Stroke volume index = Stroke volume in mL / Body surface area in m 2. iOS privacy policy Echocardiographic Imaging Challenges in Obesity: Guideline Recommendations and Limitations of Adjusting to Body Size. Maximum aortic diameter in the area of the. In this case, the swelling occurs in the wall of the root of the aorta. 8F?JOd:xOj1c/%#E1RUBVB7H:aLo C(5 52cz"6B.Lp;oW%WfaX'l}Cw#d O*j9t\mkrFY{ 2N,;g@t\@"V 3qM.7Z9=9B:~"TIo; E/#C;%2' PK ! The aorta begins at the aortic valve, where it branches off from the left ventricle of the heart. 8600 Rockville Pike Cut-off values for severe stenosis are <1.0 cm 2 for AVA and <0.6 cm 2 /m 2 for AVA index. Gender differences in aortic root dimensions. BSA: m 2; LV Long Axis Z-Score: Aortic Root Z-Score: Score: The result gives the predicted difference in percent survival for Norwood minus . Growth rate estimates, yearly . It is recommended that the changes suggested within the guideline should be discussed with sonographers, cardiologists and general clinicians when integrating the new reference intervals into everyday practice to ensure a smooth transition in the care of patients. 2021 Dec;37(12):3513-3524. doi: 10.1007/s10554-021-02354-5. LV diastolic measurements included E and A peak velocities (m/s) and their ratio as well as E-wave deceleration time (ms). The subjects underwent voluntary (or for work abilityassessment) full screening for cardiovascular disease including a questionnaire about medical history, use of medications, cardiovascular risk factors, and lifestyle habits (alcohol intake, smoking, and physical activity). Aortic dimensions now indexed for height and not BSA Should be obtained in end-diastole using inner-edge to inner-edge method Whereas previously there were different reference ranges for aortic dimensions according to age, the Society now produces age-independent ranges for men and women Read the guideline Poster orders The site is secure. the calculated cross-sectional aortic area. The reported ranges of aortic root (AR) diameters are limited by small sample size, different measurement sites, and heterogeneous cohorts. The https:// ensures that you are connecting to the The .gov means its official. Bethesda, MD 20894, Web Policies Both ASI and AHI were shown to be significant predictors of complications (p < 0.05). The mean age for this group was 58 13 years. official website and that any information you provide is encrypted Kyphoscoliotic Ehlers-Danlos Syndrome (kEDS). However, 213 patients additionally categorised as severe by AVAindex experienced significantly less valve related events than those fulfilling only the AVA criterion (p<0.001). Am J Cardiol. Results from 88 thoracic and 110 abdominal contrast material-enhanced CT examinations were analyzed in children without known cardiovascular disease who ranged in age from 0 to 20 years (mean, 9.9 years; standard deviation, 5.7), with BSA ranging from 0.19 to 2.52 m 2.Excellent interrater reliability was present (correlation coefficients ranged from 0.95 to 0.98). A rot size of 3,8 cm in a tall individual may be normal for example, but a 3,6 cm root may be enlarged in a very small. Karazincir S. et al., "CT assessment of main pulmonary artery diameter," Diagnostic and Interventional Radiology 14(2), 72-74 (2008), Density and QQ plots of raw data, and QQ plot of the Box-Cox transformed data. Figure 1 An example of aortic diameter measurements at five levels. tial proportion of the variability of aortic root size that is not accounted for by age, gender, body size and blood pressure (1). sharing sensitive information, make sure youre on a federal ID when contacting us. Historical reference intervals have often been derived from studies or echo databases that included relatively small numbers of patients. Aortic Size Assessment by Noncontrast Cardiac Computed Tomography: Normal Limits by Age, Gender, and Body Surface Area. doi: 10.1016/j.echo.2019.08.012. This was done by applying a black flood-fill to the background of the graph image, and software implementation of Hough Transform, with the expectation of finding filled circles. Careers. National Library of Medicine The function of the normal sinuses is to prevent occlusion of the coronary artery ostia during systole when the aortic valve opens. Accurate measurements of the aortic annulus and root are important for guiding therapeutic decisions regarding the need for aortic surgery. It has several subparts 1: three aortic valve leaflets and leaflet attachments. The five images were obtained from a single patient: SoV (Sin us of Valsalva), Asc (ascending