Impaired left atrial mechanical functions as indicators for increased aortic root diameter in hypertensive and diabetic patients

Herz ◽  
2020 ◽  
Author(s):  
Ezgi Kalaycıoğlu ◽  
Mustafa Çetin ◽  
Ali Gökhan Özyıldız ◽  
Tuncay Kırış
Keyword(s):  
Aortic Root ◽  
Left Atrial ◽  
Root Diameter ◽  
Diabetic Patients

Serial Assessment of Ductus Arteriosus Hemodynamics in Hyaline Membrane Disease

PEDIATRICS ◽  
1996 ◽  
Vol 98 (6) ◽  
pp. 1149-1153
Author(s):  
Ernest Z. Phillipos ◽  
Murray A. Robertson ◽  
Paul J. Byrne
Keyword(s):  
Clinical Outcome ◽  
Linear Relationship ◽  
Aortic Root ◽  
Left Atrial ◽  
Ductus Arteriosus ◽  
Hyaline Membrane Disease ◽  
Root Diameter ◽  
Shunt Volume ◽  
Hyaline Membrane ◽  
The Mean

Objectives. To assess the efficacy of Doppler echocardiography (DE) in the quantification of patent ductus arteriosus (PDA) shunt volume and to correlate PDA shunt volume with clinical outcome in infants with hyaline membrane disease. Methods. Ninety-eight DE studies were performed in 30 preterm ventilated infants with hyaline membrane disease within the first 24 hours of age and then at 48-hour intervals to a maximum of three studies while ventilated with a final study after extubation. Right and left ventricular outputs (QRV and QLV, respectively) and PDA flow were calculated using cross-sectional area and flow velocity integrals. Left atrial-to-aortic root diameter measurements were also taken. Clinical outcomes were correlated with the shunt fraction (QLV/QRV). Results. QLV/QRV demonstrated a linear relationship with the left atrial-to-aortic root diameter ratio (n = 92; r = .79). In the absence of a PDA (n = 33 studies), QRV versus QLV demonstrated a linear relationship (r = .88). In the presence of a PDA (n = 64 studies) the mean QLV (334 ± 133 ml/kg per minute) was significantly greater than the mean QRV (237 ± 84 ml/kg per minute). There was a linear relationship between QLV - QRV (PDA shunt volume) and PDA flow (n = 60; r = .84). In studies with exclusive left-to-right shunting at the PDA (n = 48), the mean QLV - QRV (112 ± 83 ml/kg per minute) was significantly higher than in those with bidirectional shunting (n = 16; mean QLV - QRV = 50 ± 27 ml/kg per minute). Two infants with severe intraventricular hemorrhage (IVH grade 3) and two infants with periventricular leukomalacia (PVL) had significantly higher QLV/QRV (2.09 ± 0.36 and 1.67 ± 0.02 respectively) than those with no IVH (n = 6; QLV/QRV = 1.31 ± 0.18) or those with IVH grades 1 and 2 (n = 8; QLV/QRV = 1.48 ± 0.27). There was no difference in QLV/QRV in infants with or without bronchopulmonary dysplasia retinopathy of prematurity. Necrotizing enterocolitis did not develop in any of the 30 infants. Conclusion. PDA shunt volume can be quantified by DE. Larger studies are needed to correlate clinical outcome with QLV/QRV.

scholarly journals Increased Mobility of the Atrial Septum in Aortic Root Dilation: An Observational Study on Transesophageal Echocardiography

2021 ◽  
Vol 12 ◽  
Author(s):  
Altair Heidemann ◽  
Lorença Dall'Oglio ◽  
Eduardo Gehling Bertoldi ◽  
Murilo Foppa
Keyword(s):  
Ejection Fraction ◽  
Aortic Root ◽  
Left Atrial ◽  
Root Diameter ◽  
Left Ventricular ◽  
Atrial Septum ◽  
Root Anatomy ◽  
Left Ventricular Ejection ◽  
Atrial Septal Aneurysm ◽  
Ventricular Ejection Fraction

