ECHOCARDIOGRAPHY IN THE EARLY DETECTION OF AORTIC ANEURYSMS

 

 

Τolis Β, Karkalousos P, Karogiannis B, Mpenekos K, Karagiannidis Ι, Triantafillou A, Tolis X

  

 

Objectives

The aortic aneurysm (AO AN) in any segment of the aorta is a disease with potentially severe complications. Thereby, the early diagnosis of AO AN has many advantages. The aim of this paper is to show the capability of  TTE in the detection of AO AN.

 

Methods

When the patients’ TTE was completed, the AO had also been examined throughout its length. The ascending and descending AO had been examined from the parasternal window, the arch from the suprasternal and the abdominal AO from the subxiphoid window. The normal value of the diameter of different AO segments is as follows: aortic root and ascending AO: £ 40mm, AO arch: £ 40, thoracic AO and abdominal AO: £ 25mm. The dilatation at every segment of AO was characterized as moderate (aneurysmatic dilatation) and large (aneurysm). For reasons of validity and comparison the patients suffering from AN-AO  were also  subjected to CT. A correlation with the familiar risk factors had also been performed. The statistical analysis was conducted in Microsoft Excel (test x2).

 

Results-conclusion

From a sample of 2000 patients that had been examined throughout the year, 71 were diagnosed with  AN-AO (total 71, male 50, female 21, age 22-90 years old,  64,78MA, SD±13,75 years). From  the sample of 71  AN-AO patients, 18,3% were diagnosed with Bicuspid Aortic valve -BAV  (total 13, male 8, female 5). The detection of aneurysm at several segments of AO and its relation to BAV is being demonstrated in the following table.

 

Aortic segment

Mean Value±mm            

Number

%

BAV

CT

Aortic root

50,37

8

12,9

1

52

Ascentic aorta

51,11

34

47,89

8

51,34

Aortic arch

45,93

16

22,86

3

 

Thoracic aorta

36,15

20

29,85

0

 

Abdominal aorta

45,6

18

25,35

0

47,4

 

Because of the number of our patients was not large enough it was impossible to analyse statistically the relation of each segment of the aorta with each one of the seven investigated risk factors. So we divided our results in two large subdivisions of the aorta. The first part was constituted by aortic root, ascentic aorta, aortic arch and the second by thoracic and abdominal aorta.

 

The results are described in the following tables:

 

 

Aortic root, Ascentic aorta, Aortic arch

Thoracic aorta, Abdominal aorta

Totals 

 

11

4

15

With hyperlipίdemia

32

5

37

Without hyperlipidemia

 

Aortic root, Ascentic aorta, Aortic arch

Thoracic aorta, Abdominal aorta

Totals 

 

7

2

9

Mellitus

36

7

43

No mellitus

 

Aortic root, Ascentic aorta, Aortic arch

Thoracic aorta, Abdominal aorta

Totals 

 

14

7

21

Smoking

30

2

32

No smoking

 

Aortic root, Ascentic aorta, Aortic arch

Thoracic aorta, Abdominal aorta

Totals 

 

29

7

36

Men

17

1

18

Female

 

Aortic root, Ascentic aorta, Aortic arch

Thoracic aorta, Abdominal aorta

Totals 

 

7

0

7

With family history

37

8

45

Without family history

 

Aortic root, Ascentic aorta, Aortic arch

Thoracic aorta, Abdominal aorta

Totals 

 

26

6

32

With hypertension

16

3

19

Without hypertension

 

Aortic root, Ascentic aorta, Aortic arch

Thoracic aorta, Abdominal aorta

Totals 

 

34

7

41

Tricuspid  Valve

8

1

9

Bicuspid  Valve

 

Aortic root, Ascentic aorta, Aortic arch

Thoracic aorta, Abdominal aorta

Totals 

 

49

8

57

BMI > 25

 

 

As the reader can see in the following table there is not statistical importance (P>0,05) between the six risk factors we examined and the presence of aneurysm in the several parts of the aorta. This is probably due to the small number of patients in some of our groups. The investigation and the collecting of new data is continuing in order to re-examine our data in the future with larger groups.

            

Risk factors

P of x2

Hyperlipidemia

0.73

Mellitus

0.98

Sex

0.61

Family history

0.69

Smoking

0.09

Hypertension

0.99

Kind of valve (tricuspid or bicuspid)

0.98

 

 

 

 

 

 

 

 

 

 

 

Conclusions

  1. The echocardiography  contributes to the diagnose of aneurysms of AO with great precision and therefore should be examined at all its length, especially in  cases with risk factors.

  2. The patients which are referring to echo laboratory without any motivation, having the above risk factors, have a great possibility of having aneurysm.

  3. Echo test can contribute to the daily clinical work as a screening test for the diagnosis of aneurysm. Echo test is simple, safe and non-invasive. Because of   CT and NMR tomography have the same findings especially in ascentic and abdominal aorta, CT and NMR are not necessary for the diagnosis and the follow-up of the aneurysm.

  4. Following these conclusions we may at this point begin to discuss the term “Echo-aortography”.

  Tελευταία ενημέρωσηΔευτέρα Σεπτεμβρίου 07, 2009

 Tελευταία ενημέρωσηΔευτέρα Σεπτεμβρίου 07, 2009