1
|
Movahed MR, Soltani Moghaddam A, Dodge M. Routine Abdominal Aortic Examination During Echocardiographic Studies Detects Significant Numbers of Abdominal Aortic Aneurysm and Should be a Part of Routine Echocardiographic Examinations. Crit Pathw Cardiol 2024; 23:17-19. [PMID: 37944006 DOI: 10.1097/hpc.0000000000000341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
BACKGROUND Early detection and follow-up of abdominal aortic aneurysm (AAA) are important and can be lifesaving. The goal of this study was to evaluate if routine abdominal aorta screenings during echocardiograms can be helpful in detecting asymptomatic abdominal aortic aneurysm. METHODS We retrospective studied consecutive patients who were sent for outpatient routine echocardiograms for various clinical reasons in 2015-2017 until we reached a total of 1000 patients. Starting from the subcostal and then proceeding to the abdomen, a long-axis screening of the abdominal aorta was attempted on all of the patients after the echocardiogram was completed. No patient preparation was given. Imaging began from the subcostal view and proceeded caudally with images obtained every 1-2 cm. Measurement of the aortic diameter was performed from the longitudinal plane using the leading-edge-to-leading-edge method. RESULTS The age range was 33-96 years with a median age of 72.4. A total of 273 (27.3%) patients did not have an appropriate window to evaluate AAA. Among the remaining 727 screenings, 18 (2.4%) had dilatation of abdominal aorta or AAA. The dilatation and aneurysms ranged between 2.5 and 4.5 cm in size. Abnormal aortic diameters were as follows: 5 (27.7%) were between 2.5 and 2.9 cm, 6 (33.3%) between 3 and 3.4 cm, 1 (5.5%) between 3.5 and 3.9, 5 (27.7%) between 4.0 and 4.4 cm, and 1 (5.5%) between 4.5 and 4.9 cm. CONCLUSIONS Performing routine abdominal aortic examinations during routine echocardiographic exams can detect a significant amount of abdominal aortic aneurysm which can be lifesaving. We suggest adding abdominal aortic assessment to routine echocardiographic examination.
Collapse
Affiliation(s)
- Mohammad Reza Movahed
- From the Division of Cardiology, Department of Medicine, University of Arizona Sarver Heart Center, Tucson, AZ
- University of Arizona College of Medicine, Phoenix, AZ
| | - Arman Soltani Moghaddam
- From the Division of Cardiology, Department of Medicine, University of Arizona Sarver Heart Center, Tucson, AZ
| | - Melisa Dodge
- From the Division of Cardiology, Department of Medicine, University of Arizona Sarver Heart Center, Tucson, AZ
| |
Collapse
|
2
|
Durieux R, Sakalihasan N, Defraigne JO. [Opportunistic screening for abdominal aortic aneurysm during echocardiography in patients with coronary artery disease: Utility or futility?]. Ann Cardiol Angeiol (Paris) 2021; 71:53-58. [PMID: 33640149 DOI: 10.1016/j.ancard.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022]
Abstract
Abdominal aortic aneurysm is a chronic degenerative disease that is usually silent until rupture occurs and this complication is still associated in contemporary era with a high rate of mortality. Screening programmes for abdominal aortic aneurysm have been shown to be effective in reducing global mortality in the screened population but these programmes are poorly implemented in the Western countries. As coronary artery disease and abdominal aorta aneurysmal disease share many risk factors, the cardiologist is centrally positioned in the screening strategy, not only to identify patients with higher risk of developing abdominal aortic aneurysm, but also to perform an opportunistic screening during echocardiography. This paper summarises evidence about the feasibility, indications, modalities, benefits and risks related to the opportunistic screening for abdominal aortic aneurysm during echocardiography with a particular emphasis on the population of patients with coronary artery disease.
