title: Effectiveness of screening for abdominal aortic aneurysm during echocardiography.
abstract: Screening patients with abdominal aortic aneurysm (AAA) is associated with reduced AAA-related mortality, but population screening is poorly implemented. Opportunistic screening during imaging for other indications might be efficient. Single-center series reported AAA rates of 0.8% to 6.5% in patients undergoing transthoracic echocardiography (TTE), with disparities due to selection bias. In this first multicenter study, we aimed to assess the feasibility and criteria for screening AAA during TTE in real-life practice. During a week of May 2011, 79 centers participated in a nationwide survey. All patients aged ≥65 years requiring TTE for any indication were eligible, except for those with operated abdominal aorta. We defined AAA by an anteroposterior diameter of the infrarenal aorta≥30 mm. Of 1,382 consecutive patients, abdominal aorta imaging was feasible in 96.7%, with a median delay of 1.7 minutes (>3 minutes in 3.6% of cases). We found AAA in 50 patients (3.7%). Unknown AAA (2.7%) was more frequent in men than women (3.7% vs 1.3%, respectively, p=0.007) and increased by age at 2.2%, 2.5%, and 5.8% in age bands of 65 to 74, 75 to 84, and 85+ years, respectively. None of the female participants aged <75 years had AAA. Smoking status and family history of AAA were significantly more frequent among patients with AAA. The ascending aorta was larger in those with AAA (36.2±4.7 vs 34.0±5.2 mm, p=0.006), and bicuspid aortic valve and/or major aortic regurgitation were also more frequent (8% vs 2.6%, p=0.017). In conclusion, rapid AAA screening during TTE is feasible and should be limited to men ≥65 years and women≥75 years.
authors.affiliation: Department of Cardiology, Dupuytren University Hospital, Limoges, France; INSERM U1094, Tropical Neuroepidemiology, Limoges University, Limoges, France. Electronic address: victor.aboyans@unilim.fr.
authors.forename: Victor
authors.initials: V
authors.lastname: Aboyans
authors.affiliation: Department of Cardiology, Rangueil University Hospital, Toulouse, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Bataille
authors.affiliation: Cardiology Center, Saint-Avold, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Bliscaux
authors.affiliation: Department of Cardiology, Saint-Antoine University and Medical School, Assistance Publique-Hôpitaux de Paris and Université Pierre et Marie Curie, Paris, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Ederhy
authors.affiliation: Cardiology Center, Draguignan, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Filliol
authors.affiliation: Department of Cardiology, Rangueil University Hospital, Toulouse, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Honton
authors.affiliation: Department of Cardiology, Rouen University Hospital, Rouen, France.
authors.forename: Baptiste
authors.initials: B
authors.lastname: Kurtz
authors.affiliation: Department of Vascular Medicine, Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Messas
authors.affiliation: Department of Cardiology, Dupuytren University Hospital, Limoges, France; INSERM U1094, Tropical Neuroepidemiology, Limoges University, Limoges, France.
authors.forename: Dania
authors.initials: D
authors.lastname: Mohty
authors.affiliation: Department of Cardiology, Bichat-Claude-Bernard University Hospital, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Brochet
authors.affiliation: Cardiology Center, Thionville, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Kownator
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors