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Published in: The International Journal of Cardiovascular Imaging 8/2011

Open Access 01-12-2011 | Original Paper

Aortic root dimension changes during systole and diastole: evaluation with ECG-gated multidetector row computed tomography

Authors: Linda M. de Heer, Ricardo P. J. Budde, Willem P. Th. M. Mali, Alexander M. de Vos, Lex A. van Herwerden, Jolanda Kluin

Published in: The International Journal of Cardiovascular Imaging | Issue 8/2011

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Abstract

Cardiac pulsatility and aortic compliance may result in aortic area and diameter changes throughout the cardiac cycle in the entire aorta. Until this moment these dynamic changes could never be established in the aortic root (aortic annulus, sinuses of Valsalva and sinotubular junction). The aim of this study was to visualize and characterize the changes in aortic root dimensions during systole and diastole with ECG-gated multidetector row computed tomography (MDCT). MDCT scans of subjects without aortic root disease were analyzed. Retrospectively, ECG-gated reconstructions at each 10% of the cardiac cycle were made and analyzed during systole (30–40%) and diastole (70–75%). Axial planes were reconstructed at three different levels of the aortic root. At each level the maximal and its perpendicular luminal dimension were measured. The mean dimensions of the total study group (n = 108, mean age 56 ± 13 years) do not show any significant difference between systole and diastole. The individual dimensions vary up to 5 mm. However, the differences range between minus 5 mm (diastolic dimension is greater than systolic dimensions) and 5 mm (vice versa). This variability is independent of gender, age, height and weight. This study demonstrated a significant individual dynamic change in the dimensions of the aortic root. These results are highly unpredictable. Most of the healthy subjects have larger systolic dimensions, however, some do have larger diastolic dimensions.
Literature
1.
go back to reference Van Herwaarden JA, Bartels LW, Muhs BE et al (2006) Dynamic magnetic resonance angiography of the aneurysm neck: conformational changes during the cardiac cycle with possible consequences for endograft sizing and future design. J Vasc Surg 44:22–28PubMedCrossRef Van Herwaarden JA, Bartels LW, Muhs BE et al (2006) Dynamic magnetic resonance angiography of the aneurysm neck: conformational changes during the cardiac cycle with possible consequences for endograft sizing and future design. J Vasc Surg 44:22–28PubMedCrossRef
2.
go back to reference Van Prehn J, Vincken KL, Muhs BE et al (2007) Toward endografting of the ascending aorta: insight into dynamics using dynamic cine-CTA. J Endovasc Ther 14:551–560PubMedCrossRef Van Prehn J, Vincken KL, Muhs BE et al (2007) Toward endografting of the ascending aorta: insight into dynamics using dynamic cine-CTA. J Endovasc Ther 14:551–560PubMedCrossRef
3.
go back to reference Teutelink A, Muhs BE, Vincken KL et al (2007) Use of dynamic computed tomography to evaluate pre- and postoperative aortic changes in AAA patients undergoing endovascular aneurysm repair. J Endovasc Ther 14:44–49PubMedCrossRef Teutelink A, Muhs BE, Vincken KL et al (2007) Use of dynamic computed tomography to evaluate pre- and postoperative aortic changes in AAA patients undergoing endovascular aneurysm repair. J Endovasc Ther 14:44–49PubMedCrossRef
4.
go back to reference Goergen CJ, Johnson BL, Greve JM, Taylor CA, Zarins CK (2007) Increased anterior abdominal aortic wall motion: possible role in aneurysm pathogenesis and design of endovascular devices. J Endovasc Ther 14:574–584PubMedCrossRef Goergen CJ, Johnson BL, Greve JM, Taylor CA, Zarins CK (2007) Increased anterior abdominal aortic wall motion: possible role in aneurysm pathogenesis and design of endovascular devices. J Endovasc Ther 14:574–584PubMedCrossRef
