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Tukker M, Leening MJG, Mohamedhoesein S, Vanmaele ALA, Caliskan K. Prevalence and clinical correlates of ascending aortic dilatation in patients with noncompaction cardiomyopathy. Int J Cardiovasc Imaging 2023; 39:1687-1695. [PMID: 37258990 PMCID: PMC10520147 DOI: 10.1007/s10554-023-02882-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/20/2023] [Indexed: 06/02/2023]
Abstract
Ascending aortic (AoAsc) dilatation can lead to acute aortic syndromes and has been described in various familial cardiac diseases. Its prevalence and clinical significance in patients with noncompaction cardiomyopathy (NCCM) are however unknown. Establishing the prevalence can facilitate recommendations on routine screening in NCCM. In this cross-sectional cohort study based on the Rijnmond Heart Failure/Cardiomyopathy Registry, the patient were enrolment between 2014 and 2021. All NCCM patients (n = 109) were age and sex matched with 109 dilated cardiomyopathy (DCM) patients as controls. The aortic diameters were measured through the parasternal long-axis transthoracic echocardiographic view at the sinuses of valsalva (SoV-Ao), sinotubular junction (STJ) and ascending aorta (AscAo). Dilatation was defined using published criteria adjusted for body surface area (BSA), sex, and age. Median age of age-sex matched NCCM and DCM patients was 45[31-56] vs. 45 [31-55] years with 53% males in both groups. NCCM patients had more familial hereditary patterns and genetic variants (55% vs. 24%, p < 0.001). DCM patients had more heart failure and left ventricular dysfunction (ejection fraction 34 ± 11 vs. 41 ± 12, p = 0.001). Ascending aortic dilatation was present in 8(7%) patients with NCCM and 5(5%) patients with DCM (p = 0.46). All dilatations were classified as mild. In conclusion, in this cross-sectional cohort study the prevalence of ascending aortic dilatation in NCCM patients was 7%, which were only mild dilatations and not significantly different from an age-sex matched cohort of DCM patients. Routine aortic dilatation screening therefore does not seem warranted in patients with NCCM.
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Affiliation(s)
- Martijn Tukker
- Department of Cardiology, Erasmus MC University Medical Center Rotterdam, Dr. Molewaterplein 40., Rotterdam, 3015 GD, The Netherlands
| | - Maarten J G Leening
- Department of Cardiology, Erasmus MC University Medical Center Rotterdam, Dr. Molewaterplein 40., Rotterdam, 3015 GD, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sharida Mohamedhoesein
- Department of Cardiology, Erasmus MC University Medical Center Rotterdam, Dr. Molewaterplein 40., Rotterdam, 3015 GD, The Netherlands
| | - Alexander L A Vanmaele
- Department of Cardiology, Erasmus MC University Medical Center Rotterdam, Dr. Molewaterplein 40., Rotterdam, 3015 GD, The Netherlands
| | - Kadir Caliskan
- Department of Cardiology, Erasmus MC University Medical Center Rotterdam, Dr. Molewaterplein 40., Rotterdam, 3015 GD, The Netherlands.
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Pradella M, Achermann R, Sperl JI, Kärgel R, Rapaka S, Cyriac J, Yang S, Sommer G, Stieltjes B, Bremerich J, Brantner P, Sauter AW. Performance of a deep learning tool to detect missed aortic dilatation in a large chest CT cohort. Front Cardiovasc Med 2022; 9:972512. [PMID: 36072871 PMCID: PMC9441594 DOI: 10.3389/fcvm.2022.972512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeThoracic aortic (TA) dilatation (TAD) is a risk factor for acute aortic syndrome and must therefore be reported in every CT report. However, the complex anatomy of the thoracic aorta impedes TAD detection. We investigated the performance of a deep learning (DL) prototype as a secondary reading tool built to measure TA diameters in a large-scale cohort.Material and methodsConsecutive contrast-enhanced (CE) and non-CE chest CT exams with “normal” TA diameters according to their radiology reports were included. The DL-prototype (AIRad, Siemens Healthineers, Germany) measured the TA at nine locations according to AHA guidelines. Dilatation was defined as >45 mm at aortic sinus, sinotubular junction (STJ), ascending aorta (AA) and proximal arch and >40 mm from mid arch to abdominal aorta. A cardiovascular radiologist reviewed all cases with TAD according to AIRad. Multivariable logistic regression (MLR) was used to identify factors (demographics and scan parameters) associated with TAD classification by AIRad.Results18,243 CT scans (45.7% female) were successfully analyzed by AIRad. Mean age was 62.3 ± 15.9 years and 12,092 (66.3%) were CE scans. AIRad confirmed normal diameters in 17,239 exams (94.5%) and reported TAD in 1,004/18,243 exams (5.5%). Review confirmed TAD classification in 452/1,004 exams (45.0%, 2.5% total), 552 cases were false-positive but identification was easily possible using visual outputs by AIRad. MLR revealed that the following factors were significantly associated with correct TAD classification by AIRad: TAD reported at AA [odds ratio (OR): 1.12, p < 0.001] and STJ (OR: 1.09, p = 0.002), TAD found at >1 location (OR: 1.42, p = 0.008), in CE exams (OR: 2.1–3.1, p < 0.05), men (OR: 2.4, p = 0.003) and patients presenting with higher BMI (OR: 1.05, p = 0.01). Overall, 17,691/18,243 (97.0%) exams were correctly classified.ConclusionsAIRad correctly assessed the presence or absence of TAD in 17,691 exams (97%), including 452 cases with previously missed TAD independent from contrast protocol. These findings suggest its usefulness as a secondary reading tool by improving report quality and efficiency.
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Affiliation(s)
- Maurice Pradella
- Department of Radiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- *Correspondence: Maurice Pradella
| | - Rita Achermann
- Department of Radiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | | | | | - Joshy Cyriac
- Department of Radiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Shan Yang
- Department of Radiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Gregor Sommer
- Department of Radiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Hirslanden Klinik St. Anna, Luzern, Switzerland
| | - Bram Stieltjes
- Department of Radiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Jens Bremerich
- Department of Radiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Philipp Brantner
- Department of Radiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Regional Hospitals Rheinfelden and Laufenburg, Rheinfelden, Switzerland
| | - Alexander W. Sauter
- Department of Radiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Radiology, University Hospital Tuebingen, University of Tuebingen, Tuebingen, Germany
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