Endocrine Abstracts

Introduction: Two major strategies can be used to verify the diagnosis of ascending aortic dilatation in Turner syndrome (TS): the diameter of the aorta adjusted for body surface area (BSA) can be estimated or the ratio of the ascending/descending aorta may be assessed.

Aim: To identify the difference of the prevalence of ascending aortic dilatation in patients with Turner syndrome by measuring the diameter of the ascending aorta adjusted for BSA and by estimating the ratio of ascending/descending diameter of aorta (AD/DD).

Methods: 63 women with TS (45, X 68%) treated in the Hospital of Lithuanian University of Health Sciences were the subjects of the study. Seven of the patients were excluded from the study as MRI angiography was contraindicative. 56 females with TS ≥18 yrs (mean age 30.98±9.1 yrs) underwent MRI angiography using Gadolinium based contrast media. Diameters of the ascending aorta were evaluated in three positions: in the level of the aortic sinuses (D1), in sinotubular junction (D2) and in the inferior margin of the right pulmonary artery (D3). The largest diameter of the aorta was included in the analysis. The diameter of descending aorta was measured between the left pulmonary artery and the superior part of the left atrium (D4). Aortic dilatation was considered to be present if the larger diameter of ascending aorta (AA) was ≥2 cm/m² (BSA-normalized) and/or the ascending and the descending ratio (AD/DD ratio) was ≥1.5.

Results: Out of 56 studied women, 48% (n=27) had the diameter of the ascending aorta ≥2 cm/m², 32.14% (n=18) had aortic dilatation confirmed after calculating the AD/DD ratio (≥ 1.5). No significant difference was found (P=0.057). If the dilatation of the ascending aorta was present the measurements of the ascending aorta were larger in all positions (D1 17.07 mm/m² vs. 22.8 mm/m², P<0.001; D2 14 mm/m² vs 17.6, P<0.001; D3 15.26 mm/m² vs 19.49 mm/m²). The size of the aorta correlated with age in all positions (D1 r=0.362, P=0.006; D2 r=0.336, P=0.011; D3 r=0.381, P=0.004; D4 r=0.484, P<0.001).

Conclusion: Measuring the diameter of ascending aorta adjusted for BSA or calculating the ratio of the ascending/descending aorta can verify the existence of aortic dilatation equivalently in Turner syndrome.