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Published on: November 28, 2018
Normal aortic dimensions and flow in 168 children and young adults
Tuija Poutanen1, Tero Tikanoja, Heikki Sairanen
1Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland. tuija.poutanen@koti.tpo.fi
Insights
This study establishes normal aortic dimensions and flow velocities in healthy children and young adults using echocardiography. These findings provide crucial reference data for diagnosing aortic root dilatation in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Imaging
- Echocardiography
Background:
- Accurate knowledge of normal aortic dimensions is essential for evaluating pediatric patients with aortic root dilatation.
- Establishing normative data is critical for identifying abnormalities in children and young adults.
Purpose of the Study:
- To establish normal values for aortic dimensions using two-dimensional echocardiography (2DE).
- To determine normal values for aortic flow velocities with Doppler echocardiography.
- To provide reference data for healthy children and young adults.
Main Methods:
- One hundred sixty-eight healthy children and young adults were evaluated by a single observer.
- Digitized two-dimensional (2DE) and Doppler echocardiography were employed.
- Measurements were taken at multiple aortic levels, including the annulus, sinuses, sinotubular junction, and along the ascending and descending aorta.
Main Results:
- Aortic dimensions, normalized to body surface area (BSA), were larger in smaller children.
- BSA was the strongest predictor of aortic dimensions (r > 0.84, P < 0.001).
- Flow velocities in the descending aorta were significantly higher than in the ascending aorta (P < 0.001).
Conclusions:
- The study provides comprehensive reference data for aortic dimensions and flow velocities in a healthy pediatric and young adult population.
- These normative values, obtained via 2DE and Doppler echocardiography, are vital for clinical use and future research in pediatric cardiovascular abnormalities.
- The data will aid in the accurate assessment of conditions like aortic root dilatation.
Background:
Knowledge of normal aortic dimensions is important while evaluating children with aortic root dilatation.
Objective:
The purpose of the study was to create normal values for aortic dimensions with two-dimensional echocardiography and for aortic flow velocities with Doppler echocardiography in healthy children and young adults.
Design And Patients:
One hundred and sixty-eight healthy children were studied by a single observer using digitized two-dimensional (2DE) and Doppler echocardiography.
Methods:
The 2DE measurements were obtained at the level of aortic annulus, sinus, sinotubular junction, before the origin of innominate artery, before and after the origin of left carotid artery, after left subclavian artery and descending aorta at the level of the diaphragm. Doppler measurements were made from ascending aorta and from descending aorta.
Results:
For the analysis the subjects were divided into five groups according to body surface area (BSA): 0.5-0.75 m2, 0.75-1.0 m2, 1.0-1.25 m2, 1.25-1.5 m2 and over 1.5 m2. Aortic dimensions normalized to BSA were greater in smaller children at all levels. All diameters correlated closely with age, BSA, height and weight (for each r>0.75, P<0.001). The best predictor of aortic dimensions was BSA with r values over 0.84 for all estimates (P<0.001). The diameters of ascending and descending aorta were similar in both genders when indexed to BSA. Flow velocities in descending aorta were greater than those measured in ascending aorta (P<0.001 for all measurements). There were significant inverse correlations with heart rate and velocity time integral in ascending and descending aorta (r=-0.32 and -0.53, P<0.001, respectively).
Conclusions:
The presented aortic dimensions at eight levels from the valve annulus to the descending thoracic aorta by 2DE in conjunction with Doppler measurements of ascending and descending aorta in 168 healthy subjects will serve as reference data for further studies and clinical use in patients with various cardiac abnormalities.
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