Normal Limits in Relation to Age, Body Size and Gender of Two-Dimensional Echocardiographic Aortic Root Dimensions in Persons ≥15 Years of Age

Nomograms to predict normal aortic root diameter for body surface area (BSA) in broad ranges of age have been widely used but are limited by lack of consideration of gender effects, jumps in upper limits of aortic diameter among age strata, and data from older teenagers. Sinus of Valsalva diameter w...

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Published in:	The American journal of cardiology Vol. 110; no. 8; pp. 1189 - 1194
Main Authors:	Devereux, Richard B., de Simone, Giovanni, Arnett, Donna K., Best, Lyle G., Boerwinkle, Eric, Howard, Barbara V., Kitzman, Dalane, Lee, Elisa T., Mosley, Thomas H., Weder, Alan, Roman, Mary J.
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 15.10.2012 Elsevier Elsevier Limited
Subjects:	Adolescent Adult Age Aged Aging - physiology Analysis of Variance Aorta, Thoracic - anatomy & histology Aorta, Thoracic - diagnostic imaging Biological and medical sciences Blood pressure Body Size Cardiology. Vascular system Cardiovascular Cardiovascular disease Cardiovascular system Echocardiography - methods Female Gender Humans Investigative techniques, diagnostic techniques (general aspects) Linear Models Male Medical sciences Methods Middle Aged Reference Values Sex Factors Sinuses Ultrasonic investigative techniques Variables New York Sonography Echocardiography Root Sex Corporal biometry Dimension Normal Body size Aorta Circulatory system Limit Cardiology Age
ISSN:	0002-9149, 1879-1913, 1879-1913
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Abstract	Nomograms to predict normal aortic root diameter for body surface area (BSA) in broad ranges of age have been widely used but are limited by lack of consideration of gender effects, jumps in upper limits of aortic diameter among age strata, and data from older teenagers. Sinus of Valsalva diameter was measured by American Society of Echocardiography convention in normal-weight, nonhypertensive, nondiabetic subjects ≥15 years old without aortic valve disease from clinical or population-based samples. Analyses of covariance and linear regression with assessment of residuals identified determinants and developed predictive models for normal aortic root diameter. In 1,207 apparently normal subjects ≥15 years old (54% women), aortic root diameter was 2.1 to 4.3 cm. Aortic root diameter was strongly related to BSA and height (r = 0.48 for the 2 comparisons), age (r = 0.36), and male gender (+2.7 mm adjusted for BSA and age, p <0.001 for all comparisons). Multivariable equations using age, gender, and BSA or height predicted aortic diameter strongly (R = 0.674 for the 2 comparisons, p <0.001) with minimal relation of residuals to age or body size: for BSA 2.423 + (age [years] × 0.009) + (BSA [square meters] × 0.461) − (gender [1 = man, 2 = woman] × 0.267), SEE 0.261 cm; for height 1.519 + (age [years] × 0.010) + (height [centimeters] × 0.010) − (gender [1 = man, 2 = woman] × 0.247), SEE 0.215 cm. In conclusion, aortic root diameter is larger in men and increases with body size and age. Regression models incorporating body size, age, and gender are applicable to adolescents and adults without limitations of previous nomograms.
