scholarly journals Determinants of aortic growth rate in patients with bicuspid aortic valve by cardiovascular magnetic resonance

Open Heart ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. e001095
Author(s):  
Froso Sophocleous ◽  
Bostjan Berlot ◽  
Maria Victoria Ordonez ◽  
Mai Baquedano ◽  
Elena Giulia Milano ◽  
...  
Keyword(s):  
Growth Rate ◽  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Aortic Valve ◽  
Root Growth ◽  
Bicuspid Aortic Valve ◽  
Aortic Root ◽  
Magnetic Resonance Data ◽  
Valve Function ◽  
Root Growth Rate

ObjectivesThis study aimed to identify determinants of aortic growth rate in bicuspid aortic valve (BAV) patients. We hypothesised that (1) BAV patients with repaired coarctation (CoA) exhibit decreased aortic growth rate, (2) moderate/severe re-coarctation (reCoA) results in increased growth rate, (3) patients with right non-coronary (RN) valve cusps fusion pattern exhibit increased aortic growth rate compared with right-left cusps fusion and type 0 valves.MethodsStarting from n=521 BAV patients with cardiovascular magnetic resonance data, we identified n=145 patients with at least two scans for aortic growth analysis. Indexed areas of the sinuses of Valsalva and ascending aorta (AAo) were calculated from cine images in end-systole and end-diastole. Patients were classified based on dilation phenotype, presence of CoA, aortic valve function and BAV morphotype. Comparisons between groups were performed. Linear regression was carried out to identify associations between risk factors and aortic growth rate.ResultsPatients (39±16 years of age, 68% male) had scans 3.7±1.8 years apart; 32 presented with AAo dilation, 18 with aortic root dilation and 32 were overall dilated. Patients with repaired CoA (n=61) showed decreased aortic root growth rate compared with patients without CoA (p≤0.03) regardless of sex or age. ReCoA, aortic stenosis, regurgitation and history of hypertension were not associated with growth rate. RN fusion pattern showed the highest aortic root growth rate and type 0 the smallest (0.30 vs 0.08 cm2/m*year, end-systole, p=0.03).ConclusionsPresence of CoA and cusp fusion morphotype were associated with changes in rate of root dilation in our BAV population.

scholarly journals Effect of statins on aortic root growth rate in patients with bicuspid aortic valve anatomy

2015 ◽  
Vol 31 (8) ◽  
pp. 1583-1590 ◽  
Author(s):  
Madelien V. Regeer ◽  
Philippe J. van Rosendael ◽  
Vasileios Kamperidis ◽  
Martin J. Schalij ◽  
Jeroen J. Bax ◽  
...  
Keyword(s):  
Growth Rate ◽  
Aortic Valve ◽  
Root Growth ◽  
Bicuspid Aortic Valve ◽  
Aortic Root ◽  
Root Growth Rate

scholarly journals Rapid ascending aorta stiffening in bicuspid aortic valve on serial cardiovascular magnetic resonance evaluation: comparison with connective tissue disorders

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Alejandro Perez-Casares ◽  
Audrey Dionne ◽  
Kimberlee Gauvreau ◽  
Ashwin Prakash
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Aortic Valve ◽  
Connective Tissue ◽  
Bicuspid Aortic Valve ◽  
Aortic Stiffness ◽  
Comparison Group ◽  
Aortic Distensibility ◽  
Connective Tissue Disorders ◽  
Aortic Stiffening

