Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of Cardiovascular Magnetic Resonance
Published in: Journal of Cardiovascular Magnetic Resonance 1/2012

Open Access 01-12-2012 | Research

Normal values of aortic dimensions, distensibility, and pulse wave velocity in children and young adults: a cross-sectional study

Authors: Inga Voges, Michael Jerosch-Herold, Jürgen Hedderich, Eileen Pardun, Christopher Hart, Dominik Daniel Gabbert, Jan Hinnerk Hansen, Colin Petko, Hans-Heiner Kramer, Carsten Rickers

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2012

Login to get access

Abstract

Background

Aortic enlargement and impaired bioelasticity are of interest in several cardiac and non-cardiac diseases as they can lead to cardiovascular complications. Cardiovascular magnetic resonance (CMR) is increasingly accepted as a noninvasive tool in cardiovascular evaluation. Assessment of aortic anatomy and bioelasticity, namely aortic distensibility and pulse wave velocity (PWV), by CMR is accurate and reproducible and could help to identify anatomical and bioelastic abnormalities of the aorta. However, normal CMR values for healthy children and young adults are lacking.

Methods

Seventy-one heart-healthy subjects (age 16.4 ± 7.6 years, range 2.3 - 28.3 years) were examined using a 3.0 Tesla CMR scanner. Aortic cross-sectional areas and aortic distensibility were measured at four positions of the ascending and descending thoracic aorta. PWV was assessed from aortic blood flow velocity measurements in a aortic segment between the ascending aorta and the proximal descending aorta. The Lambda-Mu-Sigma (LMS) method was used to obtain percentile curves for aortic cross-sectional areas, aortic distensibility and PWV according to age.

Results

Aortic areas, PWV and aortic distensibility (aortic cross-sectional areas: r = 0.8 to 0.9, p < 0.001; PWV: r = 0.25 to 0.32, p = 0.047 to 0.009; aortic distensibility r = -0.43 to -0.62, p < 0.001) correlated with height, weight, body surface area, and age. There were no significant sex differences.

