Defining ascending aorta dilatation in pediatric bicuspid aortic valve : Comparison of known classical and new z-score nomograms, and anthropometric parameters indexing for its assessment
Freixa-Benavente, Andrea (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Juzga Corrales, Diana Carolina (Hospital Universitari Vall d'Hebron)
Ayerza Casas, Ariadna (Hospital Universitario Miguel Servet (Saragossa))
Figueras-Coll, Marc (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Escriba Bori, Silvia (Hospital Universitari Son Espases (Palma de Mallorca, Balears))
Plata Izquierdo, Beatriz (Complejo Asistencial Universitario de Salamanca (Castella i Lleó))
Collell Hernández, Rosa (Hospital Universitari de Sant Joan de Reus (Reus, Catalunya))
González Marín, María Arántzazu (Hospital General Universitario de Ciudad Real)
Siurana, José Manuel (HM Hospitales)
Sorlí García, Moisés (Hospital General Universitario Santa Lucía (Cartagena, Múrcia))
Albert, Leticia (Hospital Universitario 12 de Octubre (Madrid))
Teodoro-Marín, Sílvia (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Rodríguez, Mónica (Hospital Universitario HM Monteprincipe (Madrid))
Domínguez García, Olga (Hospital General Universitario de Toledo)
Rellán Rodríguez, Sara (Hospital Clínico Universitario de Valladolid)
Manso, Begoña (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
López-Abel, Bernardo (Complejo Hospitalario Universitario de Santiago de Compostela)
Álvarez Pérez, Roser (Institut de Recerca Sant Pau)
Portillo Márquez, Manuel (Hospital de Mérida)
Rezola-Arcelus, Erika (Hospital Universitario de Donostia (Sant Sebastià, País Basc))
Centeno Malfaz, Fernando (Hospital Universitario Río Hortega (Valladolid))
Solana-Gracia, Ruth (Hospital Universitario Infanta Leonor)
Rojo-Sombrero, Henar (Hospital Universitario Príncipe de Asturias (Alcalá de Henares, Madrid))
Cantero-Tejedor, María-Teresa (Complejo Asistencial Universitario de Palencia)
Riaño, Bibiana (Hospital San Pedro (Logroño, La Rioja))
Tejero Hernández, MªAngeles (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Jiménez Casso, Soledad (Hospital General de Segovia)
Sabaté-Rotés, Anna (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)

Data:	2025
Resum:	Background Ascending aorta (AscAo) dilatation assessment and definition in pediatric bicuspid aortic valve (BAV) is challenging. We compared the Pediatric Heart Network (PHN) nomogram against the Halifax (HZ) one and analyzed their association with body surface area indexing (BSA-I). Methods Echocardiographies from a national BAV registry were analyzed. AscAo and sinus of Valsalva, standardized using nomograms and BSA-I, were compared by correlation and Bland-Altman tests. Nomogram +2 and + 3 z-scores thresholds contrasted against >21 mm/BSA-m2 by logistic regression and kappa agreement index. Age subgroup analysis was between adult-size (≥10 years and BSA ≥1. 5 m) and small children. Results A total 3858 reports were analyzed. The PHN nomogram resulted in higher AscAo z-scores (median 1. 516 versus 1. 413). Nomogram correlation was Rho = 0. 979 and Bland-Altman agreement bias was 0. 302, with higher divergence in extreme z-scores. Patients ≥10 years and BSA ≥1. 5 m showed better concordance (bias -0. 212 versus 0. 440) despite similar correlation to the younger group. There was moderate but significant correlation amongst AscAo BSA-indexed diameters and PHN (Rho = 0. 514, p < 0. 001) and HZ nomograms (Rho = 0. 366, p < 0. 001), being higher in the older cohort than the younger, both by PHN (Rho 0. 961 versus 0. 424) and HZ (Rho 0. 952 versus 0. 540). Higher area under the curve was obtained by PHN. A lower percentage was classified as dilated with PHN than by BSA-I in the adult-size cohort, but not in younger patients. Discussion There was good correlation and concordance between HZ and PHN nomograms, the latter resulting in higher z-scores. PHN has better agreement with BSA-I than HZ, with the PHN > +3 z-score threshold being the highest predictor for BSA-I dilatation definition, also showing higher specificity and sensitivity. BSA-I classified fewer patients as dilated than nomograms in adult-sized children but not in the younger cohort. Clinicians should be aware of this effect of BSA when normalizing diameters.
Nota:	Altres ajuts: the REVAB project received the Juan V Comas Grant awarded by the Spanish Society of Pediatric Cardiology and Congenital Heart Disease.
Nota:	Altres ajuts: acords transformatius de la UAB
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Ascending aorta dilatation ; Bicuspid aortic valve ; Body surface area ; Nomograms ; Pediatrics
Publicat a:	Journal of Cardiology, November 2025, ISSN 1876-4738

DOI: 10.1016/j.jjcc.2025.11.001

8 p, 899.1 KB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats