Key result
Systolic echocardiographic measurements of the aortic root, sinotubular junction, and ascending aorta were significantly larger than diastolic measurements by 7.3%, 10.24%, and 9.8%, respectively.
Why the study?
Guidelines recommend measuring the aorta in diastole in adults but systole in children, and adult studies show differences between phases, prompting evaluation in healthy children.
Are there clinically important differences between systolic and diastolic echocardiographic aortic measurements in healthy children?
Observational (n=272)
No
Are there clinically important differences between systolic and diastolic echocardiographic aortic measurements in healthy children?
Effect estimate: AOR 7.3%, STJ 10.24%, AAO 9.8%
p-value: p=<0.001
Systolic measurements of the aortic root, sinotubular junction, and ascending aorta are significantly larger than diastolic measurements in healthy children, highlighting the need for consistent cardiac cycle timing when applying reference values.
Systolic aortic measurements exceed diastolic by >5% at root, STJ, and ascending segments in children; leaves open whether guidelines should align timing with adult practice.
BACKGROUND: Current guidelines recommended aortic measurements during diastole in adults and during systole in children. Recent studies in adults have demonstrated noteworthy differences in aortic measurements during systole and diastole in the same subjects. In the present study, we aimed to characterize systolic and diastolic differences in aortic measurements in healthy children. MATERIALS AND METHODS: This retrospective study included 272 children who had a complete echocardiogram and no heart disease. Aortic measurements at the annulus (ANN), aortic root (AOR), sinotubular junction (STJ), and ascending aorta (AAO) were performed. Systolic and diastolic values were compared by calculating the mean systolic to diastolic (SD) percent difference for each segment; if the SD difference was >5%, it was considered clinically important. Similar measurements were conducted by another observer in 18% of the subjects. RESULTS: < 0.001) for the AOR (7.3% ± 5.5%), STJ (10.24% ± 7.1%), and AAO (9.8% ± 7.4%). There was no clinically significant SD difference for the ANN. There was an excellent intraclass correlation coefficient between observers (0.982-0.995). CONCLUSIONS: Systolic measurements for the AOR, STJ, and AAO were larger than diastolic measurements. Normal reference values are utilized to design treatment for patients with abnormal aortic sizes, and the timing in the cardiovascular cycle used to decide the reference values should be equivalent to the timing used to make measurements in clinical practice. This is particularly imperative as patients transition their care from a pediatric to an adult cardiologist.
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Al-mousily et al. (2021) conducted an observational in Structurally normal hearts (n=272). Systolic echocardiographic measurement vs. Diastolic echocardiographic measurement was evaluated on Mean systolic to diastolic percent difference in aortic measurements (AOR 7.3%, STJ 10.24%, AAO 9.8%, p=<0.001). Systolic echocardiographic measurements of the aortic root, sinotubular junction, and ascending aorta were significantly larger than diastolic measurements by 7.3%, 10.24%, and 9.8%, respectively.
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