aorta), Arch (aortic arch), pDTA (proximal descending thoracic aorta), and dDTA (distal descending thoracic aorta). consolidates the reporting of z-scores and reference ranges for the aortic root, based on numerous available publications. AHI categories 3.05-3.69, 3.70-4.34, and 4.35 cm/m were associated with a significantly increased risk of complications (p < 0.05). Keywords: The rationale for all suggested changes to practice are discussed in the guideline document. Results: 2. The sinuses of Valsalva and sinotubular junction were measured at end-diastole using leading edge to leading edge technique. It's about 3 to 4 centimeters wide. (Also see this page for reference values for adults.). All measurements were obtained in a zoomed parasternal long-axis view. 2021 Mar;34(3):286-300. doi: 10.1016/j.echo.2020.11.004. The following model wasfitted: log(diameter)= log a+ b log(weight)+ c log(height)+ d sex (coded 1 for men and 2 for women) or, in its exponential form: diameter= a weight b height c sex d . Allometric scaling approach for normalization was applied. and transmitted securely. Cut-off values for severe stenosis are <1.0 cm2 for AVA and <0.6 cm2/m2 for AVAindex. Hypertension has also been frequently reported to increase the diameters of large arteries . Maximal aortic diameters were measured at seven aortic regions: sinuses of Valsalva, sinotubular junction, ascending aorta, mid-descending aorta, abdominal aorta at the diaphragm, abdominal aorta at the coeliac trunk, and infrarenal abdominal aorta. Left Atrial Volume Index (LAVI) has been found to correlate with mortality from cardiovascular disease and may be measured at the end-ventricular systole, when the LA is at its maxim size. Unauthorized use of these marks is strictly prohibited. Aortic Root Index AVA (Continuity Equation VMax) AVA (Continuity Equation VTI) . Join us in the fight for victory over genetic aortic and vascular conditions. Background: The effect of BSA on aortic diameter Both cardiac output and total blood volume are elevated with increased BSA, and studies have shown that these circulatory changes result in left and right ventricular hypertrophy and cavity dilatation [ 3, 27 ]. 8600 Rockville Pike Methods: Results: Physical examination (height, weight, heart rate, and blood pressure [BP]) and clinical assessment were conducted according to standardized protocols by trained and certified staff members. An unpaired t test was performed to evaluate differences between genders. Ligurian Group of SIEC (Italian Society of Echocardiography)]. cited by this calculator preceded the publication of the 2010 ASE Guidelines. Overall, the predictive accuracy for aortic valve events was virtually identical for AVA and AVAindex in the SEAS population (mean follow-up of 46 months; area under the receiver operating characteristic curve: 0.67 (95% CI 0.64 to 0.70) vs. 0.68 (CI 0.65 to 0.71) (NS). Its highest and lowest points are located at each of the three commissures and between any two of them, respectively. BSA is calculated using the method of Dubois and Dubois. PB00if;'\kap P a!9al'tiBW PK ! The primary aim of this study was to investigate if ASI is a predictor of development AAA, and to compare the predictive impact of ASI to that of the absolute AD. THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY RECOMMENDATIONS FOR CARDIAC CHAMBER QUANTIFICATION IN ADULTS: A QUICK REFERENCE GUIDE FROM THE ASE WORKFLOW AND LAB MANAGEMENT TASK FORCE Accurate and reproducible assessment of cardiac chamber size and function is essential for clinical care. TAA size is the strongest predictor of acute aortic syndromes. BSA 65 <1.70 1.70-1.89 1.90-2.09 2.10 3) Calculator uses expected aortic diameter from sex-, age- and BSA-stratified nomograms and SD from sex-, age- and BSA-stratified table (see Notes Worksheet) 4) The condensed yellow columns from J to BE are for conversion and coding purposes and may be ignored Predicted Diameter Female <45yr Singh M, Sethi A, Mishra AK, Subrayappa NK, Stapleton DD, Pellikka PA. J Am Heart Assoc. doi: 10.1530/ERP-20-0035. Epub 2014 Apr 29. Would you like email updates of new search results? The biological variables recognized to influence aortic root size include age, sex, indexes of body size, systolic and diastolic blood pressures, and stroke volume. Normal limits in relation to age, body size and gender of two-dimensional echocardiographic aortic root dimensions in persons 15 years of age. The normal aortic diameter (AD) varies with gender, age and body surface area (BSA). PMC Aortic dimensions decrease from sinuses of Valsalva