title: In vivo assessment of aortic root geometry in normal controls using 3D analysis of computed tomography.
abstract: OBJECTIVE
  Understanding normal asymmetry in the aortic root could aid in the development of new surgical repair techniques or devices with improved haemodynamic performance. The purpose of this study was to assess geometric asymmetry and age-related changes in the normal aortic root using 3D computed tomography.
  
  
  RESULTS
  The institutional review board approved this retrospective study of 130 normal subjects (mean age, 51.4 years; 58 men). Specialized 3D software measured individual cusp sinus volumes (CSVs), cusp surface areas (CSAs), and intercommissural distances (ICDs). Age-related aortic root changes were evaluated with simple correlation, ANOVA test among age groups, and multivariable linear regression analyses. The CSV and CSA of left coronary cusp (LCC) were significantly smaller than those of right coronary cusp (RCC) and non-coronary cusp (NCC) (both, P < 0.001) in all age groups. The mean ratios of RCC or NCC-to-LCC were 1.38 and 1.36 for CSV, 1.19 and 1.20 for CSA, and 1.21 and 1.06 for ICD, respectively. The CSV and ICD increased in older age with weak-to-moderate correlation coefficients in both men and women. By multivariable linear regression, CSVs and ICDs of all cusps showed a positive correlation with age (P < 0.05), and the female gender was associated with a smaller size of the CSV and CSA.
  
  
  CONCLUSIONS
  The LCC was significantly smaller than the other two cusps, and the aortic root size increased with age.
authors.affiliation: Cardiac Imaging Center, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul 138-736, South Korea.
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Yang
authors.affiliation: Cardiac Imaging Center, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul 138-736, South Korea.
authors.forename: Dae-Hee
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Handschumacher
authors.affiliation: Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Levine
authors.affiliation: Department of Cardiothoracic Surgery, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Joon Bum
authors.initials: JB
authors.lastname: Kim
authors.affiliation: Cardiac Imaging Center, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul 138-736, South Korea.
authors.forename: Byung Joo
authors.initials: BJ
authors.lastname: Sun
authors.affiliation: Cardiac Imaging Center, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul 138-736, South Korea.
authors.forename: Jeong Yoon
authors.initials: JY
authors.lastname: Jang
authors.affiliation: Department of Convergence Medicine, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Namkug
authors.initials: N
authors.lastname: Kim
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Seunghee
authors.initials: S
authors.lastname: Baek
authors.affiliation: Cardiac Imaging Center, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul 138-736, South Korea.
authors.forename: Joon-Won
authors.initials: JW
authors.lastname: Kang
authors.affiliation: Cardiac Imaging Center, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul 138-736, South Korea.
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Song
authors.affiliation: Cardiac Imaging Center, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul 138-736, South Korea.
authors.forename: Duk-Hyun
authors.initials: DH
authors.lastname: Kang
authors.affiliation: Cardiac Imaging Center, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul 138-736, South Korea.
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Lim
authors.affiliation: Cardiac Imaging Center, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul 138-736, South Korea.
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Song
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology; D000704:Analysis of Variance; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001027:Aortography / Q000379:methods*; D015331:Cohort Studies; D000072226:Computed Tomography Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012737:Sex Factors
keywords: aortic root; computed tomography; three-dimensional analysis