Skip to main content
Top
Published in: Cardiovascular Ultrasound 1/2015

Open Access 01-12-2015 | Research

Clinical utility of transthoracic echocardiography for screening abdominal aortic aneurysm: a prospective study in a Japanese population

Authors: Yoshihisa Matsumura, Michiko Wada, Daigo Hirakawa, Yuka Yasuoka, Norihito Morimoto, Hiroaki Takeuchi, Hiroaki Kitaoka, Kazumasa Orihashi, Tetsuro Sugiura

Published in: Cardiovascular Ultrasound | Issue 1/2015

Login to get access

Abstract

Background

The aim of the present study was to evaluate the clinical utility of transthoracic echocardiography (TTE) for screening abdominal aortic aneurysm (AAA) and to identify important TTE indices associated with AAA in a Japanese population.

Methods

We prospectively studied 1912 patients who were referred for TTE. AAA was defined as ≥ 30 mm in size.

Results

The abdominal aorta was visualized in 95.1 % (1818/1912) by TTE. AAA was identified in 2.6 % (47/1818). The aortic root size was significantly larger in patients with AAA than those without (36.0 ± 4.1 vs. 31.7 ± 4.2 mm, p < 0.001). The aortic root size had a fair correlation with abdominal aortic size (r = 0.31, p < 0.001). The aortic root size of ≥ 34 mm was predictive of AAA by receiver operating characteristic curve analysis (area under the curve = 0.78, p < 0.001). Multiple logistic regression analysis revealed that aortic root size (Hazard ratio 1.23, p < 0.001) and age (Hazard ratio 1.05, p = 0.013) were the independent predictors of AAA.