to the descending aorta. Therefore, 2-D measurements have now replaced the MMode. For homozygous mice, viable E15.5 embryonic hearts were analysed by High Resolution Episcopic Microscopy and . There were no differences between athletes and controls when the aortic diameter was indexed for BSA (15.52.0 mm/m 2 (range 8.5-26.0 mm/m 2) . Growth rate estimates, yearly complication rates, and survival were assessed. Privacy policy Measurements, Indexed Separately By Bsa And By Height, Included The Aortic Annulus . Indexed aorta diameter was defined as aortic diameter divided by BSA. The Print Rooms 18 In patients who have no other conditions, the guidelines recommend surgery when the aortic root, ascending aorta, or aortic arch reaches 5.5 cm and when the descending aorta reaches 6.0 cm ( 5.5 cm with endovascular stenting). Data are presented as the mean SD, median, and twenty-fifth and seventy-fifth percentiles. According to these criteria, 76 subjects were excluded: 2 for coronary artery disease, 10 for systemic arterial hypertension, 4 for diabetes mellitus, 8 for body mass index >30kg/m 2 , 7 for more than mild valvular insufficiency (3 mitral, 2 aortic, and 2 tricuspid), 2 for aortic stenosis, 4 for bicuspid aortic valve, 1 for hypertrophic cardiomyopathy, 1 for AR dilation, 1 for dilated cardiomyopathy, 8 for the use of pharmacologic treatment (hyperlipidemia, breast cancer, thyroid, gout, and prostate disease), 20 elite athletes, and 8 for inadequate echocardiographic image quality. In international guidelines, risk estimation for thoracic ascending aortic aneurysm (TAAA) is based on aortic diameter. Indexed body surface area aortic diameters, stratified by age and gender, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Normal Values of Aortic Root Dimensions in Healthy Adults, Aortic Root Dimensions and Stiffness in Healthy Subjects, Advances in Catheter Ablation of Primary Ventricular Fibrillation, Normal Values and Differences in Ascending Aortic Diameter in a Healthy Population of Adults as Measured by the Pediatric versus Adult American Society of Echocardiography Guidelines, Heart Rate Recovery After Exercise in Adults With the Down Syndrome, Standardizing the Method of Measuring by Echocardiogram the Diameter of the Ascending Aorta in Patients With a Bicuspid Aortic Valve, Reference Values of Tricuspid Annular Peak Systolic Velocity in Healthy Pediatric Patients, Calculation of Z Score, and Comparison to Tricuspid Annular Plane Systolic Excursion, Left Ventricular and Ascending Aortic Function After Stenting of Native Coarctation of Aorta, American Journal of Cardiology Volume 114 Issue 6. However, weight might not contribute substantially to aortic size and growth. Don't worry, my wisdom won't change. Federal government websites often end in .gov or .mil. National Library of Medicine government site. LaBounty TM, Kolias TJ, Bossone E, Bach DS. There was a straight correlation between aortic diameters (absolute and indexed values), their ratios, and age in both genders (p= 0.0001). Doppler-derived LV diastolic inflow was recorded in the apical 4-chamber view by placing the sample volume atthe tip level of the mitral valve leaflets. You should use a unique identifier, not the patients name to preserve confidentiality. Charity number:1093808, Our office is open Aortic dimensions were larger in older age groups in both sexes, a trend that persisted regardless of BSA or height adjustment. 2008;1(2):200-209. The study was approved by theinstitutions Ethics Board, and informed consent was obtained from the participants. 2012 Oct 15;110(8):1189- 94. The aortic root is located between the aortic annulus (the junction of the outflow tract of the left ventricle and the aortic valve) and the sinotubular junction (where the ascending aorta originates). London Stay tuned! The normal sinus diameter is less than 4.0 cm for men and 3.6 cm for women. New-onset aortic dilatation in the population: a quarter-century follow-up. Current guidelines recommend prophylactic surgical intervention at an aortic diameter of 5.5 cm for asymptomatic patients, and between 4.0 and 5.0 cm for Marfan syndrome and other genetically-mediated thoracic aortic aneurysms (TAAs) ( 2 ). LA Volume = (8 /3 ) x (A 1 x A 2 . Methods: No significant gender differences were registered for sinuses of Valsalva and sinotubular junction to annulus diameter ratios (p= 0.9), whereas ascending aorta to annulus diameter ratio was higher in women (p= 0.0001). PMC What are the parts of the ascending aorta? 