6.
go back to reference Tops LF, Wood DA, Delgado V et al (2008) Noninvasive evaluation of the aortic root with multislice computed tomography. Implication for transcatheter aortic valve replacement. J Am Coll Cardiol Imaging 1:321–330 Tops LF, Wood DA, Delgado V et al (2008) Noninvasive evaluation of the aortic root with multislice computed tomography. Implication for transcatheter aortic valve replacement. J Am Coll Cardiol Imaging 1:321–330
7.
go back to reference Wood DA, Tops LF, Mayo JR (2009) Role of multislice computed tomography in transcatheter aortic valve replacement. Am J Cardiol 103:1295–1301PubMedCrossRef Wood DA, Tops LF, Mayo JR (2009) Role of multislice computed tomography in transcatheter aortic valve replacement. Am J Cardiol 103:1295–1301PubMedCrossRef
8.
go back to reference Kazui T, Izumoto H, Yoshioka K, Kawazoe K (2006) Dynamic morphologic changes in the normal aortic annulus during systole and diastole. J Heart Valve Dis 15:617–621PubMed Kazui T, Izumoto H, Yoshioka K, Kawazoe K (2006) Dynamic morphologic changes in the normal aortic annulus during systole and diastole. J Heart Valve Dis 15:617–621PubMed
9.
go back to reference Thubrikar MK, Nolan SP (1977) Normal aortic valve function in dogs. Am J Cardiol 50:563–568CrossRef Thubrikar MK, Nolan SP (1977) Normal aortic valve function in dogs. Am J Cardiol 50:563–568CrossRef
10.
go back to reference Gnyaneshwar R, Kumar RK, Balakrishnan KR (2002) Dynamic analysis of the aortic valve using finite element model. Ann Thorac Surg 73:1122–1129PubMedCrossRef Gnyaneshwar R, Kumar RK, Balakrishnan KR (2002) Dynamic analysis of the aortic valve using finite element model. Ann Thorac Surg 73:1122–1129PubMedCrossRef
11.
go back to reference Pang DC, Choo SJ, Luo HH et al (2000) Significant increase of aortic root volume and commissural are occurs prior to aortic valve opening. J Heart Valve Dis 9:9–15PubMed Pang DC, Choo SJ, Luo HH et al (2000) Significant increase of aortic root volume and commissural are occurs prior to aortic valve opening. J Heart Valve Dis 9:9–15PubMed
12.
go back to reference Vesely I (2000) Aortic root dilation prior to valve opening explained by passive hemodynamics. J Heart Valve Dis 9:16–20PubMed Vesely I (2000) Aortic root dilation prior to valve opening explained by passive hemodynamics. J Heart Valve Dis 9:16–20PubMed
13.
go back to reference De Vos AM, Rutten A, Van de Zaag-Loonen HJ et al (2008) Non-invasive cardiac assessment of high-risk patients (the GROUND study): rationale, objectives, design of a multi-center randomized controlled trial. Trials 9:49PubMedCrossRef De Vos AM, Rutten A, Van de Zaag-Loonen HJ et al (2008) Non-invasive cardiac assessment of high-risk patients (the GROUND study): rationale, objectives, design of a multi-center randomized controlled trial. Trials 9:49PubMedCrossRef
14.
go back to reference Vahanian A, Baumgartner H, Bax J (2007) Guidelines on the management of valvular heart disease. Eur Heart J 28:230–268PubMed Vahanian A, Baumgartner H, Bax J (2007) Guidelines on the management of valvular heart disease. Eur Heart J 28:230–268PubMed
15.
go back to reference Schultz CJ, Moelker A, Piazza N et al (2010) Three dimensional evaluation of the aortic annulus using multislice computed tomography: are manufacturer’s guidelines for sizing for percutaneous aortic valve replacement helpful? Eur Heart J 31:849–856PubMedCrossRef Schultz CJ, Moelker A, Piazza N et al (2010) Three dimensional evaluation of the aortic annulus using multislice computed tomography: are manufacturer’s guidelines for sizing for percutaneous aortic valve replacement helpful? Eur Heart J 31:849–856PubMedCrossRef
16.
