Wall Shear Stress Predicts Aortic Dilation in Patients With Bicuspid Aortic Valve

2021 ◽  
Author(s):  
Andrea Guala ◽  
Lydia Dux-Santoy ◽  
Gisela Teixido-Tura ◽  
Aroa Ruiz-Muñoz ◽  
Laura Galian-Gay ◽  
...  
Keyword(s):  
Shear Stress ◽  
Aortic Valve ◽  
Wall Shear Stress ◽  
Bicuspid Aortic Valve ◽  
Aortic Dilation ◽  
Wall Shear

scholarly journals Low and Oscillatory Wall Shear Stress Is Not Related to Aortic Dilation in Patients With Bicuspid Aortic Valve

2020 ◽  
Vol 40 (1) ◽  
Author(s):  
Lydia Dux-Santoy ◽  
Andrea Guala ◽  
Julio Sotelo ◽  
Sergio Uribe ◽  
Gisela Teixidó-Turà ◽  
...  
Keyword(s):  
Shear Stress ◽  
Aortic Valve ◽  
Wall Shear Stress ◽  
Healthy Volunteers ◽  
Aortic Arch ◽  
Bicuspid Aortic Valve ◽  
Ascending Aorta ◽  
Oscillatory Shear ◽  
Aortic Dilation ◽  
Wall Shear

Objective: To assess the relationship between regional wall shear stress (WSS) and oscillatory shear index (OSI) and aortic dilation in patients with bicuspid aortic valve (BAV). Approach and Results: Forty-six consecutive patients with BAV (63% with right-left-coronary-cusp fusion, aortic diameter ≤ 45 mm and no severe valvular disease) and 44 healthy volunteers were studied by time-resolved 3-dimensional phase-contrast magnetic resonance imaging. WSS and OSI were quantified at different levels of the ascending aorta and the aortic arch, and regional WSS and OSI maps were obtained. Seventy percent of BAV had ascending aorta dilation. Compared with healthy volunteers, patients with BAV had increased WSS and decreased OSI in most of the ascending aorta and the aortic arch. In both BAV and healthy volunteers, regions of high WSS matched regions of low OSI and vice versa. No regions of both low WSS and high OSI were identified in BAV compared with healthy volunteers. Patients with BAV with dilated compared with nondilated aorta presented low and oscillatory WSS in the aortic arch, but not in the ascending aorta where dilation is more prevalent. Furthermore, no regions of concomitant low WSS and high OSI were identified when BAV were compared according to leaflet fusion pattern, despite the well-known differences in regional dilation prevalence. Conclusions: Regions with low WSS and high OSI do not match those with the highest prevalence of dilation in patients with BAV, thus providing no evidence to support the low and oscillatory shear stress theory in the pathogenesis of proximal aorta dilation in the presence of BAV.

scholarly journals 4-D flow MRI aortic 3-D hemodynamics and wall shear stress remain stable over short-term follow-up in pediatric and young adult patients with bicuspid aortic valve

2018 ◽  
Vol 49 (1) ◽  
pp. 57-67 ◽  
Author(s):  
Michael J. Rose ◽  
Cynthia K. Rigsby ◽  
Haben Berhane ◽  
Emilie Bollache ◽  
Kelly Jarvis ◽  
...  
Keyword(s):  
Shear Stress ◽  
Young Adult ◽  
Aortic Valve ◽  
Wall Shear Stress ◽  
Bicuspid Aortic Valve ◽  
Adult Patients ◽  
Short Term ◽  
Flow Mri ◽  
Wall Shear

Association of Regional Wall Shear Stress and Progressive Ascending Aorta Dilation in Bicuspid Aortic Valve

2021 ◽  
Author(s):  
Gilles Soulat ◽  
Michael B. Scott ◽  
Bradley D. Allen ◽  
Ryan Avery ◽  
Robert O. Bonow ◽  
...  
Keyword(s):  
Shear Stress ◽  
Aortic Valve ◽  
Wall Shear Stress ◽  
Bicuspid Aortic Valve ◽  
Ascending Aorta ◽  
Regional Wall ◽  
Wall Shear

scholarly journals Contributing Factor of Proximal Arch Dilation in Patients with Bicuspid Aortic Valve—Wall Shear Stress or Upward Extension of Ascending Aorta Dilation?

2020 ◽  
Vol 23 (4) ◽  
pp. E435-E440
Author(s):  
Fei Li ◽  
Qi Gao ◽  
En Qiao ◽  
Gang Yin ◽  
Ru-Jiao Zhang ◽  
...  
Keyword(s):  
Shear Stress ◽  
Aortic Valve ◽  
Wall Shear Stress ◽  
Bicuspid Aortic Valve ◽  
Ascending Aorta ◽  
Aortic Diameter ◽  
Selective Approach ◽  
Significant Difference ◽  
Wall Shear ◽  
The One

Purpose: The dilation of proximal arch (PArc) was suspected to develop as a result of valve-related hemodynamics or in consequence to the upward extension of the ascending aorta (AAo) dilation. We aimed to investigate the one that could be the possible contributing factor in patients with bicuspid aortic valve (BAV). Methods: All enrolled BAV patients underwent four-dimensional flow magnetic resonance imaging. Contour-averaged circumferential wall shear stress (WSScirc,avg) and the diameter of the middle of AAo (mid-AAo) were compared between the patients with and without PArc dilation. Additionally, we analyzed the correlation between WSScirc,avg and aortic diameter at PArc section, as well as the correlation between the diameter of mid-AAo and that of PArc. Results: No significant difference was observed in WSScirc,avg at PArc section between the patients with and without PArc dilation (P = .621). However, the diameter of mid-AAo in the patients who suffered PArc dilation was higher than those without it (P = .007). In addition, the aortic diameter did not correlate with the WSScirc,avg at PArc level (R = -0.068, P = .701). The correlation was observed between PArc diameter and mid-AAo diameter (R = 0.521, P = .002). Conclusion: Hemodynamics may not contribute to the development of PArc dilation. PArc diameter correlated with mid-AAo diameter, indicating PArc dilation may be secondary to the upward extension of AAo dilation. The influence of AAo dilation extending upward could be treated by AAo replacement; hence, a selective approach to transverse PArc replacement might be appropriate.

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