Background: There is a growing interest in the relationship between atrial septal anatomy and cardioembolic stroke. Anecdotal reports suggest that the enlargement of the aortic root could interfere with atrial septal mobility (ASM). We sought to investigate the association between ASM and aortic root dilation.Methods and Findings: From all consecutive clinically requested transesophageal echocardiogram (TEE) studies performed during the study period in a single institution, we were able to review and evaluate the ASM and anteroposterior length, aortic root diameter, and the prevalence of atrial septal aneurysm (ASA) and of patent foramen ovale (PFO) in 336 studies. Additional variables, such as left ventricular ejection fraction, left atrial diameter, diastolic dysfunction, age, sex, weight, height, previous stroke, atrial fibrillation, and TEE indication, were extracted from patient medical records and echocardiographic clinical reports. In 336 patients, we found a mean ASM of 3.4 mm, ranging from 0 to 21 mm; 15% had ASA and 14% had PFO. There was a 1.0 mm increase in ASM for every 10-mm increase in aortic root diameter adjusted for age, sex, weight, height, ejection fraction, and left atrial size (B = 0.1; P = 0.04). Aortic diameter was not associated with a smaller septal length (B = 0.03; P = 0.7).Conclusion: An increased motion of the atrial septum can occur in association with aortic dilation. These findings deserve attention for the relevance of aortic root anatomy in future studies involving atrial septal characteristics and embolic stroke risk.

scholarly journals Distorted assessment of left atrial size by echocardiography in patients with increased aortic root diameter

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Abdullah Kaplan ◽  
Raffaele Altara ◽  
Marco Manca ◽  
Hacı Murat Gunes ◽  
Alessandro Cataliotti ◽  
...  
Keyword(s):  
Aortic Root ◽  
Left Atrial ◽  
Linear Measurement ◽  
Root Diameter ◽  
Volume Increase ◽  
Chamber View ◽  
Atrial Size ◽  
Cardiovascular Pathologies ◽  
Posterior Anterior ◽  
Axis View

Abstract Background Left atrial (LA) size is frequently assessed by posterior-anterior linear measurement of LA (LAD P-A) in the parasternal long axis to expedite examination. Aging, changes in body surface area, and several cardiovascular pathologies can affect aortic root (AoR) size, thereby affecting LA anatomical shape. We hypothesized that AoR dilatation influences LAD P-A and consequently correct assessment of LA size. Results We tested our hypothesis in a study of 70 patients with AoR diameter ranging from 2.7 to 4.8 cm. LA size assessed in parasternal long axis view as LAD P-A was compared to that with LA width and length acquired in the apical two and four chamber view. Simpson’s method of discs was used as standard measurement to assess LA volume. We observed that LAD P-A in the parasternal long axis decreases when AoR diameter increases. Thus, the increase in LA size assessed in parasternal long axis did not correlate with the increase of LA volume. Further analysis revealed that a significant positive correlation was observed when LAV was plotted as a function of LAD P-A only for those with a normal size AoR. In contrast, LA volume increase correlated with LA diameters assessed in the apical two and four chamber view regardless of AoR size. Conclusions Our study documents that increases in AoR impact on the linear measurement of LA, resulting in an underestimated LAD P-A. LA size ought to be calculated from the apical two and four chambers view parameters, especially in patients with AoR dilatation.

scholarly journals Echocardiographic Measurement of Aortic Root Diameter

1976 ◽  
Vol 17 (4) ◽  
pp. 465-470 ◽  
Author(s):  
Kotaro FURUKAWA ◽  
Junichi YOSHIKAWA ◽  
Kumeo TANAKA ◽  
Chujiro TANAKA ◽  
Seiki KAWAI ◽  
...  
Keyword(s):  
Aortic Root ◽  
Root Diameter ◽  
Echocardiographic Measurement

Aortic Root Diameter and Arterial Stiffness: Conjoint Relations to the Incidence of Cardiovascular Disease in the Framingham Heart Study

Hypertension ◽  
2021 ◽  
Author(s):  
Ramachandran S. Vasan ◽  
Rebecca J. Song ◽  
Vanessa Xanthakis ◽  
Gary F. Mitchell
Keyword(s):  
Cardiovascular Disease ◽  
Pulse Pressure ◽  
Aortic Root ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Root Diameter ◽  
Cvd Risk ◽  
Heart Study ◽  
Increased Risk ◽  
Central Pulse Pressure