go back to reference Cribier A, Etchaninoff H, Tron C (2006) Treatment of calcific aortic stenosis with the percutaneous heart valve: mid-term follow-up from the initial feasibility studies: the French experience. J Am Coll Cardiol 47:1214–1223PubMedCrossRef Cribier A, Etchaninoff H, Tron C (2006) Treatment of calcific aortic stenosis with the percutaneous heart valve: mid-term follow-up from the initial feasibility studies: the French experience. J Am Coll Cardiol 47:1214–1223PubMedCrossRef
17.
go back to reference Webb JG, Chandavimol M, Thompson CR (2006) Percutaneous aortic valve implantation retrograde from the femoral artery. Circulation 113:842–850PubMedCrossRef Webb JG, Chandavimol M, Thompson CR (2006) Percutaneous aortic valve implantation retrograde from the femoral artery. Circulation 113:842–850PubMedCrossRef
18.
go back to reference Grube E, Laborde JC, Gerckens U (2006) Percutaneous implantation of the CoreValve self-expanding valve prosthesis in high-risk patients with aortic valve disease: the Siegburg firstin-man study. Circulation 114:1616–1624PubMedCrossRef Grube E, Laborde JC, Gerckens U (2006) Percutaneous implantation of the CoreValve self-expanding valve prosthesis in high-risk patients with aortic valve disease: the Siegburg firstin-man study. Circulation 114:1616–1624PubMedCrossRef
19.
go back to reference Ng ACT, Delgado V, Van der Kley F et al (2010) Comparison of aortic root dimensions and geometries before and after transcatheter aortic valve implantation by 2- and 3-dimensional transesophageal echocardiography and multislice computed tomography. Circ Cardiovasc Imaging 3:94–102PubMedCrossRef Ng ACT, Delgado V, Van der Kley F et al (2010) Comparison of aortic root dimensions and geometries before and after transcatheter aortic valve implantation by 2- and 3-dimensional transesophageal echocardiography and multislice computed tomography. Circ Cardiovasc Imaging 3:94–102PubMedCrossRef
20.
go back to reference Bellhouse B, Bellhouse F (1969) Fluid mechanics of model normal and stenosed aortic valves. Circ Res 25:694–704 Bellhouse B, Bellhouse F (1969) Fluid mechanics of model normal and stenosed aortic valves. Circ Res 25:694–704
21.
go back to reference Brewer RJ, Deck JD, Capati B, Nolan SP (1976) The dynamic aortic root: its role in aortic valve function. J Thorac Cardiovasc Surg 72:413–417PubMed Brewer RJ, Deck JD, Capati B, Nolan SP (1976) The dynamic aortic root: its role in aortic valve function. J Thorac Cardiovasc Surg 72:413–417PubMed
22.
go back to reference Stein PD (1971) Roentgenographic method for measurement of the cross-sectional area of the aortic valve. Am Heart J 81:622–634PubMedCrossRef Stein PD (1971) Roentgenographic method for measurement of the cross-sectional area of the aortic valve. Am Heart J 81:622–634PubMedCrossRef
23.
go back to reference Bernuth GV, Tsakiris AG, Wood EH (1971) Effects of variations in the strength of left ventricular contraction on aortic valve closure in the dog. Circ Res 28:705–716 Bernuth GV, Tsakiris AG, Wood EH (1971) Effects of variations in the strength of left ventricular contraction on aortic valve closure in the dog. Circ Res 28:705–716
24.
go back to reference Thubrikar M, Bosher LP, Nolan SP (1979) The mechanism of opening of the aortic valve. J Thorac Cardiovasc Surg 77:863–870PubMed Thubrikar M, Bosher LP, Nolan SP (1979) The mechanism of opening of the aortic valve. J Thorac Cardiovasc Surg 77:863–870PubMed
25.
go back to reference Dagum P, Green GR, Nistal FJ et al (1999) Deformational dynamics of the aortic root: modes and physiological determinants. Circulation 100:II54–II62PubMed Dagum P, Green GR, Nistal FJ et al (1999) Deformational dynamics of the aortic root: modes and physiological determinants. Circulation 100:II54–II62PubMed
26.
go back to reference Lansac E, Lim HS, Shomura Y et al (2002) A four-dimensional study of the aortic root dynamics. Eur J Cardio-thorac Surg 22:497–503CrossRef Lansac E, Lim HS, Shomura Y et al (2002) A four-dimensional study of the aortic root dynamics. Eur J Cardio-thorac Surg 22:497–503CrossRef
27.
