title: Two-dimensional transthoracic echocardiographic normal reference ranges for proximal aorta dimensions: results from the EACVI NORRE study.
abstract: OBJECTIVE
  To report normal reference ranges for echocardiographic dimensions of the proximal aorta obtained in a large group of healthy volunteers recruited using state-of-the-art cardiac ultrasound equipment, considering different measurement conventions, and taking into account gender, age, and body size of individuals.
  
  
  RESULTS
  A total of 704 (mean age: 46.0 ± 13.5 years) healthy volunteers (310 men and 394 women) were prospectively recruited from the collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. A comprehensive echocardiographic examination was obtained in all subjects following pre-defined protocols. Aortic dimensions were obtained in systole and diastole, following both the leading-edge to leading-edge and the inner-edge to inner-edge conventions. Diameters were measured at four levels: ventricular-arterial junction, sinuses of Valsalva, sino-tubular junction, and proximal tubular ascending aorta. Measures of aortic root in the short-axis view following the orientation of each of the three sinuses were also performed. Men had significantly larger body sizes when compared with women, and showed larger aortic dimensions independently of the measurement method used. Dimensions indexed by height and body surface area are provided, and stratification by age ranges is also displayed. In multivariable analysis, the independent predictors of aortic dimensions were age, gender, and height or body surface area.
  
  
  CONCLUSIONS
  The NORRE study provides normal values of proximal aorta dimensions as assessed by echocardiography. Reference ranges for different anatomical levels using different (i) measurement conventions and (ii) at different times of the cardiac cycle (i.e. mid-systole and end-diastole) are provided. Age, gender, and body size were significant determinants of aortic dimensions.
authors.affiliation: Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Saura
authors.affiliation: University of Liège hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium.
authors.forename: Raluca
authors.initials: R
authors.lastname: Dulgheru
authors.affiliation: Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Caballero
authors.affiliation: University of Liège hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium.|CHU Tours, France et Université de Tours, Tours, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Bernard
authors.affiliation: Department of Cardiology, St Marianna University, School of Medicine, Kawasaki, Japan.
authors.forename: Seisyou
authors.initials: S
authors.lastname: Kou
authors.affiliation: Echocardiography Laboratory of Adult Cardiology Department of the JO ANN Medical Center, Tbilisi, Georgia.
authors.forename: Natalia
authors.initials: N
authors.lastname: Gonjilashvili
authors.affiliation: Noninvasive Diagnostics Department, Onassis Cardiac Surgery Center, Athens, Greece.
authors.forename: George D
authors.initials: GD
authors.lastname: Athanassopoulos
authors.affiliation: Laboratory of Cardiovascular Ecography-Cardiology Dpt, S. Andrea Hospital, La Spezia, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Barone
authors.affiliation: Laboratorio Di Ecocardiografia Adulti, Fondazione Toscana 'G.Monasterio', Ospedale Del Cuore, Massa, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Baroni
authors.affiliation: Hospital da Luz - Echocardiography laboratory, Lisbon, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Cardim
authors.affiliation: Echokardiographie-Labore des Universitätsklinikums AöR, Department of Cardiology-Angiology, University of Leipzig, Leipzig, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Hagendorff
authors.affiliation: Department of Noninvasive Functional Diagnostic and Imaging, University National Heart Hospital, Sofia, Bulgaria.
authors.forename: Krasimira
authors.initials: K
authors.lastname: Hristova
authors.affiliation: Cardiology Department, La Paz hospital, Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Lopez
authors.affiliation: Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: de la Morena
authors.affiliation: 'Carol Davila' University of Medicine and Pharmacy - Euroecolab, Institute of Cardiovascular Diseases, Bucharest, Romania.
authors.forename: Bogdan A
authors.initials: BA
authors.lastname: Popescu
authors.affiliation: Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium.
authors.forename: Martin
authors.initials: M
authors.lastname: Penicka
authors.affiliation: VKV Amerikan Hastanesi, Kardiyoloji Bölümü, Istanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Ozyigit
authors.affiliation: Laboratorio de Ecocardiografia Hospital de Cruces-Barakaldo, Barakaldo, Spain.
authors.forename: Jose David
authors.initials: JD
authors.lastname: Rodrigo Carbonero
authors.affiliation: Echocardiography Unit, AZ Maria Middelares Gent, Gent, Belgium.
authors.forename: Nico
authors.initials: N
authors.lastname: Van De Veire
authors.affiliation: Medical Department Cardiology, Universitätsmedizin of the Johannes Gutenberg-University Mainz, Mainz, Germany.
authors.forename: Ralph Stephan
authors.initials: RS
authors.lastname: Von Bardeleben
authors.affiliation: Cardiovascular Research Unit, University and Emergency Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
authors.forename: Dragos
authors.initials: D
authors.lastname: Vinereanu
authors.affiliation: University Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Zamorano
authors.affiliation: University of Liège hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium.
authors.forename: Ann-Stephan
authors.initials: AS
authors.lastname: Gori
authors.affiliation: CHVZ (Centrum voor Hart en Vaatziekten) - Universitair ziekenhuis Brussel, Brussel, Belgium.|ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Brussels, Belgium.
authors.forename: Bernard
authors.initials: B
authors.lastname: Cosyns
authors.affiliation: CIC-IT U 804, CHU Rennes, Université Rennes 1, Service de Cardiologie, CHU RENNES, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Donal
authors.affiliation: Aix-Marseille Université, Marseille 13005, France.|Department of Cardiology, APHM, La Timone Hospital, Marseille 13005, France.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Habib
authors.affiliation: Department of Medicine, University of Chicago Medical Center, IL, USA.
authors.forename: Karima
authors.initials: K
authors.lastname: Addetia
authors.affiliation: Department of Medicine, University of Chicago Medical Center, IL, USA.
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Lang
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, School of Medicine, Padova, Italy.
authors.forename: Luigi P
authors.initials: LP
authors.lastname: Badano
authors.affiliation: University of Liège hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium plancellotti@chu.ulg.ac.be.|Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Lancellotti
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001013:Aorta, Thoracic / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003971:Diastole / Q000502:physiology*; D004452:Echocardiography; D005060:Europe; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012016:Reference Values; D012737:Sex Factors; D013599:Systole / Q000502:physiology; D055815:Young Adult
keywords: NORRE study; echocardiography; reference values; reproducibility of results; sinus of valsalva; thoracic aorta