2014 Jul-Aug;57(1):47-54. doi: 10.1016/j.pcad.2014.05.006. Standardized TTE and Doppler examinations were performed with market available equipment in all the subjects(Aloka 10; Aloka, Tokyo, Japan and Vivid 7; GE Healthcare, Milwaukee, Wisconsin). Using aortic size index, patients were stratified into three risk groups: less than 2.75 cm/m 2 are at low risk (approximately 4% per year), 2.75 to 4.24 cm/m 2 are at moderate risk (approximately 8% per year), and those above 4.25 cm/m 2 are at high risk (approximately 20% per year). Web what is the normal size of the ascending aorta? Bookshelf Adult heterozygous mice carrying the Actn2 p.Met228Thr variant were phenotyped by echocardiography. The studied population included 1,043 healthy subjects: 503 men and 540 women. However, reported ranges of AR normal dimensions are limited by small sample size, different measurement sites, and heterogeneous cohorts. Aortic Size Assessment by Noncontrast Cardiac Computed Tomography: Normal Limits by Age, Gender, and Body Surface Area. Because the correlation coefficients between aortic diameters, height, and weight raised to the specific allometric exponent were similar to those of aortic diameters versus baseline height and weight, no exponential values were included in the multivariate models. Background: Normal Values of Right Atrial Size and Function According to Age, Sex, and Ethnicity: Results of the World Alliance Societies of Echocardiography Study. . Adjusting parameters of aortic valve stenosis severity by body size. 1 It is caused by complete or partial loss of a second sex chromosome, with or without cell line mosaicism. Web at an aortic root size in the small normal range of 2.0 to 2.4 cm, the prevalence of aortic regurgitation was 0% to 15%. Aortic dimensions were larger in older age groups in both sexes, a trend that persisted regardless of BSA or height adjustment. 2022 Aug 26. doi: 10.1007/s00392-022-02086-z. Dashed lines show existing guideline data ; colored area represents the upper and lower limits of normal, with the equation for the former (ULN) shown below each plot. J Am Soc Echocardiogr. An official website of the United States government. Example of 2D echocardiographic measurements, Example of 2D echocardiographic measurements of aortic dimensions at the level of the, Nomograms of aortic dimensions at the SoV level according to different calculated BSA,, Nomograms of aortic dimensions at the SoV level according to different heights for, MeSH Changes in the assessment of the aortic root: Aortic dimensions now indexed for height and not BSA, Should be obtained in end-diastole using inner-edge to inner-edge method, Whereas previously there were different reference ranges for aortic dimensions according to age, the Society now produces age-independent ranges for men and women. Model A included age and gender; model B included age, gender, and BSA; model C included age, gender, weight, and height. The standard size of the aortic root is between 29 and 45 millimeters. This calculator Epub 2020 Nov 17. Aneurysm surgery can save your life by preventing rupture or dissection. BP= blood pressure; BSA= body surface area; LV= left ventricle. It is a muscular tube about an inch in diameter and is about 10-12 inches long. Unable to load your collection due to an error, Unable to load your delegates due to an error. All studies were reviewed and analyzed off-line by 2 independent observers. In conclusion, we provide the full range of AR diameters by TTE. BSA was calculated according to the DuBois formula [0.20247 height (m) 0.725 weight (kg) 0.425]. Bethesda, MD 20894, Web Policies 10 considered three age strata: younger than 20 years, 20-40 years, and older than 40 years by published equations. The absolute aortic diameters were significantly greater in men than in women at all levels, whereas body surface areaindexed aortic diameters were greater in women (p= 0.0001). Sign up to get the latest news and updates from The Marfan Foundation. We report a modest increase in aortic size with both increased BSA and age across males and females. Upon dissection watch: Location of dissection Left ventricular (LV) mass was calculated by the Penn convention and indexed for BSA. Disclaimer. Epub 2014 May 20. The aortic size of a person is measured by the size of his or her aorta; a statistical analysis shows that 99.97% of people have an aortic (n = 3,572), with only 8% having a aortic greater than 4.5 cm ( Table 3 depicts . and transmitted securely. Among cardiovascular imaging techniques, 2-dimensional transthoracic color Doppler echocardiography (TTE) is widely available, safe, and