Higher central pulse pressure is associated with higher carotid-femoral pulse wave velocity (CFPWV) and an increased risk of cardiovascular disease (CVD). A smaller aortic root diameter (AoR) is associated with higher central pulse pressure. We hypothesized that the combination of a smaller AoR and higher CFPWV is associated with increased CVD risk (relative to a larger AoR and lower CFPWV). We tested this hypothesis in the community-based Framingham Study (N=1970, mean age 60 years, 57% women). We created sex-specific longitudinal echocardiographic AoR trajectories over 2 decades, categorizing participants into smaller versus larger AoR groups. We cross-classified participants based on their AoR trajectory and CFPWV (dichotomized at the sex-specific median). We used Cox regression to relate the cross-classified groups to CVD incidence on follow-up (median 17 years): lower CFPWV, larger AoR (referent group; 6.4/1000 person-years); lower CFPWV, smaller AoR (6.9/1000 person-years); higher CFPWV, larger AoR (23.1/1000 person-years); and higher CFPWV, smaller AoR (21.9/1000 person-years). In sex-pooled analyses, groups with higher CFPWV were associated with a multivariable-adjusted 1.8-fold risk of CVD ( P <0.01) regardless of AoR size. We observed effect modification by sex ( P for sex×AoR-CFPWV group interaction 0.04). In men, the group with smaller AoR and higher CFPWV was associated with a 2.5- to 2.8-fold risk of CVD ( P <0.001). In women, the group with larger AoR and higher CFPWV experienced a statistically nonsignificant 70% to 80% higher CVD risk. Our observations indicate that the prognostic significance of a smaller versus larger AoR varies in men versus women. Additional studies are warranted to confirm our findings.

scholarly journals DOES AORTIC ROOT DIAMETER PREDICT ANEURYSM OF THE ASCENDING AORTA?

2011 ◽  
Vol 57 (14) ◽  
pp. E683
Author(s):  
J. Ronald Mikolich ◽  
John Lisko ◽  
Brandon M. Mikolich
Keyword(s):  
Aortic Root ◽  
Root Diameter ◽  
Ascending Aorta

Abstract 17228: Not Just Another Knick In The Wall: An Unusual Case Of Multiple Arterial Aneurysms

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Vibha Amblihalli ◽  
Ayita Ray ◽  
Hafiz Khalid ◽  
luigi pacifico
Keyword(s):  
Subclavian Artery ◽  
Aortic Root ◽  
Left Atrial ◽  
Unusual Case ◽  
Surgical Intervention ◽  
Patch Repair ◽  
Atrial Wall ◽  
Aortic Root Aneurysm ◽  
Left Atrial Wall ◽  
Arterial Aneurysms

Case Presentation: 47-year-old Liberian woman with a history of latent TB and no prior cardiac history presented with dyspnea, palpitations, and weight loss. She had fevers, tachycardia, and cervical lymphadenopathy. Cardiac exam showed widened pulse pressure, systolic and diastolic murmur, and features of heart failure. TTE showed dilated left ventricle with preserved ejection fraction, aortic root aneurysm compressing left atrium, severe aortic and mitral regurgitation, and moderate pericardial effusion with no tamponade. CT angiogram of neck, chest and abdomen showed right subclavian artery mycotic aneurysm, large left supraclavicular lymphadenopathy, multiple aortic arch, and descending thoracic aorta mycotic aneurysms. She underwent emergent surgical intervention. Intraoperative TEE revealed rupture of aortic root aneurysm into left ventricular outflow tract causing a fistula, perforated anterior mitral leaflet, and distortion of the left atrial wall. She underwent mitral and aortic tissue valve replacement, aortic root replacement, and a pericardial patch repair of the left atrial wall. Subsequently, she underwent right subclavian artery aneurysm resection, right carotid axillary bypass, and vertebral artery reimplantation. Aortic valve pathology was suggestive of endocarditis with negative cultures. Lymph node biopsy revealed non-necrotizing granulomatous inflammation with no evidence of acid-fast bacilli, fungi, and malignancy. Autoimmune workup was negative. A PET CT showed post-surgical inflammatory changes with no evidence of malignancy. Discussion: We describe an unusual case of multiple large arterial aneurysms causing severe valvular insufficiency requiring emergent surgical intervention. The patient underwent extensive workup which was unrevealing. She was treated for subacute bacterial endocarditis and suspected Bechet’s disease. Thus, the quest for a definitive diagnosis continues to elude us.

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