Key result
Aortic annulus minimum diameter ≥25.74 mm measured by 3D-TEE predicted high-risk thoracic aorta aneurysms with 84.6% sensitivity and 63.9% specificity (AUC 0.759; 95% CI 0.668-0.850).
Why the study?
Accurate assessment of aortic annulus dimension and thoracic aorta aneurysm is crucial before surgery in aortic regurgitation, but the accuracy, reproducibility, and predictive value of 3D-TEE compared with MSCT needed evaluation.
Does 3D-TEE accurately measure the aortic annulus and predict high-risk thoracic aorta aneurysms compared to MSCT in patients with moderate-to-severe aortic regurgitation?
Cross-Sectional (n=111)
Does 3D-TEE accurately measure the aortic annulus and predict high-risk thoracic aorta aneurysms compared to MSCT in patients with moderate-to-severe aortic regurgitation?
Effect estimate: AUC 0.759 (95% CI 0.668-0.850)
3D-TEE is a feasible and reliable alternative to MSCT for measuring the aortic annulus and predicting high-risk thoracic aorta aneurysms in patients with pure aortic regurgitation.
3D-TEE annulus sizing may aid aneurysm risk prediction in aortic regurgitation; leaves open prospective validation against MSCT.
Background: Accurate assessment of the aortic annulus (AA) dimension and judgment of thoracic aorta aneurysm is crucial for patients with aortic regurgitation (AR) before surgery. The aim of this study was to evaluate the accuracy and reproducibility of three-dimensional transesophageal echocardiography (3D-TEE) methods for AA measurement and explore the predictive value of the AA dimensions obtained by 3D-TEE for high-risk thoracic aorta aneurysms using the gold standard of multi-slice computed tomography (MSCT). Methods: 3D-TEE was performed on 111 patients with pure moderate-to-severe AR, and MSCT examination was conducted simultaneously. AA dimensions were obtained using reconstruction software for these two imaging techniques. Thoracic aortic diameters at standard anatomic landmarks were also measured by MSCT. All patients were divided into two groups depending on the presence of high-risk thoracic aorta aneurysms. Results: Compared to MSCT, 3D-TEE overestimated all AA parameters. However, no statistically significant differences were found in the average bias between methods (minimum diameter: 26.07±3.57 vs. 25.88±3.68 mm, P=0.52; maximum diameter: 32.30±2.68 vs. 31.78±4.06 mm, P=0.11; area: 669.76±155.19 vs. 660.05±168.28 mm2, P=0.44; perimeter: 93.52±10.42 vs. 92.26±11.71 mm, P=0.12). 3D-TEE demonstrated good correlations with MSCT measurement for AA minimum diameter, maximum diameter, area, and perimeter (r=0.63, 0.64, 0.74, 0.69, P<0.05 for all). According to the multivariate logistic regression analysis, the AA minimum diameter obtained by 3D-TEE was the best predictor for the presence of high-risk thoracic aorta aneurysms. The sensitivity and specificity for prediction were 84.6% and 63.9%, respectively, for an AA minimum diameter ≥25.74 mm (AUC: 0.759, 95% CI: 0.668–0.850). Conclusions: AA measurements obtained by the 3D-TEE method are feasible and reliable for patients with pure AR. The AA minimum diameter measured by 3D-TEE can effectively predict the presence of high-risk thoracic aorta aneurysms.
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Meng et al. (2022) conducted a cross-sectional in Pure moderate-to-severe aortic regurgitation (n=111). Three-dimensional transesophageal echocardiography (3D-TEE) vs. Multi-slice computed tomography (MSCT) was evaluated on Prediction of high-risk thoracic aorta aneurysms (AUC 0.759, 95% CI 0.668-0.850). Aortic annulus minimum diameter ≥25.74 mm measured by 3D-TEE predicted high-risk thoracic aorta aneurysms with 84.6% sensitivity and 63.9% specificity (AUC 0.759; 95% CI 0.668-0.850).
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