Collapse
Affiliation(s)
- R Durieux
- Service de chirurgie cardio-vasculaire, CHU de Liège, domaine universitaire du Sart-Tilman, B35, 4000 Liège, Belgique.
| | - N Sakalihasan
- Service de chirurgie cardio-vasculaire, CHU de Liège, domaine universitaire du Sart-Tilman, B35, 4000 Liège, Belgique
| | - J O Defraigne
- Service de chirurgie cardio-vasculaire, CHU de Liège, domaine universitaire du Sart-Tilman, B35, 4000 Liège, Belgique
| |
Collapse
|
3
|
Matsumura Y, Ochi Y, Wada M, Hirakawa D, Yamanaka S, Kamioka M, Kitaoka H, Orihashi K, Nakaoka Y, Doi Y, Sugiura T. Usefulness of Screening for Abdominal Aortic Aneurysm During Transthoracic Echocardiography in Women ≥50 Years of Age. Am J Cardiol 2018; 122:2147-2150. [PMID: 30360889 DOI: 10.1016/j.amjcard.2018.08.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/21/2018] [Accepted: 08/24/2018] [Indexed: 01/14/2023]
Abstract
Usefulness of screening for abdominal aortic aneurysm (AAA) during transthoracic echocardiography (TTE) in women is uncertain. The aim of the present study was to clarify the clinical usefulness of screening for AAA during TTE and to identify important TTE indices associated with AAA in women in a routine clinical setting. We prospectively studied 1,495 women (≥50 years) referred for TTE. AAA was defined as ≥30 mm in size. The additional screening time for AAA was <1 minute. The abdominal aorta was visualized in 95.1 % (1,422 of 1,495) using the same TTE probe. AAA was identified in 1.9% (27 of 1422). The aortic root size was larger in patients with AAA than those without (33.3 ± 3.2 vs 30.5 ± 3.4 mm, p < 0.001). The aortic root size had a correlation with abdominal aortic size (r = 0.22, p < 0.001). The aortic root size of ≥30.3 mm was predictive of AAA (area under the curve = 0.74, p < 0.001) and all patients with AAA had the aortic root size of ≥28.0 mm. Multiple logistic regression analysis revealed that the aortic root size (Odds ratio 1.17, p = 0.007) was a most independent TTE index of AAA. In conclusion, the visibility of the abdominal aorta using TTE probe was excellent. When the aortic root size is ≥28.0 mm during TTE in women ≥50 years of age, screening for AAA should be carried out.
Collapse
|
4
|
Matsumura Y, Wada M, Hirakawa D, Yasuoka Y, Morimoto N, Takeuchi H, Kitaoka H, Orihashi K, Sugiura T. Clinical utility of transthoracic echocardiography for screening abdominal aortic aneurysm: a prospective study in a Japanese population. Cardiovasc Ultrasound 2016; 14:8. [PMID: 26868661 PMCID: PMC4751668 DOI: 10.1186/s12947-016-0051-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/06/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The aim of the present study was to evaluate the clinical utility of transthoracic echocardiography (TTE) for screening abdominal aortic aneurysm (AAA) and to identify important TTE indices associated with AAA in a Japanese population. METHODS We prospectively studied 1912 patients who were referred for TTE. AAA was defined as ≥ 30 mm in size. RESULTS The abdominal aorta was visualized in 95.1% (1818/1912) by TTE. AAA was identified in 2.6% (47/1818). The aortic root size was significantly larger in patients with AAA than those without (36.0 ± 4.1 vs. 31.7 ± 4.2 mm, p < 0.001). The aortic root size had a fair correlation with abdominal aortic size (r = 0.31, p < 0.001). The aortic root size of ≥ 34 mm was predictive of AAA by receiver operating characteristic curve analysis (area under the curve = 0.78, p < 0.001). Multiple logistic regression analysis revealed that aortic root size (Hazard ratio 1.23, p < 0.001) and age (Hazard ratio 1.05, p = 0.013) were the independent predictors of AAA. CONCLUSIONS The feasibility of the abdominal aortic visualization during TTE was excellent. The aortic root size measured by TTE was the independent predictor of AAA. Screening for AAA during TTE appeared to be useful especially in the older patients with a large (≥34 mm) aortic root.
