Abstract TP86: Prevalence of Bicuspid Aortic Valves and Thoracic Ascending Aortic Aneurysms in Patients Treated for Intracranial Aneurysms

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Manu S Goyal ◽  
Ravi Gottumukkala ◽  
Sanjeev Bhalla ◽  
Andrew M Kates ◽  
Gregory J Zipfel ◽  
...  

INTRODUCTION: Prior studies have suggested an increased prevalence of intracranial aneurysms (ICA) in patients with bicuspid aortic valves (BAV) and thoracic ascending aortic aneurysms (TAA). We tested the hypothesis that if true, conversely, the prevalence of BAV and TAA should be increased in patients with ICA. METHODS: We identified and reviewed the clinical records of patients treated for an ICA at our institution between 2002 and 2011. Only those with an echocardiogram report in their clinical record were included for further analysis. The prevalence of BAV and TAA in this cohort was determined based on the echocardiogram reports, medical records, and, when available, cross-sectional chest imaging. Proportion confidence intervals were calculated and compared to population prevalence estimates. RESULTS: Of 1051 patients with ICA, 321 had available echocardiogram reports that included assessment of the aortic valve. Of these, 85 also had cross-sectional chest imaging. Of the 321 patients, 2 were reported to have a BAV (0.6%, 95% CI 0 - 2.5%), similar to population prevalence estimates for this condition. In this same cohort, there were 15 (4.7%, 95% CI 2.7 - 7.8%) patients with a TAA. Among the 85 patients with cross-sectional chest imaging, the prevalence of TAA exceeded that expected for a community age- and gender-matched population (see Figure, gray lines represent upper and lower limits of normal). CONCLUSIONS: This retrospective analysis suggests an increased prevalence of TAA, but not BAV, in patients with ICA.

Neurology ◽  
2014 ◽  
Vol 84 (1) ◽  
pp. 46-49 ◽  
Author(s):  
M. S. Goyal ◽  
R. Gottumukkala ◽  
S. Bhalla ◽  
A. Kates ◽  
G. J. Zipfel ◽  
...  

2015 ◽  
Vol 18 (4) ◽  
pp. 134 ◽  
Author(s):  
Asad A Shah

<p><strong>Background:  </strong>Bicuspid aortic valves predispose to ascending aortic aneurysms, but the mechanisms underlying this aortopathy remain incompletely characterized.  We sought to identify epigenetic pathways predisposing to aneurysm formation in bicuspid patients.</p><p><strong>Methods:  </strong>Ascending aortic aneurysm tissue samples were collected at the time of aortic replacement in subjects with bicuspid and trileaflet aortic valves.  Genome-wide DNA methylation status was determined on DNA from tissue using the Illumina 450K methylation chip, and gene expression was profiled on the same samples using Illumina Whole-Genome DASL arrays.  Gene methylation and expression were compared between bicuspid and trileaflet individuals using an unadjusted Wilcoxon rank sum test.  </p><p><strong>Results:  </strong>Twenty-seven probes in 9 genes showed significant differential methylation and expression (P&lt;5.5x10<sup>-4</sup>).  The top gene was protein tyrosine phosphatase, non-receptor type 22 (<em>PTPN22</em>), which was hypermethylated (delta beta range: +15.4 to +16.0%) and underexpressed (log 2 gene expression intensity: bicuspid 5.1 vs. trileaflet 7.9, P=2x10<sup>-5</sup>) in bicuspid patients, as compared to tricuspid patients.  Numerous genes involved in cardiovascular development were also differentially methylated, but not differentially expressed, including <em>ACTA2</em> (4 probes, delta beta range:  -10.0 to -22.9%), which when mutated causes the syndrome of familial thoracic aortic aneurysms and dissections</p><p><strong>Conclusions:  </strong>Using an integrated, unbiased genomic approach, we have identified novel genes associated with ascending aortic aneurysms in patients with bicuspid aortic valves, modulated through epigenetic mechanisms.  The top gene was <em>PTPN22</em>, which is involved in T-cell receptor signaling and associated with various immune disorders.  These differences highlight novel potential mechanisms of aneurysm development in the bicuspid population.</p>


Author(s):  
Tarek Malas ◽  
Eric Dumont ◽  
Siamak Mohammadi ◽  
Pierre Voisine ◽  
François Dagenais

2009 ◽  
Vol 6 (5) ◽  
pp. 535-547 ◽  
Author(s):  
Deanna M. Hoelscher ◽  
Cristina Barroso ◽  
Andrew Springer ◽  
Brian Castrucci ◽  
Steven H. Kelder