AbstractList	Nomograms to predict normal aortic root diameter for body surface area (BSA) in broad ranges of age have been widely used but are limited by lack of consideration of gender effects, jumps in upper limits of aortic diameter among age strata, and data from older teenagers. Sinus of Valsalva diameter was measured by American Society of Echocardiography convention in normal-weight, nonhypertensive, nondiabetic subjects ≥15 years old without aortic valve disease from clinical or population-based samples. Analyses of covariance and linear regression with assessment of residuals identified determinants and developed predictive models for normal aortic root diameter. In 1,207 apparently normal subjects ≥15 years old (54% women), aortic root diameter was 2.1 to 4.3 cm. Aortic root diameter was strongly related to BSA and height (r = 0.48 for the 2 comparisons), age (r = 0.36), and male gender (+2.7 mm adjusted for BSA and age, p <0.001 for all comparisons). Multivariable equations using age, gender, and BSA or height predicted aortic diameter strongly (R = 0.674 for the 2 comparisons, p <0.001) with minimal relation of residuals to age or body size: for BSA 2.423 + (age [years] × 0.009) + (BSA [square meters] × 0.461) − (gender [1 = man, 2 = woman] × 0.267), SEE 0.261 cm; for height 1.519 + (age [years] × 0.010) + (height [centimeters] × 0.010) − (gender [1 = man, 2 = woman] × 0.247), SEE 0.215 cm. In conclusion, aortic root diameter is larger in men and increases with body size and age. Regression models incorporating body size, age, and gender are applicable to adolescents and adults without limitations of previous nomograms. Nomograms to predict normal aortic root diameter for body surface area (BSA) in broad ranges of age have been widely used, but are limited by lack of consideration of gender effects, jumps in upper limits of aortic diameter between age strata, and data from older teenagers. Sinuses of Valsalva diameter was measured by American Society of Echocardiography convention in normal-weight, non-hypertensive, non-diabetic individuals ≥15 years old without aortic valve disease from clinical or population-based samples. Analyses of covariance and linear regression with assessment of residuals identified determinants and developed predictive models for normal aortic root diameter. Among 1,207 apparently normal individuals ≥15 years old (54% female), aortic root diameter was 2.1 to 4.3 cm. Aortic root diameter was strongly related to BSA and height (both r=0.48), age (r=0.36) and male gender (+2.7 mm adjusted for BSA and age) (all p<0.001). Multivariable equations using age, gender, and either BSA or height predicted aortic diameter strongly (both R=0.674, p <0.001) with minimal relation of residuals to age or body size: for BSA: 2.423+(age [yrs]0.009) + (bsa [m2]0.461) -(sex [1=M, 2=F].267) SEE = 0.261 cmfor height: 1.519+(age [yrs]0.010) + (ht [cm].010)-(sex [1=M, 2=F].247) SEE = 0.215 cm. In conclusion, aortic root diameter is larger in men and increases with body size and age. Regression models incorporating body size, age and gender are applicable to adolescents and adults without limitations of previous nomograms. Nomograms to predict normal aortic root diameter for body surface area (BSA) in broad ranges of age have been widely used but are limited by lack of consideration of gender effects, jumps in upper limits of aortic diameter among age strata, and data from older teenagers. Sinus of Valsalva diameter was measured by American Society of Echocardiography convention in normal-weight, nonhypertensive, nondiabetic subjects ≥15 years old without aortic valve disease from clinical or population-based samples. Analyses of covariance and linear regression with assessment of residuals identified determinants and developed predictive models for normal aortic root diameter. In 1,207 apparently normal subjects ≥15 years old (54% women), aortic root diameter was 2.1 to 4.3 cm. Aortic root diameter was strongly related to BSA and height (r = 0.48 for the 2 comparisons), age (r = 0.36), and male gender (+2.7 mm adjusted for BSA and age, p <0.001 for all comparisons). Multivariable