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A Comparison of Echocardiography and Magnetic Resonance Imaging in Cardiovascular Screening of Adults with Turner Syndrome
Abstract
The high mortality rate from aortic dissection of women with Turner syndrome (TS) achieving ovum donation pregnancies has highlighted the need for a refinement of cardiac screening protocols. Echocardiography and magnetic resonance imaging (MRI) are used to assess the risk factors, aortic root dilatation, bicuspid aortic valve, and coarctation, but the relative merits of each modality are unclear. Cardiovascular screening was performed in 128 unselected women with TS (mean age +/- SD, 31.1 +/- 8.5 yr) using echocardiography (n = 120) and MRI (n = 115) and in 36 age-matched normal control women. Clinical history, anthropometric measurements, blood pressure, and metabolic parameters were recorded. Echocardiography was normal in 53% of women with TS; MRI was normal in 34%. Aortic root dilatation was identified in 16% of women by echocardiography, 33% on MRI criteria, and 7% by both modalities. Height-adjusted echocardiographic aortic root dimensions were greater in TS than controls (2.90 vs. 2.62 cm; P = 0.010). Bicuspid aortic valve and increasing age were associated with greater aortic dimensions; the latter effect was more marked in TS than controls. On MRI, ascending aortic diameter was greater in TS than control women (2.83 vs. 2.52 cm; P = 0.029), but descending aortic diameter and ascending/descending aortic ratio were not, because these may be affected by the presence of coarctation. The two techniques are complementary and identify different aspects of cardiovascular pathology. Ascending/descending ratio on MRI circumvents issues of stature, but may be influenced by descending aortic abnormalities. We present reference ranges for absolute aortic dimensions in a TS population to aid future interpretation of these measurements.
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“CMR is also superior to TTE for the diagnosis of BAV, aortic dilation and aortic arch anomalies395,429-433 while also providing important data on shunt fractions and ventricular volumes that may inform clinical management.388”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [432]
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WRITING GROUP MEMBERS, Hiratzka, L. F., Bakris, G. L., Beckman, J. A., Bersin, R. M., Carr, V. F., Casey, D. E., Eagle, K. A., Hermann, L. K., Isselbacher, E. M., et al. (2010) · Circulation · doi:10.1161/cir.0b013e3181d4739e · Cited by 2,346
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Metadata
- Authors
- Ostberg, J. E., Brookes, J. A. S., McCarthy, C., Halcox, J., & Conway, G. S.
- Affiliations
- University College Hospital (GB)
- Corresponding author
- Conway, Gerard S.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2004-12
- Volume
- 89
- Issue
- 12
- Pages
- 5966-5971
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1992965424
- Semantic Scholar
- 98d416e67e5b845f6a430d0879abc7bbb45d0982
- Cited by
- 146
- References
- 15
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 1 · 2022: 1 · 2021: 2 · 2019: 7 · 2018: 7 · 2017: 7 · 2016: 7 · 2015: 8 · 2014: 10 · 2013: 11 · 2012: 10
- FWCI
- 9.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
- Keywords
- Turner syndrome, cardiovascular screening, aortic root dilatation, aortic dissection, bicuspid aortic valve, coarctation of the aorta, echocardiography, cardiac magnetic resonance imaging, aortic dimensions, reference values, oocyte donation, aortic root dimensions
- MeSH terms
- Adult, Aorta, Aortic Coarctation, Cardiovascular Diseases, Echocardiography, Female, Humans, Magnetic Resonance Imaging, Middle Aged, Turner Syndrome, Vasodilation, Case-Control Studies
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