112: A new morphological and quantitative approach of aortic atheroma: a preliminary 3D transesophageal echocardiography study - 01/07/14
Résumé |
Aortic atheroma is a disease causing vascular complications including ischemic stroke. Transesophageal echocardiography (TEE) is the diagnostic method of reference for characterization of aortic atherosclerotic plaques (AAP) at risk.
Objective |
The aim of our study was to evaluate the feasibility and contribution of 3D TEE in the evaluation of aortic atheroma.
Methods and results |
We prospectively included 82 patients referred for TEE. In addition to conventional 2D TEE, a 3D TEE study of AAP of the descending and horizontal thoracic aorta was performed. Overall, 308 AAP were identified in 2D, 98% of them were analyzed using the 3D approach. We identified 3 morphological types of plaques using the 3D approach (figure 1), 2D characteristics of the 3D types of AAP were different. Type I AAP are thin and rarely calcified; type III AAP are thicker and often calcified; the 3D type II AAP have intermediate 2D characteristics (Table). All AAP ulcerations seen in 2D were identified in 3D TEE. 2D thickness measurements from 3D acquisitions correlated well with measurements performed directly on the 2D acquisitions (r=0.91; p <0.001). Area measurements of AAP were feasible in 58%, 14% and 23% of 3D types I, II and III AAP, respectively. The areas of type I AAP were not correlated with those of thickness in 2D (p=0.83).
Conclusion |
3D TEE is a feasible method for the analysis of the AAP. It provides a new morphological and quantitative approach of AAP whose clinical applications remain to be validated.
Figure – 3D morphological types of plaques
Figure – 3D morphological types of plaquesTableResultsType I (n=115)Type II (n=97)Type III (n=89)NDescending Aorta (n)776349189Horizontal Aorta (n)383440112Plaque thickness (mean ± SD; mm)1.2±0.52.6±1.23.2±1.5Not calcified plaques (n,%)103 (80.5)22 (17.2)3 (2.3)128Slightly calcified plaques (n,%)9 (8.8)62 (60.8)31(30.4)102Very calcified plaques (n,%)3 (4.2)13 (18.3)55 (77.5)71
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Vol 5 - N° 1
P. 37 - janvier 2013 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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