Conclusions

The feasibility of the abdominal aortic visualization during TTE was excellent. The aortic root size measured by TTE was the independent predictor of AAA. Screening for AAA during TTE appeared to be useful especially in the older patients with a large (≥34 mm) aortic root.
Literature
2.
go back to reference Hoornweg LL, Storm-Versloot MN, Ubbink DT, Koelemay MJ, Legemate DA, Balm R. Meta analysis on mortality of ruptured abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2008;35:558–70.CrossRefPubMed Hoornweg LL, Storm-Versloot MN, Ubbink DT, Koelemay MJ, Legemate DA, Balm R. Meta analysis on mortality of ruptured abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2008;35:558–70.CrossRefPubMed
3.
go back to reference Brady AR, Fowkes FG, Greenhalgh RM, Powell JT, Ruckley CV, Thompson SG. Risk factors for postoperative death following elective surgical repair of abdominal aortic aneurysm: results from the UK Small Aneurysm Trial, on behalf of the UK Small Aneurysm Trial participants. Br J Surg. 2000;87:742–9.CrossRefPubMed Brady AR, Fowkes FG, Greenhalgh RM, Powell JT, Ruckley CV, Thompson SG. Risk factors for postoperative death following elective surgical repair of abdominal aortic aneurysm: results from the UK Small Aneurysm Trial, on behalf of the UK Small Aneurysm Trial participants. Br J Surg. 2000;87:742–9.CrossRefPubMed
4.
go back to reference Dillavou ED, Muluk SC, Makaroun MS. Improving aneurysm-related outcomes: nationwide benefits of endovascular repair. J Vasc Surg. 2006;43:446–51.CrossRefPubMed Dillavou ED, Muluk SC, Makaroun MS. Improving aneurysm-related outcomes: nationwide benefits of endovascular repair. J Vasc Surg. 2006;43:446–51.CrossRefPubMed
5.
go back to reference Gloviczki P, Pairolero PC, Mucha Jr P, Farnell MB, Hallett Jr JW, Ilstrup DM, Toomey BJ, Weaver AL, Bower TC, Bourchier RG, Cherry Jr KJ. Ruptured abdominal aortic aneurysms: repair should not be denied. J Vasc Surg. 1992;15:851–7. Gloviczki P, Pairolero PC, Mucha Jr P, Farnell MB, Hallett Jr JW, Ilstrup DM, Toomey BJ, Weaver AL, Bower TC, Bourchier RG, Cherry Jr KJ. Ruptured abdominal aortic aneurysms: repair should not be denied. J Vasc Surg. 1992;15:851–7.
6.
go back to reference Rooke TW, Hirsch AT, Misra S, Sidawy AN, Beckman JA, Findeiss LK, Golzarian J, Gornik HL, Halperin JL, Jaff MR, Monet GL, Olin JW, Stanley JC,White CJ, White JV, Zierler R, Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM Jr, White CJ, White JV, White RA, Jacobs AK, Anderson JL, Albert N, Creager MA, Ettinger SM, Guyton RA, Halperin JL, Hochman JS, Kushner FG, Magnus OE, Stevenson W, Yancy CW. 2011 ACCF/AHA Focused Update of the Guideline for the Management of patients with peripheral artery disease (Updating the 2005 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2011;124:2020–45. Rooke TW, Hirsch AT, Misra S, Sidawy AN, Beckman JA, Findeiss LK, Golzarian J, Gornik HL, Halperin JL, Jaff MR, Monet GL, Olin JW, Stanley JC,White CJ, White JV, Zierler R, Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM Jr, White CJ, White JV, White RA, Jacobs AK, Anderson JL, Albert N, Creager MA, Ettinger SM, Guyton RA, Halperin JL, Hochman JS, Kushner FG, Magnus OE, Stevenson W, Yancy CW. 2011 ACCF/AHA Focused Update of the Guideline for the Management of patients with peripheral artery disease (Updating the 2005 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2011;124:2020–45.
7.
go back to reference Eisenberg MJ, Geraci SJ, Schiller NB. Screening for abdominal aortic aneurysms during transthoracic echocardiography. Am Heart J. 1995;130:109–15.CrossRefPubMed Eisenberg MJ, Geraci SJ, Schiller NB. Screening for abdominal aortic aneurysms during transthoracic echocardiography. Am Heart J. 1995;130:109–15.CrossRefPubMed
8.
go back to reference Schwartz KV, Rashkow AM, Akella MS. Detection of abdominal aortic aneurysm during routine echocardiography. Echocardiography. 1996;13:71–4.CrossRefPubMed Schwartz KV, Rashkow AM, Akella MS. Detection of abdominal aortic aneurysm during routine echocardiography. Echocardiography. 1996;13:71–4.CrossRefPubMed
