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Impact of methodology and the use of allometric scaling on the echocardiographic assessment of the aortic root and arch: a study by the Research and Audit Sub-Committee of the British Society of Echocardiography

Echo Research & Practice volume 1, pages 1–9 (2014)Cite this article

Abstract

The aim of the study is to establish the impact of 2D echocardiographic methods on absolute values for aortic root dimensions and to describe any allometric relationship to body size. We adopted a nationwide cross-sectional prospective multicentre design using images obtained from studies utilising control groups or where specific normality was being assessed. A total of 248 participants were enrolled with no history of cardiovascular disease, diabetes, hypertension or abnormal findings on echocardiography. Aortic root dimensions were measured at the annulus, the sinus of Valsalva, the sinotubular junction, the proximal ascending aorta and the aortic arch using the inner edge and leading edge methods in both diastole and systole by 2D echocardiography. All dimensions were scaled allometrically to body surface area (BSA), height and pulmonary artery diameter. For all parameters with the exception of the aortic annulus, dimensions were significantly larger in systole (P<0.05). All aortic root and arch measurements were significantly larger when measured using the leading edge method compared with the inner edge method (P<0.05). Allometric scaling provided a b exponent of BSA0.6 in order to achieve size independence. Similarly, ratio scaling to height in subjects under the age of 40 years also produced size independence. In conclusion, the largest aortic dimensions occur in systole while using the leading edge method. Reproducibility of measurement, however, is better when assessing aortic dimensions in diastole. There is an allometric relationship to BSA and, therefore, allometric scaling in the order of BSA0.6 provides a size-independent index that is not influenced by the age or gender.

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Authors and Affiliations

  1. Department of Cardiology, Southend University Hospital NHS Trust, Westcliffe on Sea, UK

    David Oxborough PhD, Saqib Ghani PhD & Victor Utomi MBBS

  2. Cardiology Department, Colchester Hospital NHS Trust, Colchester, UK

    Allan Harkness FRCP

  3. Cardiology Department, East Sussex Healthcare NHS Trust, Eastbourne, UK

    Guy Lloyd MD

  4. Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK

    William Moody PhD & Richard Steeds MD

  5. Cardiology Department, West Suffolk Hospital NHS Trust, Bury St Edmonds, UK

    Liam Ring PhD

  6. Cardiac Ultrasound, Leeds Teaching Hospitals NHS Trust, Leeds, UK

    Julie Sandoval DCR DMU

  7. National Heart and Lung Institute, Imperial College, London, UK

    Roxy Senior DM

  8. Department of Cardiovascular Sciences, St Georges University of London, London, UK

    Nabeel Sheikh PhD

  9. Cardiology Department, University Hospital South Manchester, Manchester, UK

    Martin Stout PhD

  10. Department of Cardiology, Royal United Hospital, Bath, UK

    James Willis BSc (Hons)

  11. Cardiology Department, Morriston Hospital, Swansea, UK

    Abbas Zaidi PhD

  12. Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 9UT, UK

    David Oxborough PhD

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  1. David Oxborough PhD
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  2. Saqib Ghani PhD
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  3. Allan Harkness FRCP
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  4. Guy Lloyd MD
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  5. William Moody PhD
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  7. Julie Sandoval DCR DMU
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  9. Nabeel Sheikh PhD
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  10. Martin Stout PhD
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  11. Victor Utomi MBBS
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  12. James Willis BSc (Hons)
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  13. Abbas Zaidi PhD
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  14. Richard Steeds MD
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Correspondence to David Oxborough PhD.

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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://doi.org/creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Oxborough, D., Ghani, S., Harkness, A. et al. Impact of methodology and the use of allometric scaling on the echocardiographic assessment of the aortic root and arch: a study by the Research and Audit Sub-Committee of the British Society of Echocardiography. Echo Res Pract 1, 1–9 (2014). https://doi.org/10.1530/ERP-14-0004

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  • DOI: https://doi.org/10.1530/ERP-14-0004

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Echo Research & Practice

ISSN: 2055-0464

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