title: Quantification of normative ranges and baseline predictors of aortoventricular interface dimensions using multi-detector computed tomographic imaging in patients without aortic valve disease.
abstract: BACKGROUND
  Multidetector computed tomographic (MDCT) assessment of the aortoventricular interface has gained increased importance with the advent of minimally invasive treatment modalities for aortic and mitral valve disease. This has included a standardised technique of identifying a plane through the nadir of each coronary cusp, the basal plane, and taking further measurements in relation to this plane. Despite this there is no published data defining normal ranges for these aortoventricular metrics in a healthy cohort. This study seeks to quantify normative ranges for MDCT derived aortoventricular dimensions and evaluate baseline demographic and anthropomorphic associates of these measurements in a normal cohort.
  
  
  METHODS
  250 consecutive patients undergoing MDCT coronary angiography were included. Aortoventricular dimensions at multiple levels of the aortoventricular interface were assessed and normative ranges quantified. Multivariate linear regression was performed to identify baseline predictors of each metric.
  
  
  RESULTS
  The mean age was 59±12 years. The basal plane was eccentric (EI=0.22±0.06) while the left ventricular outflow tract was more eccentric (EI=0.32±0.06), with no correlation to gender, age or hypertension. Male gender, height and body mass index were consistent independent predictors of larger aortoventricular dimensions at all anatomical levels, while age was predictive of supra-annular measurements.
  
  
  CONCLUSIONS
  Male gender, height and BMI are independent predictors of all aortoventricular dimensions while age predicts only supra-annular dimensions. Use of defined metrics such as the basal plane and formation of normative ranges for these metrics allows reference for clinical reporting and for future research studies by using a standardised measurement technique.
authors.affiliation: MonashHeart, Monash Health, Melbourne 3168, Australia; Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168, Australia. Electronic address: robert.gooley@monashhealth.org.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Gooley
authors.affiliation: MonashHeart, Monash Health, Melbourne 3168, Australia; Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168, Australia. Electronic address: james.cameron@monash.edu.
authors.forename: James D
authors.initials: JD
authors.lastname: Cameron
authors.affiliation: MonashHeart, Monash Health, Melbourne 3168, Australia; Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168, Australia. Electronic address: jenn.sa@gmail.com.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Soon
authors.affiliation: Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168, Australia. Electronic address: dloi2@student.monash.edu.
authors.forename: Duncan
authors.initials: D
authors.lastname: Loi
authors.affiliation: Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168, Australia. Electronic address: gchi21@student.monash.edu.
authors.forename: Gauri
authors.initials: G
authors.lastname: Chitale
authors.affiliation: Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168, Australia. Electronic address: rssye1@student.monash.edu.
authors.forename: Rifath
authors.initials: R
authors.lastname: Syeda
authors.affiliation: MonashHeart, Monash Health, Melbourne 3168, Australia; Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168, Australia. Electronic address: ian.meredith@myheart.id.au.
authors.forename: Ian T
authors.initials: IT
authors.lastname: Meredith
mesh_terms: D001011:Aorta / Q000033:anatomy & histology*; D001027:Aortography; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D012720:Severity of Illness Index
keywords: Aortic annulus; Aortic root; Aortoventricular interface; Multi-detector computed tomography; Normative ranges