Collapse
Affiliation(s)
- Yoshihisa Matsumura
- Department of Laboratory Medicine, Kochi Medical School, Kochi University, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan.
| | - Michiko Wada
- Clinical Laboratory, Kochi Medical School, Kochi University, Kochi, Japan
| | - Daigo Hirakawa
- Clinical Laboratory, Kochi Medical School, Kochi University, Kochi, Japan
| | - Yuka Yasuoka
- Clinical Laboratory, Kochi Medical School, Kochi University, Kochi, Japan
| | - Norihito Morimoto
- Clinical Laboratory, Kochi Medical School, Kochi University, Kochi, Japan
| | - Hiroaki Takeuchi
- Department of Laboratory Medicine, Kochi Medical School, Kochi University, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan
| | - Hiroaki Kitaoka
- Department of Cardiology, Neurology, and Aging Science, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kazumasa Orihashi
- Department of Cardiovascular Surgery, Kochi Medical School, Kochi University, Kochi, Japan
| | - Tetsuro Sugiura
- Department of Laboratory Medicine, Kochi Medical School, Kochi University, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan
| |
Collapse
|
5
|
Kerut EK, Hunter D, Hanawalt C, McIlwain EF, Helmcke F. Routine Screening for Abdominal Aortic Aneurysm in the Echocardiography Laboratory Using a "Modified" Abdominal Aortic Examination Protocol. Echocardiography 2006; 23:83-5. [PMID: 16412195 DOI: 10.1111/j.1540-8175.2006.00147.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Edmund Kenneth Kerut
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana 70072, USA.
| | | | | | | | | |
Collapse
|
6
|
Davis D, Craig M. Unsuspected Abdominal Aortic Aneurysm. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2002. [DOI: 10.1177/87579302018003007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The authors present three cases of occult abdominal aortic aneurysm discovered by screening the abdominal aorta during routine transthoracic echocardiography.
Collapse
|
7
|
Schwartz KV, Rashkow AM, Akella MS. Detection of Abdominal Aortic Aneurysm During Routine Echocardiography. Echocardiography 1996; 13:71-74. [PMID: 11442905 DOI: 10.1111/j.1540-8175.1996.tb00869.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE: To determine the feasibility of detecting abdominal aortic aneurysms (AAAs) in the elderly by adding abdominal screening to a standard echocardiographic study. METHODS: Prospective consecutive screening was performed on 250 patients (men over 55 years and women over 65 years) referred for standard echocardiography. After completion of the standard echocardiographic exam, abdominal aortic diameter was measured using the echocardiographic transducer. RESULTS: Adequate aortic images were obtained in 216 patients. Thirteen aneurysms (ranging from 3.3-6.6 cm in diameter, nearly equally divided between men and women) were found. CONCLUSIONS: Screening of the abdomen in elderly men and women presenting for echocardiographic examination results in a significant yield of AAAs. This simple procedure should be added to the standard echocardiographic examination in the older population. (ECHOCARDIOGRAPHY, Volume 13, January 1996)
Collapse
Affiliation(s)
- Kenneth V. Schwartz
- Department of Cardiology, The Griffin Hospital, 130 Division St., Derby, CT 06418
| | | | | |
Collapse
|
8
|
Abstract
Patients undergoing transthoracic echocardiography often have atherosclerotic vascular disease and may be at risk for the development of abdominal aortic aneurysms. We therefore examined the abdominal aorta by ultrasound in 323 consecutive patients undergoing routine two-dimensional transthoracic echocardiography over a 6-month period. Measurements were made of aortic length (diaphragm to most caudal portion visualized) and maximum diameter. The study group comprised 169 men and 154 women with an average age of 57 +/- 19 years (range 13 to 94). The abdominal aorta was imaged in 265 (82%) patients. The average aortic length visualized was 13.0 +/- 4.6 cm, the average diameter 1.7 +/- 0.4 cm, and the time required for screening < 5 minutes. Seven (3%) patients were identified as having abdominal aortas > or = 2.5 cm in diameter: 1 with an aneurysm measuring 6.7 cm in diameter and 6 with mild dilatations measuring 2.5 to 3.0 cm in diameter. One of the patients with mild aortic dilatation was subsequently found to have an infrarenal aneurysm measuring 3.5 cm in diameter. Aortic dilatation was associated with male gender (p = 0.0006) and older age (p = 0.05) but was not associated with a history of ischemic heart disease (p = 0.16). From these results, we conclude that screening for abdominal aortic aneurysms in patients undergoing transthoracic echocardiography is practical and clinically useful. Only a small number of these patients are identified as having aneurysms, but the low cost and brief time required suggest that routine screening in this population may be worthwhile.
Collapse
Affiliation(s)
- M J Eisenberg
- Department of Medicine, University of California, San Francisco 94143, USA
| | | | | |
Collapse
|