go back to reference Laniado S, Yellin E, Terdiman R, Meytes I, Stadler J (1978) Hemodynamic correlates of the normal aortic valve echogram: a study of sound, flow and motion. Circulation 54:729–737 Laniado S, Yellin E, Terdiman R, Meytes I, Stadler J (1978) Hemodynamic correlates of the normal aortic valve echogram: a study of sound, flow and motion. Circulation 54:729–737
28.
go back to reference Acar C, Varnous S. In response to Kazui T, Izumoto H, Yoshioka K, Kawazoe K (2006) Dynamic morphological changes in the normal aortic annulus during systole and diastole. J Heart Valve Dis, 15:617–621 Acar C, Varnous S. In response to Kazui T, Izumoto H, Yoshioka K, Kawazoe K (2006) Dynamic morphological changes in the normal aortic annulus during systole and diastole. J Heart Valve Dis, 15:617–621
29.
go back to reference Van Steenhoven AA, Verlaan CWJ, Veenstra PC, Reneman RS (1986) In vivo cinematographic analysis of behavior of the aortic valve. Am J Physiol 251:H236–H241 Van Steenhoven AA, Verlaan CWJ, Veenstra PC, Reneman RS (1986) In vivo cinematographic analysis of behavior of the aortic valve. Am J Physiol 251:H236–H241
30.
go back to reference Higashidate M, Tamiya K, Beppu T, Imai Y (1995) Regulation of the aortic valve opening. In vivo dynamic measurement of the aortic valve orifice area. J Thorac Cardiovasc Surg 110:496–503PubMedCrossRef Higashidate M, Tamiya K, Beppu T, Imai Y (1995) Regulation of the aortic valve opening. In vivo dynamic measurement of the aortic valve orifice area. J Thorac Cardiovasc Surg 110:496–503PubMedCrossRef
31.
go back to reference Howard IC, Patterson EA, Yoxall A (2003) On the opening mechanism of the aortic valve: some observations of simulations. J Med Eng Technol 27:259–266PubMedCrossRef Howard IC, Patterson EA, Yoxall A (2003) On the opening mechanism of the aortic valve: some observations of simulations. J Med Eng Technol 27:259–266PubMedCrossRef
32.
go back to reference Van Prehn J, Vincken KL, Sprinkhuizen SM et al (2009) Aortic pulsatile distention in young healthy volunteers is asymmetric: analysis with ECG-gated MRI. Eur J Vasc Endovasc Surg 37:168–174PubMedCrossRef Van Prehn J, Vincken KL, Sprinkhuizen SM et al (2009) Aortic pulsatile distention in young healthy volunteers is asymmetric: analysis with ECG-gated MRI. Eur J Vasc Endovasc Surg 37:168–174PubMedCrossRef
33.
go back to reference Vitarelli A, Giordano M, Germano G, Pergolini M, Cicconetti P, Tomei F, Sancini A, Battaglia D, Dettori O, Capotosto L, De Cicco V (2010) De MaioM, Vitarelli M, Bruno P. Assessment of the ascending aorta wall stiffness in hypertensive patients by tissue Doppler imaging and strain Doppler echocardiography. Heart 96:1469–1474PubMedCrossRef Vitarelli A, Giordano M, Germano G, Pergolini M, Cicconetti P, Tomei F, Sancini A, Battaglia D, Dettori O, Capotosto L, De Cicco V (2010) De MaioM, Vitarelli M, Bruno P. Assessment of the ascending aorta wall stiffness in hypertensive patients by tissue Doppler imaging and strain Doppler echocardiography. Heart 96:1469–1474PubMedCrossRef
34.
go back to reference Huang Y, Hu B, Huang PT, Sun HY, Zhu JA (2008) Abdominal aortic wall motion of healthy and hypertensive subjects: evaluation of tissue Doppler velocity imaging. J Clin Ultrasound 36:218–225PubMedCrossRef Huang Y, Hu B, Huang PT, Sun HY, Zhu JA (2008) Abdominal aortic wall motion of healthy and hypertensive subjects: evaluation of tissue Doppler velocity imaging. J Clin Ultrasound 36:218–225PubMedCrossRef
Metadata
Title
Aortic root dimension changes during systole and diastole: evaluation with ECG-gated multidetector row computed tomography
Authors
Linda M. de Heer
Ricardo P. J. Budde
Willem P. Th. M. Mali
Alexander M. de Vos
Lex A. van Herwerden
Jolanda Kluin
Publication date
01-12-2011
Publisher
Springer Netherlands
Published in
The International Journal of Cardiovascular Imaging / Issue 8/2011
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-011-9838-x

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