Comparison of Body Surface Area and Optimized Multivariate Allometric Model Approaches in Correcting Echocardiographic Aortic Dimensions for Physiological Variances: An International and Multicenter Study (CITED I)

Guihua Yao , Xiaoxia Hu , Xiangyun Chen , Xueying Zeng , Francesco Ferrara , Andreina Carbone , Salvatore Rega , Monica Franzese , Pin Sun , Mei Zhang , Olga Vriz , Cheng Zhang , Eduardo Bossone , Yun Zhang

MedComm ›› 2026, Vol. 7 ›› Issue (6) : e70788

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MedComm ›› 2026, Vol. 7 ›› Issue (6) :e70788 DOI: 10.1002/mco2.70788
ORIGINAL ARTICLE
Comparison of Body Surface Area and Optimized Multivariate Allometric Model Approaches in Correcting Echocardiographic Aortic Dimensions for Physiological Variances: An International and Multicenter Study (CITED I)
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Abstract

Aortic dimensions differ between ethnic groups. To correct the ethnicity-related differences in aortic dimensions, Ao-a, Ao-s, and Ao-asc were measured by echocardiography in a total of 1820 Chinese and Italian healthy adults. The correction equations based on an optimized multivariate allometric model (OMAM) were constructed and tested, and the correction efficacies of the two approaches of body surface area (BSA) and OMAM were compared. The aortic dimensions were found to vary with physiological variables and ethnicities (all p < 0.05). Correction using BSA eliminated neither the differences in aortic dimensions across study populations nor the residual correlations with physiological variables (all p < 0.05). In contrast, indexation with OMAM equations eliminated both the ethnicity-related differences and residual correlations (all |r| < 0.20 and p > 0.05). The success rate of the BSA approach was 0%, while that of the OMAM approach was 100% for correcting all aortic dimensions in Chinese, Italian, and combined populations, respectively. In conclusion, the OMAM approach is superior to BSA approach in correcting the variations in aortic dimensions. Using OMAM as a novel indexing tool may facilitate establishing universal cutoffs between normal and abnormal aortic dimensions among different ethnic populations in the world.

Keywords

aortic dimensions / body surface area / isometric and allometric scaling / optimized multivariate allometric model / physiological variance

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Guihua Yao, Xiaoxia Hu, Xiangyun Chen, Xueying Zeng, Francesco Ferrara, Andreina Carbone, Salvatore Rega, Monica Franzese, Pin Sun, Mei Zhang, Olga Vriz, Cheng Zhang, Eduardo Bossone, Yun Zhang. Comparison of Body Surface Area and Optimized Multivariate Allometric Model Approaches in Correcting Echocardiographic Aortic Dimensions for Physiological Variances: An International and Multicenter Study (CITED I). MedComm, 2026, 7 (6) : e70788 DOI:10.1002/mco2.70788

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References

[1]

J. A. Elefteriades, “Natural History of Thoracic Aortic Aneurysms: Indications for Surgery, and Surgical versus Nonsurgical Risks,” Annals of Thoracic Surgery 74 (2002): S1877–1880.

[2]

M. A. Ergin, D. Spielvogel, A. Apaydin, et al., “Surgical Treatment of the Dilated Ascending Aorta: When and How?,” Annals of Thoracic Surgery 67 (1999): 1834–1839.

[3]

D. Saura, R. Dulgheru, L. Caballero, et al., “Two-dimensional Transthoracic Echocardiographic Normal Reference Ranges for Proximal Aorta Dimensions: Results From the EACVI NORRE Study,” European Heart Journal - Cardiovascular Imaging 18 (2017): 167–179.

[4]

E. B. Turkbey, A. Jain, C. Johnson, et al., “Determinants and Normal Values of Ascending Aortic Diameter by Age, Gender, and Race/Ethnicity in the Multi-Ethnic Study of Atherosclerosis (MESA),” Journal of Magnetic Resonance Imaging 39 (2014): 360–368.

[5]

R. M. Lang, L. P. Badano, V. Mor-Avi, et al., “Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update From the American Society of Echocardiography and the European Association of Cardiovascular Imaging,” Journal of the American Society of Echocardiography 28 (2015): 1–39.

[6]

D. DuBois and E. F. DuBois, “A Formula to Estimate the Approximate Surface Area If Height and Weight be Known,” Archives of Internal Medicine 17 (1916): 863–871.

[7]

G. H. Yao, X. Y. Chen, Q. Zhang, et al., “A Novel Mathematical Model for Correcting the Physiologic Variance of Two-dimensional Echocardiographic Measurements in Healthy Chinese Adults,” Journal of the American Society of Echocardiography 32 (2019): 876–883.

[8]

H. N. Patel, T. Miyoshi, K. Addetia, et al., “Normal Values of Aortic Root Size According to Age, Gender, and Race: Results of the World Alliance of Societies of Echocardiography Study,” Journal of the American Society of Echocardiography 35 (2022): 267–274.

[9]

X. X. Hu, Z. W. Lin, Y. Li, et al., “Comparisons of Two-dimensional Echocardiographic Aortic Dimensions Between Chinese, Japanese, and Europeans,” Journal of Thoracic Imaging 38 (2023): 399–496.