Conclusions

This study provides percentile curves for cross-sectional areas, distensibility and pulse wave velocity of the thoracic aorta in children and young adolescents between their 3rd and 29th year of life. These data may serve as a reference for the detection of pathological changes of the aorta in cardiovascular disease.
Appendix
Available only for authorised users
Literature
1.
Metafratzi ZM, Efremidis SC, Skopelitou AS, De Roos A: The clinical significance of aortic compliance and its assessment with magnetic resonance imaging. J Cardiovasc Magn Reson. 2002, 4: 481-91.CrossRefPubMed
2.
London GM, Guerin AP: Influence of arterial pulse and reflected waves on blood pressure and cardiac function. Am Heart J. 1999, 138: 220-4. 10.1016/S0002-8703(99)70313-3.CrossRefPubMed
3.
Voges I, Jerosch-Herold M, Hedderich J, Westphal C, Hart C, Helle M, Scheewe J, Pardun E, Kramer HH, Rickers C: Maladaptive aortic properties in children after palliation of hypoplastic left heart syndrome assessed by cardiovascular magnetic resonance imaging. Circulation. 2010, 122: 1068-76. 10.1161/CIRCULATIONAHA.109.889733.CrossRefPubMed
4.
Kühn A, Baumgartner D, Baumgartner C, Hörer J, Schreiber C, Hess J, Vogt M: Impaired elastic properties of the ascending aorta persist within the first 3 years after neonatal coarctation repair. Pediatr Cardiol. 2009, 30: 46-51. 10.1007/s00246-008-9280-6.CrossRefPubMed
5.
Grotenhuis HB, Ottenkamp J, de Bruijn L, Westenberg JJ, Vliegen HW, Kroft LJ, de Roos A: Aortic elasticity and size are associated with aortic regurgitation and left ventricular dysfunction in tetralogy of Fallot after pulmonary valve replacement. Heart. 2009, 95: 1931-6. 10.1136/hrt.2009.175877.CrossRefPubMed
6.
Grotenhuis HB, Ottenkamp J, Fontein D, Vliegen HW, Westenberg JJ, Kroft LJ, de Roos A: Aortic elasticity and left ventricular function after arterial switch operation: MR imaging–initial experience. Radiology. 2008, 249: 801-9. 10.1148/radiol.2492072013.CrossRefPubMed
7.
Aboulhosn J, Child JS: Left ventricular outflow obstruction: subaortic stenosis, bicuspid aortic valve, supravalvar aortic stenosis, and coarctation of the aorta. Circulation. 2006, 114: 2412-22. 10.1161/CIRCULATIONAHA.105.592089.CrossRefPubMed
8.
Laurent S, Katsahian S, Fassot C, Tropeano AI, Gautier I, Laloux B, Boutouyrie P: Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke. 2003, 34: 1203-6. 10.1161/01.STR.0000065428.03209.64.CrossRefPubMed
9.
Boese JM, Bock M, Schoenberg SO, Schad LR: Estimation of aortic compliance using magnetic resonance pulse wave velocity measurement. Phys Med Biol. 2000, 45: 1703-13. 10.1088/0031-9155/45/6/320.CrossRefPubMed
10.
Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, Vita JA, Levy D, Benjamin EJ: Arterial stiffness and cardiovascular events: the Framingham heart study. Circulation. 2010, 121: 505-11. 10.1161/CIRCULATIONAHA.109.886655.PubMedCentralCrossRefPubMed
11.
Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H: European network for Non-invasive investigation of large arteries: expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006, 27: 2588-605. 10.1093/eurheartj/ehl254.CrossRefPubMed
12.
Mohiaddin RH, Underwood SR, Bogren HG, Firmin DN, Klipstein RH, Rees RS, Longmore DB: Regional aortic compliance studied by magnetic resonance imaging: the effects of age, training, and coronary artery disease. Br Heart J. 1989, 62: 90-6. 10.1136/hrt.62.2.90.PubMedCentralCrossRefPubMed
13.
Mohiaddin RH, Firmin DN, Longmore DB: Age-related changes of human aortic flow wave velocity measured noninvasively by magnetic resonance imaging. J Appl Physiol. 1993, 74: 492-7.PubMed
14.
Groenink M, de Roos A, Mulder BJ, Spaan JA, van der Wall EE: Changes in aortic distensibility and pulse wave velocity assessed with magnetic resonance imaging following beta-blocker therapy in the Marfan syndrome. Am J Cardiol. 1998, 82: 203-8. 10.1016/S0002-9149(98)00315-4.CrossRefPubMed
15.
Cole TJ, Green PJ: Smoothing reference centile curves: the LMS method and penalized likelihood. Stat Med. 1992, 11: 1305-19. 10.1002/sim.4780111005.CrossRefPubMed
16.
Cole TJ: The LMS method for constructing normalized growth standards. Eur J Clin Nutr. 1990, 44: 45-60.PubMed
17.
Pennell DJ, Sechtem UP, Higgins CB, Manning WJ, Pohost GM, Rademakers FE, van Rossum AC, Shaw LJ, Yucel EK: European Society of cardiology; Society for Cardiovascular Magnetic Resonance: Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report. J Cardiovasc Magn Reson. 2004, 6: 727-65. 10.1081/JCMR-200038581.CrossRefPubMed
18.
Snider AR, Enderlein MA, Teitel DF, Juster RP: Two-dimensional echocardiographic determination of aortic and pulmonary artery sizes from infancy to adulthood in normal subjects. Am J Cardiol. 1984, 53: 218-24. 10.1016/0002-9149(84)90715-X.CrossRefPubMed
19.
