{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T13:55:08Z","timestamp":1775829308737,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,5,12]],"date-time":"2017-05-12T00:00:00Z","timestamp":1494547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2017,7]]},"abstract":"Background<\/jats:title>Body surface area (BSA<\/jats:styled-content>)\u2010indexed Z\u2010scores are used to assess the ascending aorta (AA<\/jats:styled-content>o) and diagnose aortic dilation (AoD) in children. BSA<\/jats:styled-content> is directly related to body weight and corresponds to body mass index (BMI<\/jats:styled-content>). We hypothesized extremes in BMI<\/jats:styled-content> alter interpretation of aortic size in pediatric patients with AoD.<\/jats:p><\/jats:sec>Methods<\/jats:title>We reviewed all echocardiograms with a diagnosis of AoD performed at our institution from January 2013 through June 2013. Those with an age <2 or >20\u00a0years, history of aortic root surgery, or inadequate images were excluded. The aorta was measured by standard methods at the sinus of Valsalva, sinotubular junction, and proximal AA<\/jats:styled-content>o. Using subject age, height, and gender, hypothetical weights for each subject were calculated to provide BMI<\/jats:styled-content>s corresponding to the 5th, 50th, 85th, and 95th percentiles. The derived weights were then used to determine hypothetical BSA<\/jats:styled-content>, and Z\u2010scores were calculated for the subject's aortic diameters in each BMI<\/jats:styled-content> group.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 153 patients met inclusion criteria. Mean age was 11.1\u00b14.6\u00a0years (68% male). Mean height was 142.7\u00b127.9\u00a0cm, mean weight 44.6\u00b124.8\u00a0kg, and mean true BMI<\/jats:styled-content> was the 62nd centile. Significant differences in all aortic dimension Z\u2010scores were found among normal and underweight, overweight, and obese BMI<\/jats:styled-content> groups (P<\/jats:italic><.001 for all comparisons), respectively.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Using current recommended methods, AoD will be missed in overweight and obese patients and overdiagnosed in underweight patients. For children of normal weight, a Z\u2010score based on BSA<\/jats:styled-content> may be reliable. As obesity rates increase, weight\u2010independent Z\u2010scores must be developed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13565","type":"journal-article","created":{"date-parts":[[2017,5,12]],"date-time":"2017-05-12T06:52:41Z","timestamp":1494571961000},"page":"1029-1034","source":"Crossref","is-referenced-by-count":19,"title":["The impact of body weight on the diagnosis of aortic dilation\u2014misdiagnosis in overweight and underweight groups"],"prefix":"10.1111","volume":"34","author":[{"given":"Katherine T.","family":"Braley","sequence":"first","affiliation":[{"name":"University of Arkansas for Medical Sciences Little Rock AR USA"},{"name":"Department of Pediatrics University of Arkansas for Medical Sciences Little Rock AR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyu","family":"Tang","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences Little Rock AR USA"},{"name":"Department of Pediatrics University of 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