Background
To investigate if a relative-size-index of the abdominal aortic diameter influences
the prevalence estimates of abdominal aortic dilatations compared to absolute diameters.
Methods
Cross-sectional study. Participants from the Viborg Vascular Screening Trial, Viborg
Women Cohort, and the Viborg Screening Program. Through multivariate linear regression
analyses, 2 gender-specific prediction-equations were developed based upon body-surface
area and age. The definitions of absolute and relative size of aortic ectasies were
25–29 mm and 1.25–1.49× individual-predicted size (IPS), abdominal aortic aneurysm
(AAA) 30 mm and 1.5× IPS, and large repair-recommendable AAA ≥55 mm or ≥ 2.75× IPS,
respectively.
Results
Nineteen thousand two hundred and sixty nine males (69.6 years) and 2,426 females
(67.1 years) attended the population- and ultrasound-based screening studies for AAA.
The mean peak systolic abdominal anterior-posterior inner to inner diameter was 19.1 mm
(±5.3 mm) and 16.6 mm (±2.8 mm) (P < 0.001) in males and females, respectively. Body surface area showed the strongest
correlation with aortic diameters in both males (r = 0.19, P < 0.001) and females (r = 0.17, P < 0.001). Age correlated significantly with size, but only in males (r = 0.03, P < 0.001). The prevalence in men of absolute size–defined and relative size index–defined
screening-detected aortic ectasies, AAAs and repair-recommendable AAAs were: 5.9%
and 9.5% (P < 0.001), 3.3% and 4.2% (P < 0.001) and 9.9% and 15.2% (P = 0.004), respectively. Prevalence in females of absolute-size-defined and relative-size-index-defined
screening-detected aortic ectasies, AAAs and repair-recommendable AAAs were 1.2% and
5.8% (P < 0.001), 0.5% and 1.3% (P = 0.003) and 0.0% and 23.1% (P = 0.553), respectively.
Conclusions
Despite statistical differences, ultrasound-based absolute diameters to detect AAA
seem acceptable in men. In females, poor agreements were noticed concerning all 3
categories of aneurysms, indicating that the current absolute diagnostic cut-points
do not reflect female anatomy.
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Article info
Publication history
Published online: December 19, 2022
Accepted:
November 23,
2022
Received:
August 15,
2022
Footnotes
J. S. K. and L. M. O. Joint first authorship.
All authors mentioned above take responsibility of the reliability and freedom from bias of data presented and their discussed interpretation.
Availability of Data and Materials: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Competing Interests: The authors declare that they have no competing interests.
Disclosure: The authors report no conflicts of interest in this work.
Funding: The work was supported by the Danish Heart Foundation (Hjerteforeningen) [grant number 16-R107-A6778-22022].
Authors' contributions: JSSK together with LMO drafted the work. MD and ALH contributed with data collection and study design. JSL contributed with statistical analyses, study design, and revision of the work. All authors read and approved the final manuscript.
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