Z-критерий, как оптимальный параметр оценки эхокардиографических размеров корня аорты в норме и патологии

А. С. Рудой, А. М. Урываев, А. М. Литвиненко, Ю. С. Денещук БГМУ, ГУ «432 ГВКМЦ ВС РБ»

2015 №1 | Новые технологии

Аннотация

Список литературы

В статье приводятся самые оптимальные параметры оценки эхокардиографических размеров корня аорты. Представлена интерпретация их показателей, должным образом не оцениваемая на практике, особенно в плане прогноза жизнеугрожающего расширения аорты при таких наследственных нарушениях соединительной ткани, как синдром Марфана, синдром Луиса-Дитца и пр.

Ключевые слова:

z-критерий, эхокардиографические размеры, аорта

Z-criteria as evaluation parameter as optimal echocardiographic aortic root size norm and pathology

In the article the paper presents the optimum parameters of echocardiographic assessment of the size of the aortic root. Interpretation of their indicators are not properly evaluated in practice, especially in terms of the forecast life-threatening aortic enlargement in such inherited disorders of connective tissue, as Marfan syndrome, Louis-Dietz and others. We give an explanation of the predictive value of Z-test as the best criterion of normal size aorta for the timely monitoring of these disorders. Variability of interpretation of functional and anatomical structure of the ascending department and KA, misunderstanding of optimum approaches to an assessment their true and calculation of the due sizes, can potentially lead in practice to the wrong interpretation of the studied data. Acceptance of more strict coordinated standardized definitions and an assessment of the sizes of structural elements of a root of an aorta important for modern practical recommendations and cardiological practice.

