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Two-Dimensional Aortic Size Normalcy: A Novelty Detection Approach
- 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.
- Subjects :
- Marfan syndrome
medicine.medical_specialty
Clinical Biochemistry
030204 cardiovascular system & hematology
Standard score
Article
03 medical and health sciences
0302 clinical medicine
Bicuspid aortic valve
Aneurysm
thoracic aorta
medicine.artery
Internal medicine
Linear regression
medicine
Thoracic aorta
echocardiography
030212 general & internal medicine
normalcy
sinuses of Valsalva
Body surface area
lcsh:R5-920
business.industry
Z-score
Area under the curve
medicine.disease
machine learning
Cardiology
business
lcsh:Medicine (General)
Subjects
Details
- Language :
- English
- ISSN :
- 20754418
- Volume :
- 11
- Issue :
- 220
- Database :
- OpenAIRE
- Journal :
- Diagnostics
- Accession number :
- edsair.doi.dedup.....cce13ad3ef33222a22324b30787f3b3a