cost-effective, and thus, it represents an excellent first-line screening tool toevaluate the aortic root (AR) morphology and dimensions. Echocardiographic assessment of aortic stenosis: a practical guideline from the British Society of Echocardiography. Look up reference values adjusted for age, gender, and body size for the aortic root (aortic valve and sinus of valsalva) using data published in the american journal of. Step 2: Click the Calculate Button . Those with aortic size index 2.5 cm/m 2 are at highest risk for aortic dissection. Principally, the Society wanted to ensure that reference intervals were derived from the most contemporaneous and prospectively acquired data; that reference intervals were derived from evidence that best applies to the British population; and finally that echo guidance and cut-offs reflect UK practice. TTE measurements of the AR were made at end-diastole in parasternal long-axis views at 4 levels: (1) annulus, (2) sinuses of Valsalva, (3) sinotubular junction, and (4) proximal ascending aorta. doi: 10.1161/CIRCIMAGING.116.005121. Recent years have seen the publication of large, international, prospectively recruited studies from which the British Society of Echocardiography has now derived updated, robust reference intervals for use in echocardiographic practice within the UK. Of note, the upper limits of normal for all aortic dimensions were lower across all age groups, compared with the guidelines. sharing sensitive information, make sure youre on a federal The overall fit of the model using AHI was modestly superior based on the concordance statistic. Wolak A, Gransar H, Thomson LJ, et al. The diameter of the AA, typically measured at the level of the right pulmonary artery, is used to define the dimensions of the AA. This group previously published data that used aortic diameter indexed to BSA as a more patient-specific predictor of risk. Three models were developed in multiple regression analysis to explain aortic dimensions. Mean Platelet Volume to Platelet Count Ratio Predicts Left Atrial Stasis in Patients with Non-Valvular Atrial Fibrillation So I just had a "New Year, New Me" moment and my resolution is to become a new and improved version of myself in a couple of weeks. Aortic dimensions were expressed as mean, median, and twenty-fifth and seventy-fifth percentiles; the aortic dimension above the ninety-fifth percentile of the overall distribution was used as cutoff for the upper limit. What is the Normal Size of the Aortic Root? Aortic root dimensions indexed by annulus. 2012 Oct 15;110(8):1189-94. The key differences in the updated guidance are: Pre-orders are now open for this poster which will also feature our soon to be published diastolic function guideline. A diameter of < 40 mm and a ratio left atrium/aortic root of < 1.3 are considered normal. Any change in the value will pose trouble for any individual because the contraction and expansion make it difficult for the blood to flow smoothly through the aorta. Demographics and clinical characteristics, LV dimensions, and aortic diameters, both absolute and relative to BSA, are presented as mean SD and were tested by unpaired t test to evaluate differences between genders. An online calculator for the borderline left ventricle: consolidated reporting of the Rhodes score, Discriminant score, and the CHSS scores. In this study, the authors found that a simpler measure of aortic diameter indexed to height had similar predictive power compared to aortic diameter indexed to BSA. Specific measurements were made by the average of 5 cardiac cycles. The prevalence of severe stenosis increased with the AVAindex criterion compared to AVA from 71% to 80% in the retrospective cohort, and from 29% to 44% in SEAS (both p<0.001). Pathogenic variants in ACTN2, coding for alpha-actinin 2, are known to be rare causes of Hypertrophic Cardiomyopathy. Valvular regurgitation was quantified from color Doppler imaging and categorized as absent, minimal (within normal limits), mild, moderate, or severe. Copyright 2015 - 2016 Radiology Universe Institute, a public benefit corporation. Current echocardiographic guidelines for identification of aortic root dilatation are limited because current normative values were derived predominantly from white individuals in narrow age ranges, and based partially on M-mode measurements. Cookie policy. Published by at june 13, 2022. There are significant differences in aortic dimensions according to sex, age, and race. ( 20 ), in which the diameter of each segment of the aorta and BSA Epub 2016 May 18. Changes in