209Examination of abdominal aorta during echocardiography performance.


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Abstract

Purpose: Patients with abdominal aortic aneurysm (AAA) often present the same clinical conditions and cardiovascular risk factors than patients referred to routine transthoracic echocardiography (TTE). Our aim was to study the feasibility and clinical utility of AAA screening in a selected population ( men over 50 years and women over 60 years) of 598 consecutive patients referred to TTE for any indication. We also wanted to know the prevalence of AAA in this population and to identify wich patients benefit more from AAA screening.Methods: Prospectively, an ultrasound examination of the abdominal aorta was performed as an extension of TTE, with the same probe. AAA was defined as a diameter of ≥ 3 cm. We also studied the following clinical conditions and parameters: age, sex, smoking, hyperlipemia, hypertension, diabetes, coronary artery disease, peripheral artery disease, diameter of the ascending aorta and diameters, mass, wall thickness and ejection fraction of the left ventricle.Results: the visualization of the aorta was excellent ( 556/598: 92,9%). Although we did not measure the time employed to study the aorta, it could be done easily without a significant prolongation of the time of TTE. The AAA prevalence in our population was 7,01% ( 9,85% in men and 2,71% in women). Dilated ascending aorta ( Odds Ratio= 3,30) , male sex ( OR= 2,53)and smoking (OR= 2,41) were found to be significant risk factors in the univariate and in the multivariate logistic analysis: AUC= 0,73 (C.I. 95% 0,65-0,81). Interestingly, dilatation of the ascending aorta identified a group of patients at higher risk of having AAA. All female patients with AAA had dilatation of the ascending aorta; however, women are usually excluded from AAA screening.Conclusions: AAA is prevalent in patients referred to regular TTE. The study of the abdominal aorta as an extension of TTE in this population is feasible with very low extra time consuming and with potential clinical benefit. We therefore recommend it, specially in men over 50 years, in patients with a smoking history or with a dilated ascending aorta.

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