Standardizing the method of measuring by echocardiogram the diameter of the ascending aorta in patients with a bicuspid aortic valve

UMMS Affiliation

Department of Medicine, Division of Cardiovascular Medicine; School of Medicine

Faculty Mentor

Linda Pape

Publication Date


Document Type



Aorta; Aortic Valve; Echocardiography; Female; Heart Defects, Congenital; Humans; Male; Middle Aged


Cardiology | Cardiovascular Diseases


Serial echocardiographic follow-up of patients with a bicuspid aortic valve (BAV), in addition to providing assessment of valve dysfunction, can help identify those at risk of aortic complications. However, currently there is no standardized echocardiographic method for measuring the ascending aorta. We examined the echocardiograms of 45 patients with a BAV and 45 matched controls to understand the effects of the measurement location (1, 2, and 3 cm above the sinotubular junction) and the point in the cardiac cycle (end-diastole, mid-systole, and end-systole) at which the ascending aortic measurements are made. A greater length of aorta could be measured in end-systole than in end-diastole, presumably because of aortic recoil. Using the control data for comparison, we found that more dilated ascending aortas were detected by measuring 3 cm above the sinotubular junction in the patients with a BAV (56%) than at 1 cm (42%). The increases in size between 1 and 2 cm were greater than those between 2 and 3 cm. In conclusion, we propose that all transthoracic echocardiograms should include the proximal aorta at least 2 cm and preferably 3 cm above the sinotubular junction and suggest that for standardization and optimal visualization the measurements be done at end-systole in all patients.

DOI of Published Version



Am J Cardiol. 2010 Apr 1;105(7):1000-4. doi: 10.1016/j.amjcard.2009.11.020. Epub 2010 Feb 13.. Link to article on publisher's site

Journal/Book/Conference Title

The American journal of cardiology


Medical student Alfred Albano participated in this study as part of the Senior Scholars research program at the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

PubMed ID