[10]

T. G. Neilan, A. D. Pradhan, and A. E. Weyman, “Derivation of a Size-independent Variable for Scaling of Cardiac Dimensions in a Normal Adult Population,” Journal of the American Society of Echocardiography 21 (2008): 779–785.

[11]

D. Oxborough, S. Ghani, A. Harkness, et al., “Impact of Methodology and the Use of Allometric Scaling on the Echocardiographic Assessment of the Aortic Root and Arch: A Study by the Research and Audit Sub-Committee of the British Society of Echocardiography,” Echo Research and Practice 1 (2014): 1–9.

[12]

O. Vriz, V. Aboyans, and A. D'Andrea, “Normal Values of Aortic Root Dimensions in Healthy Adults,” American Journal of Cardiology 114 (2014): 921–927.

[13]

C. M. Reed, P. A. Richey, D. A. Pulliam, et al., “Aortic Dimensions in Tall Men and Women,” American Journal of Cardiology 71 (1993): 608–610.

[14]

F. E. Dewey, D. Rosenthal, D. J. Murphy, et al., “Does Size Matter? Clinical Applications of Scaling Cardiac Size and Function for Body Size,” Circulation 117 (2008): 2279–2287.

[15]

S. A. Oates, L. Forsythe, J. D. Somauroo, et al., “Scaling to Produce Size-independent Indices of Echocardiographic Derived Aortic Root Dimensions in Elite Rugby Football League Players,” Ultrasound 27 (2019): 94–100.

[16]

M. Abulí, G. Grazioli, M. Sanz de la Garza, et al., “Aortic Root Remodelling in Competitive Athletes,” European Journal of Preventive Cardiology 27 (2020): 1518–1526.

[17]

A. Boraita, M.-E. Heras, P. L. Valenzuela, et al., “Age-independent Aortic Dimensions in Adolescent Athletes: A Practical Approach Using Allometric Scaling,” Revista Espanola De Cardiologia 75 (2022): 607–610.

[18]

P. Biaggi, F. Matthews, J. Braun, et al., “Gender, Age, and Body Surface Area Are the Major Determinants of Ascending Aorta Dimensions in Subjects With Apparently Normal Echocardiograms,” Journal of the American Society of Echocardiography 22 (2009): 720–725.

[19]

O. Mirea, F. Maffessanti, P. Gripari, et al., “Effects of Aging and Body Size on Proximal and Ascending Aorta and Aortic Arch: Inner Edge-to-inner Edge Reference Values in a Large Adult Population by Two-dimensional Transthoracic Echocardiography,” Journal of the American Society of Echocardiography 26 (2013): 419–427.

[20]

F. M. Asch, T. Miyoshi, K. Addetia, et al., “Similarities and Differences in Left Ventricular Size and Function Among Races and Nationalities: Results of the World Alliance Societies of Echocardiography Normal Values Study,” Journal of the American Society of Echocardiography 32 (2019): 1396–1406.

[21]

G. H. Yao, Y. Deng, Y. Liu, et al., “Echocardiographic Measurements in Normal Chinese Adults Focusing on Cardiac Chambers and Great Arteries: A Prospective, Nationwide, and Multicenter Study,” Journal of the American Society of Echocardiography 28 (2015): 570–579.

[22]

E. Bossone, E. Yuriditsky, S. Desale, et al., “Normal Values and Differences in Ascending Aortic Diameter in a Healthy Population of Adults as Measured by the Pediatric versus Adult American Society of Echocardiography guidelines,” Journal of the American Society of Echocardiography 29 (2016): 166–172.

[23]

A. Evangelista, M. Sitges, G. Jondeau, et al., “Multimodality Imaging in Thoracic Aortic Diseases: A Clinical Consensus Statement From the European Association of Cardiovascular Imaging and the European Society of Cardiology Working Group on Aorta and Peripheral Vascular Diseases,” European Heart Journal - Cardiovascular Imaging 24 (2023): e65–e85.

[24]

L. Mazzolai, G. Teixido-Tura, S. Lanzi, et al., “2024 ESC Guidelines for the Management of Peripheral Arterial and Aortic Diseases,” European Heart Journal 45 (2024): 3538–3700.

[25]

G. H. Yao, X. Y. Chen, W. J. Yang, et al., “Correction of Left Ventricular Doppler Echocardiographic Measurements for Physiological Variances Using a Novel Optimized Multivariable Allometric Model in Healthy Chinese Han Adults,” Engineering 16 (2022): 115–122.

[26]

P. Zong, L. Zhang, N. M. Shaban, et al., “Left Heart Chamber Quantification in Obese Patients: How Does Larger Body Size Affect Echocardiographic Measurements?,” Journal of the American Society of Echocardiography 27 (2014): 1267–1274.

[27]

J. Moukarzel, E. Guevara, M. E. Casciaro, et al., “Echocardiographic Measurements of Left Heart Chamber Size in a Large Cohort of Subjects: Comparison of Body Surface Area and Height Indexing to Account for Effects of Obesity,” Journal of the American Society of Echocardiography 35 (2022): 1159–1167.

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2026 The Author(s). MedComm published by Sichuan International Medical Exchange & Promotion Association (SCIMEA) and John Wiley & Sons Australia, Ltd.

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