Prevalence of Aortic Dilation in Turner Patients without Congenital Heart Disease (CHD) Studied at Echocardiography and Transthoracic MRI

Aortic dilation (AoDil) occurs in Turner syndrome (TS) pts, although in absence of CHD as risk factor. There is limited information on its prevalence and natural history. Aim of our study: to evaluate AoDil prevalence (at echocardiography and MRI) in patients without CHD aged over 15 years, followed for at least 5 years. Methods: In our center 190 TS unselected pts were followed (2-25.5 yrs) with periodic cardiologic evaluations. Between 2000 and 2003, 52 consecutive patients without CHD and age over 15 yrs (15-35.2 yrs) had a cardiologic re-evaluation with echo (2D and color Doppler) and transthoracic MRI. Two had HBP. For Ao diameters the same criteria as for echo were used for MRI, taking as normal the values within the 95% normal confidence limits indexed to body surface area (Roman et al., 1989). Results: 30.7% of pts had Ao dimensions within upper normal limits, the same at echo and MRI (16/52 pts). In particular the prevalence of DilAo was the same (echo and MRI) at anulus and the sinuses of Valsalva (19.2% and 21% respectively). At proximal ascending Ao echography showed a higher prevalence of 28.8% (15/52) than MRI (19.2% -10 of 52). 13.5% (7/52) of pts were above upper normal limits at echo and 7.7% (4/52) at MRI. In our series the follow-up did not show any progressive and rapid evolution of AoDil. Conclusions: This data confirms the higher prevalence of AoDil in TS pts than in the GP also for severe dilation. An accurate echo follow-up of the different segments of Ao is highly recommendable in these pts even in absence of CHD. Echo pproach may cause some distortion in the image of the thoracic Ao in TS pts and this may explain the higher AoDil prevalence found at echo than at MRI in the proximal ascending Ao. The importance of AoMRI in these pts should be emphasize in particular when an ascending AoDil is detected at echo and in any case before seeking to become pregnant