9.
go back to reference Spittell PC, Ehrsam JE, Anderson L, Seward JB. Screening for abdominal aortic aneurysm during transthoracic echocardiography in a hypertensive patient population. J Am Soc Echocardiogr. 1997;10:722–7.CrossRefPubMed Spittell PC, Ehrsam JE, Anderson L, Seward JB. Screening for abdominal aortic aneurysm during transthoracic echocardiography in a hypertensive patient population. J Am Soc Echocardiogr. 1997;10:722–7.CrossRefPubMed
10.
go back to reference Jaussi A, Fontana P, Mueller XM. Imaging of the abdominal aorta during examination of patients referred for transthoracic echocardiography. Schweiz Med Wochenschr. 1999;129:71–6.PubMed Jaussi A, Fontana P, Mueller XM. Imaging of the abdominal aorta during examination of patients referred for transthoracic echocardiography. Schweiz Med Wochenschr. 1999;129:71–6.PubMed
11.
go back to reference Giaconi S, Lattanzi F, Orsini E, Prosperi R, Tartarini G. Feasibility and accuracy of a rapid evaluation of the abdominal aorta during routine transthoracic echocardiography. Ital Heart J. 2003;4:332–6. Giaconi S, Lattanzi F, Orsini E, Prosperi R, Tartarini G. Feasibility and accuracy of a rapid evaluation of the abdominal aorta during routine transthoracic echocardiography. Ital Heart J. 2003;4:332–6.
12.
go back to reference Bekkers SC, Habets JH, Cheriex EC, Palmans A, Pinto Y, Hofstra L, Crijns HJ. Abdominal aortic aneurysm screening during transthoracic echocardiography in an unselected population. J Am Soc Echocardiogr. 2005;18:389–93. Bekkers SC, Habets JH, Cheriex EC, Palmans A, Pinto Y, Hofstra L, Crijns HJ. Abdominal aortic aneurysm screening during transthoracic echocardiography in an unselected population. J Am Soc Echocardiogr. 2005;18:389–93.
13.
go back to reference Ruggiero M, Lenti ML, Cavallari D, Dicillo CP, Mascolo AR, Musci S, Tota F, Sabato G, Tortorella C, Damiani D, Colonna P, Franchini G. Screening for abdominal aortic aneurysm during transthoracic echocardiography. A prospective study in 1202 consecutive patients at high risk: incidence, correlation with risk factors, feasibility, diagnostic accuracy, and increase in echocardiography time. G Ital Cardiol. 2006;7:217–23. Ruggiero M, Lenti ML, Cavallari D, Dicillo CP, Mascolo AR, Musci S, Tota F, Sabato G, Tortorella C, Damiani D, Colonna P, Franchini G. Screening for abdominal aortic aneurysm during transthoracic echocardiography. A prospective study in 1202 consecutive patients at high risk: incidence, correlation with risk factors, feasibility, diagnostic accuracy, and increase in echocardiography time. G Ital Cardiol. 2006;7:217–23.
14.
go back to reference Roshanali F, Mandegar MH, Yousefnia MA, Mohammadi A, Baharvand B. Abdominal aorta screening during transthoracic echocardiography. Echocardiography. 2007;24:685–8.CrossRefPubMed Roshanali F, Mandegar MH, Yousefnia MA, Mohammadi A, Baharvand B. Abdominal aorta screening during transthoracic echocardiography. Echocardiography. 2007;24:685–8.CrossRefPubMed
15.
go back to reference Gentille-Lorente DI, Salvadó-Usach T. Screening for abdominal aortic aneurysm by means of transthoracic echocardiography. Rev Esp Cardiol. 2011;64:395–400.CrossRefPubMed Gentille-Lorente DI, Salvadó-Usach T. Screening for abdominal aortic aneurysm by means of transthoracic echocardiography. Rev Esp Cardiol. 2011;64:395–400.CrossRefPubMed
16.
go back to reference Aboyans V, Bataille V, Bliscaux P, Ederhy S, Filliol D, Honton B, Kurtz B, Messas E, Mohty D, Brochet E, Kownator S. Effectiveness of screening for abdominal aortic aneurysm during echocardiography. Am J Cardiol. 2014;114:1100–4. Aboyans V, Bataille V, Bliscaux P, Ederhy S, Filliol D, Honton B, Kurtz B, Messas E, Mohty D, Brochet E, Kownator S. Effectiveness of screening for abdominal aortic aneurysm during echocardiography. Am J Cardiol. 2014;114:1100–4.
17.
