Aortic Dilatation in Patients With Bicuspid Aortic Valve

Wang, Jing; Deng, Wenhui; Lv, Qing; Li, Yuman; Liu, Tianshu; Xie, Mingxing

doi:10.3389/fphys.2021.615175

Cited by 314 publications

(7 citation statements)

References 151 publications

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“…Kong et al [ 15 ] demonstrated that the presence of a raphe is of clinical and prognostic importance and is significantly correlated with valve dysfunction and aortic dilation. Most studies have focused on specific BAV morphology according to the orientation of leaflet fusion and the number of commissures [ 1 , 15 ]; however, only a few studies have focused on the presence of a raphe.…”

Section: Discussionmentioning

confidence: 99%

“…A bicuspid aortic valve (BAV) is the most common congenital heart disease, affecting 0.5% to 2% of the general population [ 1 ]. Although a BAV can be an isolated disorder, it is often associated with serious valvular disorders, including aortic stenosis (AS) and aortic regurgitation (AR), as well as aortic wall abnormalities such as aortopathy, aneurysm, and dissection.…”

Section: Introductionmentioning

confidence: 99%

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Aortic Valve Dysfunction and Aortopathy Based on the Presence of Raphe in Patients with Bicuspid Aortic Valve Disease

Zhang,

Choi,

Chee

et al. 2023

JCDD

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(1) Background: To identify the association between the presence or absence of a raphe and aortic valve dysfunction, as well as the presence of aortopathy in patients with a bicuspid aortic valve (BAV); (2) Methods: This retrospective study enrolled 312 participants (mean (SD) age, 52.7 (14.3) years; 227 men (72.8%)) with BAV. The BAVs were divided into those with the presence (raphe+) or absence (raphe−) of a raphe. Valvular function was classified as normal, aortic regurgitation (AR), or aortic stenosis (AS) using TTE. The pattern of BAV aortopathy was determined by the presence of dilatation at the sinus of Valsalva and the middle ascending aorta using CCT; (3) Results: BAVs with raphe+ had a higher prevalence of AR (148 (79.5%) vs. 48 (37.8%), p < 0.001), but a lower prevalence of AS (90 (48.6%) vs. 99 (78.0%), p < 0.001) compared with those with raphe−. The types of BAV aortopathy were significantly different (p = 0.021) according to those with BAV–raphe+ and BAV–raphe−; (4) Conclusions: The presence of a raphe was significantly associated with a higher prevalence of AR, but a lower prevalence of AS and combined dilatation of the aortic root and middle ascending aorta. The presence of a raphe was an independent determinant of AR.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Aortic Valve Dysfunction and Aortopathy Based on the Presence of Raphe in Patients with Bicuspid Aortic Valve Disease

Zhang,

Choi,

Chee

et al. 2023

JCDD

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“…The group had varying degrees and presences of valvular disease as well as different phenotypes of BAVs ( Table 1 ). This could likely lead to an increase in the variability of the results as the different pathoanatomical features of BAVs can correspond to different unfavourable haemodynamic environments [ 55 ].…”

Section: Limitationsmentioning

confidence: 99%

Feasibility of Wave Intensity Analysis from 4D Cardiovascular Magnetic Resonance Imaging Data

et al. 2023

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Congenital heart defects (CHD) introduce haemodynamic changes; e.g., bicuspid aortic valve (BAV) presents a turbulent helical flow, which activates aortic pathological processes. Flow quantification is crucial for diagnostics and to plan corrective strategies. Multiple imaging modalities exist, with phase contrast magnetic resonance imaging (PC-MRI) being the current gold standard; however, multiple predetermined site measurements may be required, while 4D MRI allows for measurements of area (A) and velocity (U) in all spatial dimensions, acquiring a single volume and enabling a retrospective analysis at multiple locations. We assessed the feasibility of gathering hemodynamic insight into aortic hemodynamics by means of wave intensity analysis (WIA) derived from 4D MRI. Data were collected in n = 12 BAV patients and n = 7 healthy controls. Following data acquisition, WIA was successfully derived at three planes (ascending, thoracic and descending aorta) in all cases. The values of wave speed were physiological and, while the small sample limited any clinical interpretation of the results, the study shows the possibility of studying wave travel and wave reflection based on 4D MRI. Below, we demonstrate for the first time the feasibility of deriving wave intensity analysis from 4D flow data and open the door to research applications in different cardiovascular scenarios.

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“…Клинические проявления чаще встречаются после 40 лет и демонстрируют свое многообразие [1,4,5,6]. несмотря на то, что у большинства пациентов развиваются такие осложнения, как дисфункция аК и/или дилатация аорты, некоторые из них могут оставаться бессимптомными в течение всей своей жизни.…”

Section: Introductionunclassified

Pathomorphological features of complications inpatients with bicuspid aortic valve

Pugina,

Gareev,

Korzhova

et al. 2023

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Purpose: to evaluate the features of the course of complications in patients with BAV based on the results of a pathomorphological study.Material and methods: a retrospective analysis of a register of 328 patients with AS and dilation of the ascending aorta (DAA), based on histological studies performed in 2010–2022 was carried out. 209 patients were diagnosed with BAV as a result of histological examination, and 119 patients were diagnosed with tricuspid aortic valve (TAV). The type of BAV was analyzed in 139 operated patients based on the results of the analysis of surgical protocols.Results: according to the obtained results, the first type with fusion of the right and left coronary cusps prevailed among patients with BAV (78%), the smallest number of patients with BAV was with fusion of the right coronary and non-coronary cusps of the aortic valve (4%), while fusion of the left coronary with the non-coronary cusps of the aortic valve (AV) and patients with "true" BAV occurred in each case in 9% of patients. The formation of AS (75.6%), DAA (68.4%), and the combination of AS+DAA (81%) was more observed in the group of patients with the first type of BAV. According to the results of histology of the AV, there were no significant differences depending on the morphology of the valve. In particular, according to the results of AV histology, the frequency of calcification did not differ in groups of patients with BAV and TAV. Fibrosis with erasing of the layered histoarchitectonics of the AV of varying severity was detected in every second patient, regardless of the presence of congenital heart disease (CHD). According to the results of aortic histology, hemodynamic aneurysm in patients with BAV was much more common than in patients with TAV (p=0.0027). In addition, it was verified that in 39 patients out of 40 without pathomorphological changes in the aortic wall, aortic stenosis appeared in the diagnosis, of which 80% of patients had CHD: BAV. It was verified that 39 out of 40 patients without pathomorphological changes in the aortic wall had aortic stenosis in the diagnosis. Moreover, in 80% of patients, the main cause of aortic dilatation was identified as BAV.Conclusions: the results of this study demonstrated that in the vast majority of cases, aortic dilatation and aortic stenosis are formed during fusion of the right and left coronary cusps. The absence of morphological changes in the aortic wall in almost every third patient with DAA and BAV, confirms the genetic contribution to the formation of aortic dilatation in this category of patients and requires further study.

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Aortic Dilatation in Patients With Bicuspid Aortic Valve

Cited by 314 publications

References 151 publications

Aortic Valve Dysfunction and Aortopathy Based on the Presence of Raphe in Patients with Bicuspid Aortic Valve Disease

Aortic Valve Dysfunction and Aortopathy Based on the Presence of Raphe in Patients with Bicuspid Aortic Valve Disease

Feasibility of Wave Intensity Analysis from 4D Cardiovascular Magnetic Resonance Imaging Data

Pathomorphological features of complications inpatients with bicuspid aortic valve

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