TWO-DIMENSIONAL ECHOCARDIOGRAPHIC AORTIC ROOT DIMENSIONS IN NORMAL-CHILDREN AND ADULTS
TWO-DIMENSIONAL ECHOCARDIOGRAPHIC AORTIC ROOT DIMENSIONS IN NORMAL-CHILDREN AND ADULTS
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DOI：
10.1016/0002-9149(89)90430-x
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发表时间：
1989-09-01
影响因子：
2.8
通讯作者：
ROBINS, J
中科院分区：
文献类型：
--
作者：
ROMAN, MJ;DEVEREUX, RB;ROBINS, J
二维超声心动图越来越多地用于测量主动脉根部的尺寸，这提供了主动脉瓣返流和马凡综合征的预后信息。主动脉根部扩张目前通过基于M型超声心动图数据的列线图检测。应用二维超声心动图测量了135例正常成人和52例正常儿童主动脉瓣环、主动脉窦、主动脉上嵴和升主动脉近端的主动脉根部直径，并与年龄、性别、体质、血压、每搏输出量、M型所见及正常范围进行了比较。主动脉窦的二维测量值大于M型主动脉根部值（p < 0.001），使用二维值和M型列线图错误诊断40%的正常儿童和19%的正常成人的主动脉扩张。儿童鼻窦二维测量值与体表面积密切相关（r = 0.93，p < 0.0005），40岁以下成人中度相关（r = 0.71，p < 0.0005），老年人弱相关（r = 0.40，p < 0.0005）。在成人中，性别影响所有节段的主动脉根部尺寸（p < 0.001），但体表面积指数的尺寸相似。年龄强烈影响主动脉上嵴和升主动脉直径;血压和每搏输出量对主动脉大小没有独立影响。结论：（1）二维超声心动图主动脉根部尺寸受年龄和体型的影响，但不受血压的影响;（2）主动脉根部扩张与主动脉窦处主动脉直径的M型列线图相比被过度诊断;（3）主动脉直径与体表面积的列线图应用于儿童;（4）尽管使用基于成人体型的列线图可以最大限度地提高主动脉扩张的敏感性，但使用2.1 cm/m2的主动脉窦直径正常上限，男性和女性的特异性均达到98%。
Two-dimensional echocardiography is increasingly used to measure aortic root dimensions, which provide prognostic information in aortic regurgitation and the Marfan syndrome. Aortic root dilatation is currently detected by nomograms based on M-mode echocardiographic data. Aortic root diameters measured by 2-dimensional echocardiography at the anulus, sinuses of Valsalva, supraaortic ridge and proximal ascending aorta in 135 normal adults and 52 normal children were compared with age, gender, body habitus, blood pressure and stroke volume, and with M-mode findings and normal limits. Two-dimensional measurements at the sinuses of Valsalva were larger than M-mode aortic root values (p < 0.001), and use of 2-dimensional values with M-mode nomograms falsely diagnosed aortic dilatation in 40% of normal children and 19% of normal adults. Two-dimensional measurements at the sinuses closely correlated with body surface area in children (r = 0.93, p < 0.0005), moderately in adults younger than 40 years of age (r = 0.71, p < 0.0005) and weakly in older adutls (r = 0.40, p < 0.0005). In adults, gender influenced aortic root size at all levels (p < 0.001), but dimensions were similar when indexed for body surface area. Age strongly influenced supraaortic ridge and ascending aortic diameters; blood pressure and stroke volume had no independent effect on aortic size. In conclusion, (1) 2-dimensional echocardiographic aortic root dimensions are influenced by age and body size but not by blood pressure; (2) aortic root dilatation is overdiagnosed when aortic diameter at the sinuses of Valsalva is compared with M-mode nomograms; (3) nomograms comparing aortic diameter with body surface area should be used in children; and (4) although use of nomograms based on body size in adults should maximize sensitivity for aortic dilatation, 98% specificity is attained by use of an upper normal limit of 2.1 cm/m2 for aortic diameter at the sinuses of Valsalva in both men and women.