the reference intervals for LV ejection fraction: A new borderline low LV ejection fraction group of 50-54%, Patients with an LV ejection fraction of 36-49% are defined as impaired LV ejection fraction. The aim of this study was to explore the full spectrum. . The aortic size criterion is extremely valuable, having held up clinically over the years as a dependable . All of the references Stay tuned! Am J Cardiol. official website and that any information you provide is encrypted Invasive Cardiovascular Angiography and Intervention, Screening for CAD in Cancer Survivors: Key Points, Findings From NCDR AFib Ablation Registry, Outcomes of Simultaneous Heart and Kidney Transplantation, Cardiac Damage and Quality of Life After Aortic Valve Replacement, Pregnancy in Women With Congenital Heart Disease and Pulmonary Hypertension, Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Pulmonary Hypertension and Venous Thromboembolism. The https:// ensures that you are connecting to the There was a linear correlation between the aortic diameters (absolute and indexed values) and their ratios with age in both genders, except for the aortic annulus (p= 0.0001; Figures1 and 2 ). Annulo-aortic ectasia can be an isolated condition or can occur as part of a generalised connective tissue disorder, e.g. Five-year complication-free survival was progressively worse with increasing ASI and AHI. The absolute aortic diameters were significantly greater in men than in women at all levels, whereas BSA-indexed aortic diameters were greater in women ( Table2 ). Disclaimer. All ct short axis measurements of the aortic root had excellent. :! tZf|}68meG.Hio)0*6&x. Please enable it to take advantage of the complete set of features! #^ NpnL9+>IUKsuIu)7[.p`,%K&LXA9 ++-/964^Td[@? Aortic valve area calculation by the Gorlin formula is an indirect method of determining AVA based on the flow through the valve during ventricular systole divided by the systolic pressure gradient across the valve times a constant (44.3). oculus quest 2 floor level too high Click To Call Now (270) 478-5489; battle of the bulge ww2 quizlet 2016 Jul;9(7):797-805. doi: 10.1016/j.jcmg.2015.09.026. For interobserver variability, Pearson correlations were as follows: for the aortic annulus, r= 0.88 (p <0.0001); for the sinuses of Valsalva, r= 0.96 (p <0.0001); for the sinotubular junction, r= 0.95 (p <0.0001); and for the maximum diameter of the proximal ascending aorta, r= 0.84 (p <0.0001). Step 1: Enter the Height, Weight, and Age of the Patient. For patients > 15 years of age and adults: utilizing diastole and leading edge-to-leading edge measurement of the sinuses of valsalva. Devereux RB, de Simone G, Arnett DK, Best LG, Boerwinkle E, Howard BV, Kitzman D, Lee ET, Mosley TH Jr, Weder A, Roman MJ. It then runs up the chest, behind the breastbone, and down the . Ring L, Shah BN, Bhattacharyya S, Harkness A, Belham M, Oxborough D, Pearce K, Rana BS, Augustine DX, Robinson S, Tribouilloy C. Echo Res Pract. Women were slightly older, lighter, and smaller than men. [Dimensions of the proximal thoracic aorta from childhood to adult age: reference values for two-dimensional echocardiography. Data analysis was performed using SYSTAT, version 12 (University of Illinois, Chicago, Illinois). The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Annulo-aortic ectasia is a combination of: 1) ascending aortic aneurysm 2) dilatation of the sinuses of Valsalva and 3) dilatation of the aortic annulus. Colored area represents upper and lower limits of normal, with the equation for the former (ULN) shown below each plot. Copyright 2021 American Society of Echocardiography. Epub 2020 Jan 9. Aortic Root Z-Score Calculator Data Input Form Z-scores of the aortic root (aortic annulus, sinuses of Valsalva, sinotubular junction, and ascending aorta) are commonly reported for conditions such as Marfan syndrome, bicuspid aortic valve, and Kawasaki disease. The intraobserver variability analysis revealed Pearson correlations as follows: r= 0.90 (p <0.0001) for the aortic annulus, r= 0.97 (p <0.0001) for the sinuses of Valsalva, r= 0.96 (p <0.0001) for the sinotubular junction, and r= 0.86 (p <0.0001) for the maximum diameter of the proximal ascending aorta. Additional studies have supported the use of BSA as a strong deter - minant of aortic dimensions.7-9 Sports with extremes of BSA and height, such as basketball and volleyball, have shown a higher prevalence of athletes with aortic roots Please enable it to take advantage of the complete set of features!
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