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. 2010 Mar 11;12(1):12.
doi: 10.1186/1532-429X-12-12.

Thoracic aortopathy in Turner syndrome and the influence of bicuspid aortic valves and blood pressure: a CMR study

Britta E Hjerrild  1 , Kristian H Mortensen, Keld E Sørensen, Erik M Pedersen, Niels H Andersen, Erik Lundorf, Klavs W Hansen, Arne Hørlyck, Alfred Hager, Jens S Christiansen, Claus H Gravholt
Affiliations

Thoracic aortopathy in Turner syndrome and the influence of bicuspid aortic valves and blood pressure: a CMR study

Britta E Hjerrild et al. J Cardiovasc Magn Reson. .

Abstract

Background: To investigate aortic dimensions in women with Turner syndrome (TS) in relation to aortic valve morphology, blood pressure, karyotype, and clinical characteristics.

Methods and results: A cross sectional study of 102 women with TS (mean age 37.7; 18-62 years) examined by cardiovascular magnetic resonance (CMR- successful in 95), echocardiography, and 24-hour ambulatory blood pressure. Aortic diameters were measured by CMR at 8 positions along the thoracic aorta. Twenty-four healthy females were recruited as controls. In TS, aortic dilatation was present at one or more positions in 22 (23%). Aortic diameter in women with TS and bicuspid aortic valve was significantly larger than in TS with tricuspid valves in both the ascending (32.4 +/- 6.7 vs. 26.0 +/- 4.4 mm; p < 0.001) and descending (21.4 +/- 3.5 vs. 18.8 +/- 2.4 mm; p < 0.001) aorta. Aortic diameter correlated to age (R = 0.2 - 0.5; p < 0.01), blood pressure (R = 0.4; p < 0.05), a history of coarctation (R = 0.3; p = 0.01) and bicuspid aortic valve (R = 0.2-0.5; p < 0.05). Body surface area only correlated with descending aortic diameter (R = 0.23; p = 0.024).

Conclusions: Aortic dilatation was present in 23% of adult TS women, where aortic valve morphology, age and blood pressure were major determinants of the aortic diameter.

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Figures

Figure 1
Figure 1
CMR measuring positions, where pos1, pos3 and pos 6 were also measured by echocardiography. Post-processing of 3D isotropic CMR in positon 1 of the ascending aorta, at sinotubular level. It illustrates the ability to ensure precise and reproducible measurement of aortic diameter, where accuracy is ensured by the use of 3 separate planes placed perpendicular to each other and the aortic wall at the position of measuremtn.
Figure 2
Figure 2
Correlations between ascending (pos2) (A, left panel) and descending (pos7) (B, right panel) aortic diameter and age and BSA. Correlations are shown separately for TS with bicuspid (TSbicuspid) and tricuspid (TStricuspid) aortic valves.
Figure 3
Figure 3
Individual ascending aortic diameters (pos2) in TS by CMR. The individuals are marked according to their aortic valve status.
See this image and copyright information in PMC

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