Abstract 14509: Aortic Root Areas: A Three-Dimensional Echocardiographic Study

Abstract

Background: Recent studies have shown that the aortic root is elliptical rather than spherical. Thus, 2DE diameter measurements poorly estimate true aortic root size. However, three-dimensional echocardiography (3DE) overcomes this limitation allowing true 3D aortic root areas to be measured.

Objectives: The aims were: 1) to establish normal gender- and BSA-adjusted aortic root areas obtained from 3DE; and 2) to determine if gender- and BSA-indexed aortic root areas should be adjusted for age.

Methods: We performed clinically indicated transesophageal 3DE (Philips, iE33) in 58 healthy patients (28 female; average age 54+23 years; age range 9-88 years). Custom software (eSie Valves, Siemens) was used to track the aortic root in 3D throughout the cardiac cycle. BSA-indexed aortic valve area was measured (FIGURE). As well, BSA-indexed maximum areas were measured at the following aortic root locations: aortic annulus, sinus of Valsalva and sinotubular junction (FIGURE). We performed linear regression to examine the change in areas with age when adjusted for gender. P-values <0.05 were considered significant.

Results: For males, only BSA-indexed sinus of Valsalva and sinotubular junction areas, significantly increased with age (GRAPH). For females, all BSA-indexed areas except for aortic valve area, significantly increased with age.

Conclusions: This is the first study to examine the normal pattern of aortic root areas measured from 3DE. We found that when controlled for gender, BSA-indexed aortic root area measurements increase with age suggesting that age be taken into account when evaluating aortic root size.