Rammos S, Apostolopoulou SC, Kramer HH, Kozlik-Feldmann R, Heusch A, Laskari CV, Anagnostopoulos C: Normative angiographic data relating to the dimensions of the aorta and pulmonary trunk in children and adolescents. Cardiol Young. 2005, 15: 119-24. 10.1017/S1047951105000272.CrossRefPubMed
20.
Clarkson PM, Brandt PW: Aortic diameters in infants and young children: normative angiographic data. Pediatr Cardiol. 1985, 6: 3-6. 10.1007/BF02265400.CrossRefPubMed
21.
Kaiser T, Kellenberger CJ, Albisetti M, Bergsträsser E, Valsangiacomo Buechel ER: Normal values for aortic diameters in children and adolescents--assessment in vivo by contrast-enhanced CMR-angiography. J Cardiovasc Magn Reson. 2008, 10: 56-10.1186/1532-429X-10-56.PubMedCentralCrossRefPubMed
22.
Mohiaddin RH, Schoser K, Amanuma M, Burman ED, Longmore DB: MR imaging of age-related dimensional changes of thoracic aorta. J Comput Assist Tomogr. 1990, 14: 748-52. 10.1097/00004728-199009000-00012.CrossRefPubMed
23.
Sievers HH, Onnasch DG, Lange PE, Bernhard A, Heintzen PH: Dimensions of the great arteries, semilunar valve roots, and right ventricular outflow tract during growth: normative angiocardiographic data. Pediatr Cardiol. 1983, 4: 189-96. 10.1007/BF02242254.CrossRefPubMed
24.
Senzaki H, Akagi M, Hishi T, Ishizawa A, Yanagisawa M, Masutani S, Kobayashi T, Awa S: Age-associated changes in arterial elastic properties in children. Eur J Pediatr. 2002, 161: 547-51. 10.1007/s00431-002-1025-6.CrossRefPubMed
25.
Avolio AP, Chen SG, Wang RP, Zhang CL, Li MF, O'Rourke MF: Effects of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. Circulation. 1983, 68: 50-8. 10.1161/01.CIR.68.1.50.CrossRefPubMed
26.
Jo CO, Lande MB, Meagher CC, Wang H, Vermilion RP: A simple method of measuring thoracic aortic pulse wave velocity in children: methods and normal values. J Am Soc Echocardiogr. 2010, 23: 735-40. 10.1016/j.echo.2010.04.018.CrossRefPubMed
27.
Grotenhuis HB, Westenberg JJ, Steendijk P, van der Geest RJ, Ottenkamp J, Bax JJ, Jukema JW, de Roos A: Validation and reproducibility of aortic pulse wave velocity as assessed with velocity-encoded MRI. J Magn Reson Imaging. 2009, 30: 521-6. 10.1002/jmri.21886.CrossRefPubMed
28.
Glukhova MA, Frid MG, Koteliansky VE: Phenotypic changes of human aortic smooth muscle cells during development and in the adult vessel. Am J Physiol. 1991, 261: 78-80.PubMed
29.
Marty CN, Greenwald SE: Impaired synthesis of elastin in walls of aorta and large conduit arteries during early development as an initiating event in pathogenesis of systemic hypertension. Lancet. 1997, 350: 953-5. 10.1016/S0140-6736(96)10508-0.CrossRef
30.
Nichols WW, O’Rourke MF: Aging, high blood pressure and disease in humans. In: McDonald’s blood flow in arteries. 1990, London: Edward Arnold, 398-420.
31.
Rerkpattanapipat P, Hundley WG, Link KM, Brubaker PH, Hamilton CA, Darty SN, Morgan TM, Kitzman DW: Relation of aortic distensibility determined by magnetic resonance imaging in patients > or =60years of age to systolic heart failure and exercise capacity. Am J Cardiol. 2002, 90: 1221-5. 10.1016/S0002-9149(02)02838-2.CrossRefPubMed
32.
Sharma J, Friedman D, Dave-Sharma S, Harbison M: Aortic distensibility and dilation in Turner's syndrome. Cardiol Young. 2009, 19: 568-72. 10.1017/S1047951109990874.CrossRefPubMed
33.
Meyer AA, Kundt G, Steiner M, Schuff-Werner P, Kienast W: Impaired flow-mediated vasodilation, carotid artery intima-media thickening, and elevated endothelial plasma markers in obese children: the impact of cardiovascular risk factors. Pediatrics. 2006, 117: 1560-7. 10.1542/peds.2005-2140.CrossRefPubMed
Metadata
Title
Normal values of aortic dimensions, distensibility, and pulse wave velocity in children and young adults: a cross-sectional study
Authors
Inga Voges
Michael Jerosch-Herold
Jürgen Hedderich
Eileen Pardun
Christopher Hart
Dominik Daniel Gabbert
Jan Hinnerk Hansen
Colin Petko
Hans-Heiner Kramer
Carsten Rickers
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Cardiovascular Magnetic Resonance / Issue 1/2012
Electronic ISSN: 1532-429X
DOI
https://doi.org/10.1186/1532-429X-14-77

Other articles of this Issue 1/2012

Journal of Cardiovascular Magnetic Resonance 1/2012 Go to the issue

Research

Heme arginate improves reperfusion patterns after ischemia: a randomized, placebo-controlled trial in healthy male subjects

Research

Cardiovascular magnetic resonance by non contrast T1-mapping allows assessment of severity of injury in acute myocardial infarction

Research

Undersampled Cine 3D tagging for rapid assessment of cardiac motion

Technical notes

A non-invasive clinical application of wave intensity analysis based on ultrahigh temporal resolution phase-contrast cardiovascular magnetic resonance

Research

Left ventricular remodeling and hypertrophy in patients with aortic stenosis: insights from cardiovascular magnetic resonance

Research

Comparison of exercise electrocardiography and stress perfusion CMR for the detection of coronary artery disease in women