Keywords

z-criterion, echocardiographic sizes, aorta

1. Anderson, R. H. // Heart. – 2000. – Vol. 84. – P. 670–673.
2. Arturo Evangelista, et al. Echocardiography in aortic diseases: EAE recommendations for clinical practice, European Journal of Echocardiography (2010) 11, 645–658.
3. Belz, G. G. Elastic properties and Windkessel function of the human aorta. Cardiovasc Drugs Ther. 1995 Feb;9(1):73–83.
4. Biddinger, A., Rocklin M., Coselli J. and Milewicz D. M. (1997) Familial thoracic aortic dilatations and dissections: a case control study. J. Vasc. Surg.,25, 506–511.
5. Boyd, E. The Growth of the Surface Area of the Human Body. – Westport, CT: Greenwood, 1935.
6. Braverman, A. C., Thompson R. W., Sanchez L. A. Diseases of the aorta. In: Bonow R. O., Mann D. L., Zipes D. P., Libby P. (eds). Braunwald’s Heart Disease. 9th ed. Philadelphia: Elsevier Saunders; 2012, p. 1309–1337.
7. Coady, M. A., Rizzo J. A., Goldstein L. J., Elefteriades J. A. Natural history, pathogenesis, and etiology of thoracic aortic aneurysms and dissections. Cardiol Clin; 17(4):615–35, 1999.
8. Coady, M. A., Rizzo J. A., Hammond G. L., Mandapati D., Darr U., Kopf G. S., Elefteriades J. A. What is the appropriate size criterion for resection of thoracic aortic aneurysms? J. Thorac Cardiovasc Surg 1997;113:476–491.
9. Devereux, R. B., de Simone G., Arnett D. K., Best L. G., Boerwinkle E., Howard B. V., Kitzman D., Lee E. T., Mosley T. H. Jr., Weder A., Roman M. J. Normal limits in relation to age, body size and gender of two-dimensional echocardiographic aortic root dimensions in persons ≥ 15 years of age. Am J. Cardiol 2012;110:1189–1194.
10. Drexler, M., Erbel R., Muller U., Wittlich N., Mohr-Kahaly S., Meyer J. Measurement of intracardiac dimensions and structures in normal young adult subjects by transesophageal echocardiography. Am J Cardiol 1990;65:1491–6.
11. Dreyer, G. and Ray W. Further experiments upon the blood volume of mammals and its relation to the surface area of the body. Philos Trans R Soc Lond 202: 191–212, 1912.
12. Du Bois D. and Du Bois E. F. A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 17: 863–871, 1916.
13. Elefteriades, J. Natural history of thoracic aortic aneurysms: indications for surgery, and surgical versus nonsurgical risks. Ann Thorac Surg. 2002; 74(5):1877–80.
14. Erbel, R., Aboyans V., Boileau C., Bossone E., Di Bartolomeo R., Eggebrecht H., Evangelista A., Falk H., Gaemperli O., Grabenwoger M., Haverich A., Iung B., Manolis A. J., Meijboom F., Nienaber C. A., Roffi M., Rousseau H., Sechtem U., Sirnes P. A., von Allmen R. S., Vrints C. J., 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases. Eur Heart J. 2014 Aug 29. pii: ehu281.
15. Evangelista, A., Flachskampf F., Lancellotti P., Badano L., Aguilar R., Monaghan M. et al. European Association of Echocardiography for standardization of performance, digital storage and reporting of echocardiographic studies. Eur J Echocardiogr 2008;9:438–48.
16. Gautier, M., Detaint D., Fermanian C., Aegerter P., Delorme G., Arnoult F., Milleron O., Raoux F., Stheneur C., Boileau C., Vahanian A., Jondeau G. Nomograms for aortic root diameters in children using two-dimensional echocardiography. Am J Cardiol. 2010 Mar 15;105(6):888–94. doi: 10.1016/j. amjcard. 2009.11.040.
17. Haycock, G. B., Schwartz G. J. and Wisotsky D. H. Geometric method for measuring body surface area: a heightweight formula validated in infants, children, and adults. J Pediatr 93: 62–66, 1978.
18. Kalsch, H., Lehmann N., Mohlenkamp S., Becker A., Moebus S., Schmermund A., Stang A., Mahabadi A. A., Mann K.,Jockel K. H., Erbel R., Eggebrecht H. Body-surface adjusted aortic reference diameters for improved identification of patients with thoracic aortic aneurysms: results from the population-based Heinz Nixdorf Recall study. Int J Cardiol 2013;163:72–78.
19. Lam, C. S., Xanthakis V., Sullivan L. M., Lieb W., Aragam J., Redfield M. M., Mitchell G. F., Benjamin E. J., Vasan R. S. Aortic root remodeling over the adult life course: longitudinal data from the Framingham Heart Study. Circulation 2010;122:884–890.
20. Lang, R., Bierig M., Devereux R., Flachskampf F. A., Foster E., Pellikka P. et al. Recommendations for Chamber Quantification. A report from the American Society of Echocardiography’s Nomenclature and Standards CommitTOE, the Task Force on Chamber Quantification, and the European Association of Echocardiography. Eur J Echocardiogr 2006;7:79–108.
21. Lang, R. M., Bierig M., Devereux R. B., Flachskampf F. A., Foster E., Pellikka P. A., Picard M. H., Roman M. J., Seward J., Shanewise J., Solomon S. D., Spencer K. T., St. John Sutton M., Stewart W. J. Members of the Chamber Quantification Writing Group. Recommendations for Chamber Quantification. A report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group. J Am Soc Echocardiogr. 2005; 18:1440–1463.
22. Muraru, D. et al. Ascending aorta diameters measured by echocardiography using both leading edge-to-leading edge and inner edge-to-inner edge conventions in healthy volunteers / D. Muraru, F. Maffessanti, G. Kocabay1 et all. // European Heart Journal – Cardiovascular Imaging Advance Access published October 4, 2013.
23. Pettersen, M. D., Du W., Skeens M. E., Humes R. A. Regression equations for calculation of z scores of cardiac structures in a large cohort of healthy infants, children, and adolescents: an echocardiographic study. J Am Soc Echocardiogr. 2008 Aug;21(8):922–34. doi: 10.1016/j. echo.2008.02.006. Epub 2008 Apr 11.
24. Rogers, I. S., Massaro J. M., Truong Q. A., Mahabadi A. A., Kriegel M. F., Fox C. S., Thanassoulis G., Isselbacher E. M., Hoffmann U., O’Donnell C. J. Distribution, determinants, and normal reference values of thoracic and abdominal aortic diameters by computedtomography (fromthe Framingham Heart Study). Am JCardiol 2013;111: 1510–1516.
25. Roman, M. J., Devereux R. B., Kramer-Fox R., O’Loughlin J. Two-dimensional echocardiographic aortic root dimensions in normal children and adults. Am J Cardiol 1989; 64:507–512.
26. Sahn, D. J., DeMaria A., Kisslo J., Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echccardiographic measurements. Circulation 1978;58:1072–1083.
27. Sampson, U. K. A., Norman P. E., Fowkes G. R., Aboyans V., Song Y., Harrell F. E., Forouzanfar M. H., Naghavi M., Denenberg J. O., McDermott M. M., Criqui M. H., Mensah G. A., Ezzati M., Murray C. Global and regional burden of aortic dissection and aneurysms. Global Heart 2014;8:171–180.
28. Schaefer, B. M., Lewin M. B., Stout K. K., Gill E., Prueitt A., Byers P. H. et al. The bicuspid aortic valve: an integrated phenotypic classification of leafiet morphology and aortic root shape. Heart 2008;94:1634–8.
29. Sluysmans, T., Colan S. D. Theoretical and empirical derivation of cardiovascular allometric relationships in children. J Appl Physiol (1985). 2005 Aug;99(2):445–57. Epub 2004 Nov 19. 30. Son, M. K. et al. Comparative measurement of aortic root by transthoracic echocardiography in normal Korean population based on two different guidelines / M. K. Son, Sung-A Chang, J. H. Kwak et al. // Cardiovascular Ultrasound 2013, 11:28. 31. Sutton, J. P., Ho S. Y., Anderson R. H. // Ann. Thorac. Surg. – 1995. – Vol. 59. – P. 419–427. 32. Wang, L., Guo D. C., Cao J., Gong L., Kamm K. E. et al. Mutations in myosin light chain kinase cause familial aortic dissections. Am J Hum Genet. 2010;87:701–7.