Background:Few studies have compared physical activity (PA) and sedentary activity (SA) by grade and ethnicity, specifically including elementary school students. A cross-sectional probability-based design was used to provide data by ethnicity (African American, Hispanic, and White/Other), gender, and grade (4th, 8th, and 11th) from 2000 to 2002.Methods:Two validated questionnaires (elementary and secondary) assessed self-reported PA and SA. Point-prevalence estimates and 95% confidence intervals were computed.Results:Over 70% of students reported vigorous PA on ≥3 days/week, but <50% participated in daily physical education. A significant percentage (30% to 50%) of students reported ≥3 hours per day in SA. Fourth-grade boys and girls reported equal PA; however, 8th and 11th grade girls reported lowered vigorous PA. African American 8th- and 11th-grade boys reported the highest PA, but African American children also reported the highest prevalence of SA.Conclusions:Findings from this study highlight the disparities in physical and sedentary activities by gender, grade, and race/ethnicity, and the need to address these differences with programs and policy. In general, grade level and gender differences were more striking and consistent than racial/ethnic differences.


Circulation ◽  
2000 ◽  
Vol 102 (suppl_3) ◽  
Author(s):  
Martin G. Keane ◽  
Susan E. Wiegers ◽  
Ted Plappert ◽  
Alberto Pochettino ◽  
Joseph E. Bavaria ◽  
...  

Background —Bicuspid aortic valves (BAVs) are associated with premature valve stenosis, regurgitation, and ascending aortic aneurysms. We compared aortic size in BAV patients with aortic size in control patients with matched valvular lesions (aortic regurgitation, aortic stenosis, or mixed lesions) to determine whether intrinsic aortic abnormalities in BAVs account for aortic dilatation beyond that caused by valvular hemodynamic derangement alone. Methods and Results —Diameters of the left ventricular outflow tract, sinus of Valsalva, sinotubular junction, and proximal aorta were measured from transthoracic echocardiograms in 118 consecutive BAV patients. Annular area was measured by planimetry, and BAV eccentricity was expressed as the ratio of the right leaflet area to the total annular area. Seventy-seven control patients with tricuspid aortic valves were matched for sex and for combined severity of regurgitation and stenosis. BAV patients (79 men and 39 women, aged 44.1±15.5 years) had varying degrees of regurgitation (84 patients [71%]) and stenosis (48 patients [41%]). Within the bicuspid group, multivariate analysis demonstrated that aortic diameters increased with worsening aortic regurgitation ( P <0.001) and advancing age ( P <0.05) but not with the severity of aortic stenosis. BAV patients had larger aortic diameters than did control patients at all ascending aortic levels measured ( P <0.01), despite advanced age in the control patients. Conclusions —Aortic dimensions are larger in BAV patients than in control patients with comparable degrees of tricuspid aortic valve disease. Although more severe degrees of aortic regurgitation are associated with aortic dilatation in BAV patients, intrinsic pathology appears to be responsible for aortic enlargement beyond that predicted by hemodynamic factors.


2007 ◽  
Vol 16 (3) ◽  
pp. 144-150 ◽  
Author(s):  
Ramanath Majumdar ◽  
Dylan V. Miller ◽  
Karla V. Ballman ◽  
Gopinathan Unnikrishnan ◽  
Stephen H. McKellar ◽  
...  

2003 ◽  
Vol 8 (3) ◽  
pp. 131-147 ◽  
Author(s):  
Gian Vittorio Caprara ◽  
Mariagiovanna Caprara ◽  
Patrizia Steca

Three cross-sectional studies examined stability and change in personality over the course of life by measuring the relations linking age to personality traits, self-efficacy beliefs, values, and well-being in large samples of Italian male and female participants. In each study, relations between personality and age were examined across several age groups ranging from young adulthood to old age. In each study, personality constructs were first examined in terms of mean group differences accrued by age and gender and then in terms of their correlations with age across gender and age groups. Furthermore, personality-age correlations were also calculated, controlling for the demographic effects accrued by marital status, education, and health. Findings strongly indicated that personality functioning does not necessarily decline in the later years of life, and that decline is more pronounced in males than it is in females across several personality dimensions ranging from personality traits, such as emotional stability, to self-efficacy beliefs, such as efficacy in dealing with negative affect. Findings are discussed in terms of their implications for personality theory and social policy.


Sign in / Sign up

Export Citation Format

Share Document