equations using age, gender, and BSA or height predicted aortic diameter strongly (R = 0.674 for the 2 comparisons, p <0.001) with minimal relation of residuals to age or body size: for BSA 2.423 + (age [years] × 0.009) + (BSA [square meters] × 0.461) - (gender [1 = man, 2 = woman] × 0.267), SEE 0.261 cm; for height 1.519 + (age [years] × 0.010) + (height [centimeters] × 0.010) - (gender [1 = man, 2 = woman] × 0.247), SEE 0.215 cm. In conclusion, aortic root diameter is larger in men and increases with body size and age. Regression models incorporating body size, age, and gender are applicable to adolescents and adults without limitations of previous nomograms. Nomograms to predict normal aortic root diameter for body surface area (BSA) in broad ranges of age have been widely used but are limited by lack of consideration of gender effects, jumps in upper limits of aortic diameter among age strata, and data from older teenagers. Sinus of Valsalva diameter was measured by American Society of Echocardiography convention in normal-weight, nonhypertensive, nondiabetic subjects ≥15 years old without aortic valve disease from clinical or population-based samples. Analyses of covariance and linear regression with assessment of residuals identified determinants and developed predictive models for normal aortic root diameter. In 1,207 apparently normal subjects ≥15 years old (54% women), aortic root diameter was 2.1 to 4.3 cm. Aortic root diameter was strongly related to BSA and height (r = 0.48 for the 2 comparisons), age (r = 0.36), and male gender (+2.7 mm adjusted for BSA and age, p <0.001 for all comparisons). Multivariable equations using age, gender, and BSA or height predicted aortic diameter strongly (R = 0.674 for the 2 comparisons, p <0.001) with minimal relation of residuals to age or body size: for BSA 2.423 + (age [years] × 0.009) + (BSA [square meters] × 0.461) - (gender [1 = man, 2 = woman] × 0.267), SEE 0.261 cm; for height 1.519 + (age [years] × 0.010) + (height [centimeters] × 0.010) - (gender [1 = man, 2 = woman] × 0.247), SEE 0.215 cm. In conclusion, aortic root diameter is larger in men and increases with body size and age. Regression models incorporating body size, age, and gender are applicable to adolescents and adults without limitations of previous nomograms.Nomograms to predict normal aortic root diameter for body surface area (BSA) in broad ranges of age have been widely used but are limited by lack of consideration of gender effects, jumps in upper limits of aortic diameter among age strata, and data from older teenagers. Sinus of Valsalva diameter was measured by American Society of Echocardiography convention in normal-weight, nonhypertensive, nondiabetic subjects ≥15 years old without aortic valve disease from clinical or population-based samples. Analyses of covariance and linear regression with assessment of residuals identified determinants and developed predictive models for normal aortic root diameter. In 1,207 apparently normal subjects ≥15 years old (54% women), aortic root diameter was 2.1 to 4.3 cm. Aortic root diameter was strongly related to BSA and height (r = 0.48 for the 2 comparisons), age (r = 0.36), and male gender (+2.7 mm adjusted for BSA and age, p <0.001 for all comparisons). Multivariable equations using age, gender, and BSA or height predicted aortic diameter strongly (R = 0.674 for the 2 comparisons, p <0.001) with minimal relation of residuals to age or body size: for BSA 2.423 + (age [years] × 0.009) + (BSA [square meters] × 0.461) - (gender [1 = man, 2 = woman] × 0.267), SEE 0.261 cm; for height 1.519 + (age [years] × 0.010) + (height [centimeters] × 0.010) - (gender [1 = man, 2 = woman] × 0.247), SEE 0.215 cm. In conclusion, aortic root diameter is larger in men and increases with body size and age. Regression models incorporating body size, age, and gender are applicable to adolescents and adults without limitations of previous nomograms.
Author	Boerwinkle, Eric Kitzman, Dalane Mosley, Thomas H. Arnett, Donna K. de Simone, Giovanni Best, Lyle G. Roman, Mary J. Devereux, Richard B. Weder, Alan Howard, Barbara V. Lee, Elisa T.
