Increased distensibility paralleled altered kinetics, as evidenced by decreased time to peak strain (p = 0.01) and increased velocity (p = 0.002). Augmented distensibility and flow velocity occurred despite similar pre- and post-graft blood pressure and medications (all p = NS), and was independent of pre-surgical aortic regurgitation or change in left ventricular stroke volume (both p = NS). Magnitude of change in GCS and FAC was 5-10 fold greater among patients with congenital or genetically associated AA vs. degenerative AA (p<0.001), paralleling larger descending aortic size, greater wall thickness, and higher prevalence of calcific atherosclerotic plaque in the degenerative group (all p<0.05). In multivariate analysis, congenital/genetically associated AA etiology conferred a 4-fold increment in magnitude of augmented native descending aortic strain after proximal grafting (B = 4.19 [CI 1.6, 6.8]; p = 0.002) independent of age and descending aortic size.ConclusionsProsthetic graft replacement of the ascending aorta increases magnitude and rapidity of distal aortic distension. Graft effects are greatest with congenital or genetically associated AA, providing a potential mechanism for increased energy transmission to the native descending aorta and adverse post-surgical aortic remodeling.

Dataset Information

Accuracy of aortic annulus measurements by three-dimensional transesophageal echocardiography and predictive value for thoracic aorta aneurysm in patients with aortic regurgitation.

Background

Methods

Results

Conclusions

Publications

Accuracy of aortic annulus measurements by three-dimensional transesophageal echocardiography and predictive value for thoracic aorta aneurysm in patients with aortic regurgitation.

Similar Datasets

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