Aortic root anatomy and atrial septal mobility analyzed by transesophageal echocardiography

doi:10.3969/j.issn.1004-583X.2023.11.009

Abstract

Abstract:

Objective To investigate the correlation between aortic sinus diameter and atrial septal mobility (ASM). Methods A total of 103 patients who underwent transesophageal echocardiography (TEE) were retrospectively collected. ASM, anterior and posterior diameter of interatrial septum, aortic root diameter, and incidence of patent foramen ovale (PFO) and atrial septal aneurysm (ASA) were reviewed and evaluated. Age, sex, weight, height, previous stroke, medical history of atrial fibrillation, TEE indication, left ventricular ejection fraction, left atrial diameter, and left ventricular diastolic function were obtained from the electronic medical records and TEE reports. Linear regression model was used to analyze the correlation between ASM and aortic root diameter. Results In 103 patients, the mean ASM was 4.3 mm. The prevalence of ASA and PFO was 9.7%(10/103) and 44.7%(46/103), respectively. After adjustment for age, sex, weight, height and left atrial size, ASM increased by 6.3 mm for every 10 mm increase in aortic root diameter (B=0.63; $P$ <0.01). There was no correlation between aortic root diameter and anteroposterior diameter of atrial septum ( $P$ =0.083). Conclusion The increased ASM may be related to aortic dilatation. Aortic root diameter should be considered in studies of the association between atrial septal characteristics and the risk of embolic stroke.

Key words: transesophageal echocardiography, atrial septal aneurysm, aortic dilation, stroke

CLC Number:

R540.45
R541

Li Lisha, Shen Xianghui, Liu Yanhui, Ren Yanbin. Aortic root anatomy and atrial septal mobility analyzed by transesophageal echocardiography[J]. Clinical Focus, 2023, 38(11): 1012-1015.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.11.009

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I11/1012

Figures/Tables 5

Fig. 1 TEE a.Aortic measurements at Valsalva sinus plane; b.Interatrial septal size and oscillation

Tab.1 Transesophageal echocardiographic measurements and findings of patients with clinically indicated studies( n=103)

项目	数据
经食管超声图像
主动脉根部直径(mm)	32.2±3.5
主动脉瓣[例(%)]
正常	92(89.3)
钙化	10(9.7)
狭窄	1(1.0)
房间隔直径(mm)	25.6±5.1
房间隔活动度(mm)	4.3±3.1
ASA[例(%)]	10(9.7)
PFO[例(%)]	46(44.7)
经胸超声图像
左房前后径(mm)	35.7±6.5
LVEF[例(%)]
≤50%	12(11.7)
>50%	91(88.3)
舒张功能[例(%)]
正常	63(61.2)
功能受限	40(38.8)

Fig. 2 Correlation between atrial septal mobility and aortic root diameter

Tab. 2 Crude and adjusted linear regression coeffificients between aortic root diameter and ASM

主动脉直径	B系数	95% $C I$	$P$
未调整	0.50	0.349~0.642	<0.01
调整后
年龄	0.013	-0.024~0.051	0.487
性别	4.184	2.754~5.613	<0.01
体重	-0.036	-0.095~0.025	0.226
身高	0.17	0.044~0.297	<0.01
左房前后径	-0.30	-0.116~0.057	0.501
多变量调整^*	0.63	0.477~0.784	<0.01

Tab. 2 Crude and adjusted linear regression coeffificients between aortic root diameter and ASM

主动脉直径	B系数	95% $C I$	$P$
未调整	0.50	0.349~0.642	<0.01
调整后
年龄	0.013	-0.024~0.051	0.487
性别	4.184	2.754~5.613	<0.01
体重	-0.036	-0.095~0.025	0.226
身高	0.17	0.044~0.297	<0.01
左房前后径	-0.30	-0.116~0.057	0.501
多变量调整^*	0.63	0.477~0.784	<0.01

Tab. 3 Direction of atrial septal excursion and prevalence of patent foramen ovale (n[%])

组别	例数	PFO
无偏移	13	2(15.4)
右偏移	80	37(46.2)^*
左偏及左右偏移	10	7(70.0)^*
χ²值		7.188
$P$ 值		0.027

Tab. 3 Direction of atrial septal excursion and prevalence of patent foramen ovale (n[%])

组别	例数	PFO
无偏移	13	2(15.4)
右偏移	80	37(46.2)^*
左偏及左右偏移	10	7(70.0)^*
χ²值		7.188
$P$ 值		0.027

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