AuthorAffiliation	h Oklahoma University College of Public Health, Oklahoma City, OK e University of Texas - Houston Health Science Center, Houston, TX f Medstar Research Institute, Washington, DC g Wake Forrest University School of Medicine, Winston-Salem, NC c University of Alabama-Birmingham, Dept. Epidemiology, Birmingham, AL d Missouri Breaks Industries Research, Inc, Timber Lake, SD j University of Michigan Medical Center, Ann Arbor, MI b Department of Clinical & Experimental Medicine, Federico II University Hospital, Naples Italy; NY i University of Mississippi Medical Center, Jackson, MS a Greenberg Division of Cardiology, Weill Cornell Medical College, New York
AuthorAffiliation_xml	– name: j University of Michigan Medical Center, Ann Arbor, MI – name: e University of Texas - Houston Health Science Center, Houston, TX – name: c University of Alabama-Birmingham, Dept. Epidemiology, Birmingham, AL – name: a Greenberg Division of Cardiology, Weill Cornell Medical College, New York – name: f Medstar Research Institute, Washington, DC – name: h Oklahoma University College of Public Health, Oklahoma City, OK – name: b Department of Clinical & Experimental Medicine, Federico II University Hospital, Naples Italy; NY – name: d Missouri Breaks Industries Research, Inc, Timber Lake, SD – name: g Wake Forrest University School of Medicine, Winston-Salem, NC – name: i University of Mississippi Medical Center, Jackson, MS
Author_xml	– sequence: 1 givenname: Richard B. surname: Devereux fullname: Devereux, Richard B. email: rbdevere@med.cornell.edu organization: Greenberg Division of Cardiology, Weill Cornell Medical College, New York, New York – sequence: 2 givenname: Giovanni surname: de Simone fullname: de Simone, Giovanni organization: Greenberg Division of Cardiology, Weill Cornell Medical College, New York, New York – sequence: 3 givenname: Donna K. surname: Arnett fullname: Arnett, Donna K. organization: Department of Epidemiology, University of Alabama, Birmingham, Alabama – sequence: 4 givenname: Lyle G. surname: Best fullname: Best, Lyle G. organization: Missouri Breaks Industries Research, Inc., Timber Lake, South Dakota – sequence: 5 givenname: Eric surname: Boerwinkle fullname: Boerwinkle, Eric organization: University of Texas–Houston Health Science Center, Houston, Texas – sequence: 6 givenname: Barbara V. surname: Howard fullname: Howard, Barbara V. organization: Medstar Research Institute, Washington, DC – sequence: 7 givenname: Dalane surname: Kitzman fullname: Kitzman, Dalane organization: Wake Forest University School of Medicine, Winston-Salem, North Carolina – sequence: 8 givenname: Elisa T. surname: Lee fullname: Lee, Elisa T. organization: Oklahoma University College of Public Health, Oklahoma City, Oklahoma – sequence: 9 givenname: Thomas H. surname: Mosley fullname: Mosley, Thomas H. organization: University of Mississippi Medical Center, Jackson, Mississippi – sequence: 10 givenname: Alan surname: Weder fullname: Weder, Alan organization: University of Michigan Medical Center, Ann Arbor, Michigan – sequence: 11 givenname: Mary J. surname: Roman fullname: Roman, Mary J. organization: Greenberg Division of Cardiology, Weill Cornell Medical College, New York, New York
BackLink	http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26497267$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/22770936$$D View this record in MEDLINE/PubMed
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Snippet	Nomograms to predict normal aortic root diameter for body surface area (BSA) in broad ranges of age have been widely used but are limited by lack of... Nomograms to predict normal aortic root diameter for body surface area (BSA) in broad ranges of age have been widely used, but are limited by lack of...
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SubjectTerms	Adolescent Adult Age Aged Aging - physiology Analysis of Variance Aorta, Thoracic - anatomy & histology Aorta, Thoracic - diagnostic imaging Biological and medical sciences Blood pressure Body Size Cardiology. Vascular system Cardiovascular Cardiovascular disease Cardiovascular system Echocardiography - methods Female Gender Humans Investigative techniques, diagnostic techniques (general aspects) Linear Models Male Medical sciences Methods Middle Aged Reference Values Sex Factors Sinuses Ultrasonic investigative techniques Variables
Title	Normal Limits in Relation to Age, Body Size and Gender of Two-Dimensional Echocardiographic Aortic Root Dimensions in Persons ≥15 Years of Age
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