go back to reference Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ. Recommendations for chamber quantification: a report from the American society of echocardiography’s guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the European association of echocardiography, a branch of the European society of cardiology. J Am Soc Echocardiogr. 2005;18:1440–63. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ. Recommendations for chamber quantification: a report from the American society of echocardiography’s guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the European association of echocardiography, a branch of the European society of cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.
18.
go back to reference Reynolds T, Santos T, Weidemann J, Langenfeld K, Warner MG. The evaluation of the abdominal aorta: a “how-to” for cardiac sonographers. J Am Soc Echocardiogr. 1990;3:336–46.CrossRefPubMed Reynolds T, Santos T, Weidemann J, Langenfeld K, Warner MG. The evaluation of the abdominal aorta: a “how-to” for cardiac sonographers. J Am Soc Echocardiogr. 1990;3:336–46.CrossRefPubMed
19.
go back to reference Wilmink AB, Quick CR. Epidemiology and potential for prevention of abdominal aortic aneurysm. Br J Surg. 1998;85:155–62.CrossRefPubMed Wilmink AB, Quick CR. Epidemiology and potential for prevention of abdominal aortic aneurysm. Br J Surg. 1998;85:155–62.CrossRefPubMed
20.
go back to reference Seelig MH, Malouf YL, Klingler PJ, Oldenburg WA, Atkinson EJ. Clinical utility of routine screening for abdominal aortic aneurysm during echocardiography. Vasa. 2000;29:265–8.CrossRefPubMed Seelig MH, Malouf YL, Klingler PJ, Oldenburg WA, Atkinson EJ. Clinical utility of routine screening for abdominal aortic aneurysm during echocardiography. Vasa. 2000;29:265–8.CrossRefPubMed
21.
go back to reference Oh SH, Chang SA, Jang SY, Park SJ, Choi JO, Lee SC, Park SW, Oh JK, Kim DK. Routine screening for abdominal aortic aneurysm during clinical transthoracic echocardiography in a Korean population. Echocardiography. 2010;27:1182–7.CrossRefPubMed Oh SH, Chang SA, Jang SY, Park SJ, Choi JO, Lee SC, Park SW, Oh JK, Kim DK. Routine screening for abdominal aortic aneurysm during clinical transthoracic echocardiography in a Korean population. Echocardiography. 2010;27:1182–7.CrossRefPubMed
22.
go back to reference Aboyans V, Kownator S, Lafitte M, Brochet E, Emmerich J, Tribouilloy C, Lafitte S, Ferrini M. Working Group for Vascular Diseases/Thrombosis, French Society of Cardiology; Council of Echocardiography, French Society of Cardiology. Screening abdominal aorta aneurysm during echocardiography: literature review and proposal for a French nationwide study. Arch Cardiovasc Dis. 2010;103:552–8. Aboyans V, Kownator S, Lafitte M, Brochet E, Emmerich J, Tribouilloy C, Lafitte S, Ferrini M. Working Group for Vascular Diseases/Thrombosis, French Society of Cardiology; Council of Echocardiography, French Society of Cardiology. Screening abdominal aorta aneurysm during echocardiography: literature review and proposal for a French nationwide study. Arch Cardiovasc Dis. 2010;103:552–8.
23.
go back to reference Agricola E, Slavich M, Tufaro V, Fisicaro A, Oppizzi M, Melissano G, Bertoglio L, Marone E, Civilini E, Margonato A, Chiesa R. Prevalence of thoracic ascending aortic aneurysm in adult patients with known abdominal aortic aneurysm: an echocardiographic study. Int J Cardiol. 2013;168:3147–8. Agricola E, Slavich M, Tufaro V, Fisicaro A, Oppizzi M, Melissano G, Bertoglio L, Marone E, Civilini E, Margonato A, Chiesa R. Prevalence of thoracic ascending aortic aneurysm in adult patients with known abdominal aortic aneurysm: an echocardiographic study. Int J Cardiol. 2013;168:3147–8.
Metadata
Title
Clinical utility of transthoracic echocardiography for screening abdominal aortic aneurysm: a prospective study in a Japanese population
Authors
Yoshihisa Matsumura
Michiko Wada
Daigo Hirakawa
Yuka Yasuoka
Norihito Morimoto
Hiroaki Takeuchi
Hiroaki Kitaoka
Kazumasa Orihashi
Tetsuro Sugiura
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Cardiovascular Ultrasound / Issue 1/2015
Electronic ISSN: 1476-7120
DOI
https://doi.org/10.1186/s12947-016-0051-x

Other articles of this Issue 1/2015

Cardiovascular Ultrasound 1/2015 Go to the issue