Abstract Background Aortic stiffness has been shown to be abnormal in patients with bicuspid aortic valve (BAV), and is considered a component of the aortopathy associated with this condition. Progressive aortic stiffening associated with aging has been previously described in normal adults. However, it is not known if aging related aortic stiffening occurs at the same rate in BAV patients. We determined the longitudinal rate of decline in segmental distensibility in BAV patients using serial cardiovascular magnetic resonance (CMR) studies, and compared to previously published results from a group of patients with connective tissue disorders (CTD). Methods A retrospective review of CMR and clinical data on children and adults with BAV (n = 49, 73% male; 23 ± 11 years) with at least two CMRs (total 98 examinations) over a median follow-up of 4.1 years (range 1–9 years) was performed to measure aortic distensibility at the ascending (AAo) and descending aorta (DAo). Longitudinal changes in aortic stiffness were assessed using linear mixed-effects modeling. The comparison group of CTD patients had a similar age and gender profile (n = 50, 64% male; 20.6 ± 12 years). Results Compared to CTD patients, BAV patients had a more distensible AAo early in life but showed a steeper decline in distensibility on serial examinations [mean 10-year decline in AAo distensibility (× 10−3 mmHg−1) 2.4 in BAV vs 1.3 in CTD, p = 0.005]. In contrast, the DAo was more distensible in BAV patients throughout the age spectrum, and DAo distensibility declined with aging at a rate similar to CTD patients [mean 10 year decline in DAo distensibility (× 10−3 mmHg−1) 0.3 in BAV vs 0.4 in CTD, p = 0.58]. Conclusions On serial CMR measurements, AAo distensibility declined at significantly steeper rate in BAV patients compared to a comparison group with CTDs, while DAo distensibility declined at similar rates in both groups. These findings offer new mechanistic insights into the differing pathogenesis of the aortopathy seen in BAV and CTD patients.

Serial evaluation of the thoracic aorta in patients with a bicuspid aortic valve: A magnetic resonance angiography study

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 140-144 ◽  
Author(s):  
Tutarel ◽  
Meyer ◽  
Lotz ◽  
Westhoff-Bleck
Keyword(s):  
Aortic Valve ◽  
Thoracic Aorta ◽  
Bicuspid Aortic Valve ◽  
Aortic Root ◽  
Innominate Artery ◽  
Ascending Aorta ◽  
Current Data ◽  
Descending Aorta ◽  
Valve Function ◽  
A Prospective Study

Background: Bicuspid aortic valve (BAV) is associated with an arteriopathy leading to a progressive dilatation of the aortic root. Recent studies have shown that the whole thoracic aorta is affected by this arteriopathy. Longitudinal data regarding the progression of this arteriopathy in the whole thoracic aorta has not been reported before. Patients and methods: In this retrospective study 40 patients (mean age 28.5 ± 9.1 years) had 2 MR-angiographies (mean interval 37.1 ± 15.2 months). In 23 patients the aortic valve was regurgitant, in 1 stenotic, in 4 combined aortic stenosis / regurgitation was found, while in 12 the valve function was normal. Aortic diameters were measured at 6 different, standardized anatomical points. The influence of demographic and clinical parameters was assessed. Results: A significant increase of the diameter was observed at the aortic root (35.4 ± 5.6 mm → 39.1 ± 6.5 mm, p < 0.001), the ascending aorta (37.3 ± 8.0 mm → 39.5 ± 8.5 mm, p = 0.001), proximal to the innominate artery (29.4 ± 6.1 mm → 31.6 ± 6.8 mm, p = 0.008), and the descending aorta (20.2 ± 2.4 mm → 21.6 ± 4.2 mm, p = 0.03). There was no significant increase proximal (24.0 ± 5.7 mm → 24.6 ± 5.3 mm, p = 0.44) and distal to the left subclavian artery (21.4 ± 4.6 mm → 21.9 ± 4.5 mm, p = 0.19). These observations were independent of the presence of arterial hypertension, a previous operation, gender, and functional status of the aortic valve. Conclusions: The progressive dilatation of the aortic root and ascending aorta that can be observed in patients with BAV was not found in the more distal parts of the thoracic aorta with the exception of the descending aorta in this study. If the dilatation of the descending aorta bears any clinical significance can't be answered with the current data. A prospective study should be performed to confirm these results.

Variable phenotypes of bicuspid aortic valve disease: classification by cardiovascular magnetic resonance

Heart ◽  
2010 ◽  
Vol 96 (15) ◽  
pp. 1233-1240 ◽  
Author(s):  
S. Buchner ◽  
M. Hulsmann ◽  
F. Poschenrieder ◽  
O. W. Hamer ◽  
C. Fellner ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Valve Disease ◽  
Disease Classification ◽  
Valve Disease
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