title: A new on-line method for predicting aortic root dilatation during two-dimensional echocardiography in pediatric patients with Marfan syndrome using the sinus of valsalva to annulus ratio.
abstract: The objective of this study was to determine if calculation of the sinus of Valsalva to annulus ratio (SOV/Ann) effectively screens for root dilatation (ARD) during two-dimensional (2D) echocardiography in young patients (1 month-15 years) with suspected or confirmed Marfan syndrome. The aortic root was imaged using 2D echocardiography (parasternal long-axis view) and the SOV/Ann ratio calculated/analyzed in 27 Marfan patients and 45 age-matched controls. All controls had a SOV/Ann ratio <1.45, and 82% of Marfan's with ARD had a SOV/Ann ratio 1.45. Five of the Marfan patients with ARD had a SOV/Ann ratio < 1.45 due to normalization of the SOV/Ann ratio because of pathologic annular enlargement. Determination of the SOV/Ann ratio allows rapid on-line screening for aortic root dilatation during 2D echocardiography. A SOV/Ann ratio 1.45 predicted ARD in young Marfan patients with a high degree of accuracy (sensitivity = 0.82, specificity = 1.00). Screening for ARD using the SOV/Ann ratio fails when annular dilatation has progressed to the degree that the SOV/Ann ratio normalizes (SOV/Ann < 1.45). In this subgroup of patients, determination of aortic root dilatation will have to be evaluated by standard methods.
authors.affiliation: Penn State University, Hershey Medical Center, Hershey, PA 17033, USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Mart
authors.forename: S A
authors.initials: SA
authors.lastname: Khan
authors.forename: F C
authors.initials: FC
authors.lastname: Smith
authors.forename: R E W
authors.initials: RE
authors.lastname: Kavey
mesh_terms: D000293:Adolescent; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000473:pathology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D004108:Dilatation, Pathologic / Q000150:complications / Q000000981:diagnostic imaging; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008382:Marfan Syndrome / Q000150:complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012850:Sinus of Valsalva / Q000000981:diagnostic imaging* / Q000503:physiopathology