Back to Search Start Over

Two-Dimensional Aortic Size Normalcy: A Novelty Detection Approach

Authors :
Ada Kura
Guglielmina Pepe
Stefano Nistri
Paolo Frasconi
Gaia Spaziani
Silvia Favilli
Daniele Baracchi
Andrea Di Lenarda
Betti Giusti
Antonella Cherubini
Source :
Diagnostics, Vol 11, Iss 220, p 220 (2021), Diagnostics, Diagnostics; Volume 11; Issue 2; Pages: 220
Publication Year :
2021
Publisher :
MDPI AG, 2021.

Abstract

Background: To develop a tool for assessing normalcy of the thoracic aorta (TA) by echocardiography, based on either a linear regression model (Z-score), or a machine learning technique, namely one-class support vector machine (OC-SVM) (Q-score). Methods: TA diameters were measured in 1112 prospectively enrolled healthy subjects, aging 5 to 89 years. Considering sex, age and body surface area we developed two calculators based on the traditional Z-score and the novel Q-score. The calculators were compared in 198 adults with TA > 40 mm, and in 466 patients affected by either Marfan syndrome or bicuspid aortic valve (BAV). Results: Q-score attained a better Area Under the Curve (0.989; 95% CI 0.984–0.993, sensitivity = 97.5%, specificity = 95.4%) than Z-score (0.955; 95% CI 0.942–0.967, sensitivity = 81.3%, specificity = 93.3%; p < 0.0001) in patients with TA > 40 mm. The prevalence of TA dilatation in Marfan and BAV patients was higher as Z-score > 2 than as Q-score < 4% (73.4% vs. 50.09%, p < 0.00001). Conclusions: Q-score is a novel tool for assessing TA normalcy based on a model requiring less assumptions about the distribution of the relevant variables. Notably, diameters do not need to depend linearly on anthropometric measurements. Additionally, Q-score can capture the joint distribution of these variables with all four diameters simultaneously, thus accounting for the overall aortic shape. This approach results in a lower rate of predicted TA abnormalcy in patients at risk of TA aneurysm. Further prognostic studies will be necessary for assessing the relative effectiveness of Q-score versus Z-score.

Details

Language :
English
ISSN :
20754418
Volume :
11
Issue :
220
Database :
OpenAIRE
Journal :
Diagnostics
Accession number :
edsair.doi.dedup.....cce13ad3ef33222a22324b30787f3b3a