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Prevalence of pectus excavatum in an adult population-based cohort estimated from radiographic indices of chest wall shape

BACKGROUND: Pectus excavatum is the most common chest wall skeletal deformity. Although commonly evaluated in adolescence, its prevalence in adults is unknown. METHODS AND FINDINGS: Radiographic indices of chest wall shape were analyzed for participants of the first (n = 2687) and second (n = 1780)...

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Autores principales: Biavati, Mikaela, Kozlitina, Julia, Alder, Adam C., Foglia, Robert, McColl, Roderick W., Peshock, Ronald M., Kelly, Robert E., Kim Garcia, Christine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205298/
https://www.ncbi.nlm.nih.gov/pubmed/32379835
http://dx.doi.org/10.1371/journal.pone.0232575
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author Biavati, Mikaela
Kozlitina, Julia
Alder, Adam C.
Foglia, Robert
McColl, Roderick W.
Peshock, Ronald M.
Kelly, Robert E.
Kim Garcia, Christine
author_facet Biavati, Mikaela
Kozlitina, Julia
Alder, Adam C.
Foglia, Robert
McColl, Roderick W.
Peshock, Ronald M.
Kelly, Robert E.
Kim Garcia, Christine
author_sort Biavati, Mikaela
collection PubMed
description BACKGROUND: Pectus excavatum is the most common chest wall skeletal deformity. Although commonly evaluated in adolescence, its prevalence in adults is unknown. METHODS AND FINDINGS: Radiographic indices of chest wall shape were analyzed for participants of the first (n = 2687) and second (n = 1780) phases of the population-based Dallas Heart Study and compared to clinical cases of pectus (n = 297). Thoracic computed tomography imaging studies were examined to calculate the Haller index, a measure of thoracic axial shape, and the Correction index, which quantitates the posterior displacement of the sternum relative to the ribs. At the level of the superior xiphoid, 0.5%, 5% and 0.4% of adult Dallas Heart Study subjects have evidence of pectus excavatum using thresholds of Haller index >3.25, Correction index >10%, or both, respectively. Radiographic measures of pectus are more common in females than males and there is a greater prevalence of pectus in women than men. In the general population, the Haller and Correction indices are associated with height and weight, independent of age, gender, and ethnicity. Repeat imaging of a subset of subjects (n = 992) demonstrated decreases in the mean Haller and Correction indices over seven years, suggesting change to a more circular axial thorax, with less sternal depression, over time. CONCLUSIONS: To our knowledge, this is the first study estimating the prevalence of pectus in an unselected adult population. Despite the higher reported prevalence of pectus cases in adolescent boys, this study demonstrates a higher prevalence of radiographic indices of pectus in adult females.
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spelling pubmed-72052982020-05-12 Prevalence of pectus excavatum in an adult population-based cohort estimated from radiographic indices of chest wall shape Biavati, Mikaela Kozlitina, Julia Alder, Adam C. Foglia, Robert McColl, Roderick W. Peshock, Ronald M. Kelly, Robert E. Kim Garcia, Christine PLoS One Research Article BACKGROUND: Pectus excavatum is the most common chest wall skeletal deformity. Although commonly evaluated in adolescence, its prevalence in adults is unknown. METHODS AND FINDINGS: Radiographic indices of chest wall shape were analyzed for participants of the first (n = 2687) and second (n = 1780) phases of the population-based Dallas Heart Study and compared to clinical cases of pectus (n = 297). Thoracic computed tomography imaging studies were examined to calculate the Haller index, a measure of thoracic axial shape, and the Correction index, which quantitates the posterior displacement of the sternum relative to the ribs. At the level of the superior xiphoid, 0.5%, 5% and 0.4% of adult Dallas Heart Study subjects have evidence of pectus excavatum using thresholds of Haller index >3.25, Correction index >10%, or both, respectively. Radiographic measures of pectus are more common in females than males and there is a greater prevalence of pectus in women than men. In the general population, the Haller and Correction indices are associated with height and weight, independent of age, gender, and ethnicity. Repeat imaging of a subset of subjects (n = 992) demonstrated decreases in the mean Haller and Correction indices over seven years, suggesting change to a more circular axial thorax, with less sternal depression, over time. CONCLUSIONS: To our knowledge, this is the first study estimating the prevalence of pectus in an unselected adult population. Despite the higher reported prevalence of pectus cases in adolescent boys, this study demonstrates a higher prevalence of radiographic indices of pectus in adult females. Public Library of Science 2020-05-07 /pmc/articles/PMC7205298/ /pubmed/32379835 http://dx.doi.org/10.1371/journal.pone.0232575 Text en © 2020 Biavati et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Biavati, Mikaela
Kozlitina, Julia
Alder, Adam C.
Foglia, Robert
McColl, Roderick W.
Peshock, Ronald M.
Kelly, Robert E.
Kim Garcia, Christine
Prevalence of pectus excavatum in an adult population-based cohort estimated from radiographic indices of chest wall shape
title Prevalence of pectus excavatum in an adult population-based cohort estimated from radiographic indices of chest wall shape
title_full Prevalence of pectus excavatum in an adult population-based cohort estimated from radiographic indices of chest wall shape
title_fullStr Prevalence of pectus excavatum in an adult population-based cohort estimated from radiographic indices of chest wall shape
title_full_unstemmed Prevalence of pectus excavatum in an adult population-based cohort estimated from radiographic indices of chest wall shape
title_short Prevalence of pectus excavatum in an adult population-based cohort estimated from radiographic indices of chest wall shape
title_sort prevalence of pectus excavatum in an adult population-based cohort estimated from radiographic indices of chest wall shape
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205298/
https://www.ncbi.nlm.nih.gov/pubmed/32379835
http://dx.doi.org/10.1371/journal.pone.0232575
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