Echo Reference — Chamber Quantification
Aortic Dimensions
Normal aortic root and ascending aorta measurements with BSA-indexed and height-indexed values by sex. Sinus of Valsalva severity grading and age-specific upper-limit-of-normal nomogram equations.
Normal Aortic Dimensions
All measurements at end-diastole via leading-edge-to-leading-edge method, except the aortic annulus which is measured at mid-systole using inner-edge-to-inner-edge. Values exceeding 2 standard deviations above the mean should be classified as dilated.
Men
| Level | Absolute (cm) | BSA-Indexed (cm/m²) | Height-Indexed (cm/m) |
|---|---|---|---|
| Aortic annulus | 2.12 ± 0.22 | 1.13 ± 0.13 | 1.22 ± 0.13 |
| Sinus of Valsalva | 3.22 ± 0.37 | 1.72 ± 0.25 | 1.86 ± 0.23 |
| Sinotubular junction | 2.77 ± 0.37 | 1.48 ± 0.23 | 1.60 ± 0.22 |
| Proximal ascending aorta | 3.00 ± 0.4 | 1.5 ± 0.2 | — |
| Aortic arch | 2.2 – 3.6 | — | — |
| Descending aorta | 2.0 – 3.0 | — | — |
Women
| Level | Absolute (cm) | BSA-Indexed (cm/m²) | Height-Indexed (cm/m) |
|---|---|---|---|
| Aortic annulus | 1.95 ± 0.21 | 1.1 ± 0.14 | 1.22 ± 0.13 |
| Sinus of Valsalva | 2.93 ± 0.36 | 1.80 ± 0.26 | 1.84 ± 0.23 |
| Sinotubular junction | 2.55 ± 0.33 | 1.56 ± 0.24 | 1.59 ± 0.22 |
| Proximal ascending aorta | 2.70 ± 0.4 | 1.60 ± 0.3 | — |
| Aortic arch | 2.2 – 3.6 | — | — |
| Descending aorta | 2.0 – 3.0 | — | — |
Aortic Root (Sinus of Valsalva) — Severity Grading
| Method | Normal | Mildly Abnormal | Moderately Abnormal | Severely Abnormal |
|---|---|---|---|---|
| Absolute (cm) | < 4.0 | 4.0 – 4.5 | 4.5 – 5.5 | > 5.5 |
| By Height (cm/m) | < 2.2 | 2.2 – 2.43 | 2.43 – 3.17 | > 3.17 |
| By BSA (cm/m²) | < 2.0 | 2.0 – 2.3 | 2.3 – 2.8 | > 2.8 |
Upper Limit of Normal — Nomogram Equations
Age-stratified regression equations for identifying aortic root dilatation at the sinus of Valsalva level. These ULN equations define the upper boundary of the normal range — a measured SoV diameter exceeding the calculated ULN is abnormal for that patient's body size and age.
ULN by BSA
18 – 40 years
ULN = 0.69 × BSA + 2.45
r = 0.42
41 – 65 years
ULN = 0.70 × BSA + 2.60
r = 0.38
> 65 years
ULN = 0.39 × BSA + 3.22
r = 0.22
ULN by Height
18 – 40 years
ULN = 0.014 × Ht + 1.33
r = 0.37 · Height in cm
41 – 65 years
ULN = 0.016 × Ht + 1.15
r = 0.40 · Height in cm
> 65 years
ULN = 0.010 × Ht + 2.25
r = 0.28 · Height in cm
BSA-Indexed Aortic Root Calculator
Enter the measured sinus of Valsalva diameter, patient height, weight, and age group. Calculates BSA (Du Bois), indexed SoV, height-indexed SoV, severity grade, and the age-specific upper limit of normal.
Height-Indexed Aortic Root Calculator
Use when weight is unavailable. Enter the measured sinus of Valsalva diameter, patient height, and age group. Calculates height-indexed SoV, severity grade, and the age-specific upper limit of normal by height.
References
- Patel HN, et al; WASE Investigators. Normal Values of Aortic Root Size According to Age, Sex, and Race: Results of the World Alliance of Societies of Echocardiography Study. J Am Soc Echocardiogr. 2022;35(3):267–274.
- Lang RM, 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. J Am Soc Echocardiogr. 2015;28:1–39.
- Evangelista A, et al. Echocardiography in aortic diseases: EAE recommendations for clinical practice. Eur J Echocardiogr. 2010;11(8):645–58.