Echo Assessment of Size of Aortic Root and Ascending Aorta

This episode of Echocardiography Chat discusses how to use echo to assess the size of the aortic root and ascending aorta, including a discussion on the controversies in how to measure the aorta, how echo and CT compare and clinical correlations including the size at which aortic dissection becomes more likely. 

It includes references to ASE, EACVI, BSE, ESC and ACC guidelines.

An echo education podcast.

References:

Mitchell, C. et al. Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults: recommendations from the American Society of Echocardiography. 2018; 32(1): P1-64. https://doi.org/10.1016/j.echo.2018.06.004

Lang, R. et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. EHJ. 2015; 16(3): 233-271. https://academic.oup.com/ehjcimaging/article/16/3/233/2400086

Galderisi, M. et al. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging. 2017; 18(12): 1301-1310. https://doi.org/10.1093/ehjci/jex244

Lancellotti, P. et al. Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. European Heart Journal - Cardiovascular Imaging. 2013; 14(7): 611-644.

Hiratzka, L. et al. 2010 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease. JACC. 2010; 55(14): e27-e129. https://www.jacc.org/doi/10.1016/j.jacc.2010.02.015

Harkness, A. et al. Normal reference intervals for cardiac dimensions and function for use in echocardiographic practice: a guideline from the British Society of Echocardiography. Echo Research and Practice. 2020; 7(1): G1-G18. https://doi.org/10.1530/ERP-19-0050

Saura, D. et al. Two-dimensional transthoracic echocardiographic normal reference ranges for proximal aorta dimensions: results from the EACVI NORRE study. European Heart Journal - Cardiovascular Imaging. 2016; 18(2): 167-179. 

Muraru, D.  et al. Ascending aorta diameters measured by echocardiography using both leading edge to leading edge and inner edge to inner edge conventions in healthy volunteers. European Heart Journal - Cardiovascular Imaging 2013; 15(4): 415-422. 

Frazao, C. et al. Multimodality Assessment of Thoracic Aortic Dimensions: Comparison of Computed Tomography Angiography, Magnetic Resonance Imaging, and Echocardiography Measurements. J Thorac Imaging. 2020; 35(6):399-406. 

Roman et al. Two dimensional echocardiographic aortic root dimensions in normal children and adults. The American Journal of Cardiology. 1989; 64(8): 507-512. 

Erbel, R. et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases. European Heart Journal. 2014. 35: 2873-2926. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Aortic-Diseases