Aortic distensibility in bicuspid aortic valve patients with normal aortic diameter

Moaref, Alireza; Khavanin, Mohammad; Shekarforoush, Shahnaz

doi:10.1177/1753944714531062

Cited by 9 publications

(11 citation statements)

References 23 publications

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“…Previous adult studies reported that aortic elasticity was not correlated with different phenotypes of BAV . Two adult studies and one pediatric study reported that the morphology of BAV seems to play a major role in the outcome of BAV disease and that the A‐P phenotype shows worse elasticity quality although the L‐R phenotype is more prone to aortic valve dysfunction .…”

Section: Discussionmentioning

confidence: 95%

“…Being a relatively new method, aortic elasticity may be used for this purpose in patients with BAV. Increased aortic stiffness has been observed in adults with BAV …”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4] To recognize the BAV patient having risk of undesired cardiovascular complication, risk assessments parameters must be developed. For this purpose, many researchers have evaluated aortic valve leaflet morphology, 4,5 histopathology, [6][7][8][9] elasticity, [10][11][12][13][14][15][16][17] and biochemical 6,18 and biomechanical properties [19][20][21] of patients with BAV.…”

Section: Introductionmentioning

confidence: 99%

“…Increased aortic stiffness has been observed in adults with BAV. 10,11,[15][16][17] Some of studies have also evaluated EP in infants, children, and adolescent. However, the numbers of these studies are quite limited.…”

Section: Introductionmentioning

confidence: 99%

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Elasticity of ascending aorta and left ventricular myocardial functions in children with bicuspid aortic valve

2017

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Section: Discussionmentioning

confidence: 95%

“…Being a relatively new method, aortic elasticity may be used for this purpose in patients with BAV. Increased aortic stiffness has been observed in adults with BAV …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Elasticity of ascending aorta and left ventricular myocardial functions in children with bicuspid aortic valve

2017

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“…Tissue dysfunction: altered stiffness and biomechanics (Nistri et al, 2002, 2008; Schaefer et al, 2007; Pees and Michel-Behnke, 2012; Oulego-Erroz et al, 2013; Warner et al, 2013; Forsell et al, 2014; Moaref et al, 2014; Petrini et al, 2014)…”

Section: Pathophysiology and Wavering Guidelinesmentioning

confidence: 99%

Evolution of Precision Medicine and Surgical Strategies for Bicuspid Aortic Valve-Associated Aortopathy

et al. 2017

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Bicuspid aortic valve (BAV) is a common congenital cardiac malformation affecting 1–2% of people. BAV results from fusion of two adjacent aortic valve cusps, and is associated with dilatation of the aorta, known as bicuspid valve associated aortopathy. Bicuspid valve aortopathy is progressive and associated with catastrophic clinical events, such as aortic dissection and rupture. Therefore, frequent monitoring and early intervention with prophylactic surgical resection of the proximal aorta is often recommended. However, the specific pattern of aortopathy is highly variable among patients, with different segments of the ascending aorta being affected. Individual patient risks are sometimes difficult to predict. Resection strategies are informed by current surgical guidelines which are primarily based on aortic size and growth criteria. These criteria may not optimally reflect the risk of important aortic events. To address these issues in the care of patients with bicuspid valve aortopathy, our translational research group has focused on validating use of novel imaging techniques to establish non-invasive hemodynamic biomarkers for risk-stratifying BAV patients. In this article, we review recent efforts, successes, and ongoing challenges in the development of more precise and individualized surgical approaches for patients with bicuspid aortic valves and associated aortic disease.

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Aortic strain in bicuspid aortic valve: an analysis

Carlos

Freitas

Alves

et al. 2021

Int J Cardiovasc Imaging

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Introduction: Bicuspid aortic valve (BAV) is frequently related to aortic valve disease and aortopathy and it is usually monitored by transthoracic echocardiography and computed tomography (CT) angiography. However, early markers of disease progression are not currently available. Speckletracking echocardiography (STE) has shown consistent results among other cardiac pathologies. The present study evaluated STE aortic and left ventricle (LV) strain prognostic value, their discriminative power and their correlation with the degree of valvular regurgitation. Methods:We retrospectively followed forty-eight adult patients with BAV and twenty gender and age matched controls for a median period of approximately twenty months, all with LV ejection fraction > 50% and without wall-motion abnormalities or poor acoustic window. We measured LV and aortic classic and STE parameters and we analysed their statistically significant differences, as well as their discriminative power of BAV presence. Hereinafter, we assessed their correlation with the primary cardiac outcome -aortic valve replacement (AVR) -through a COX regression analysis. Finally, our population with BAV was divided according to their severity of aortic regurgitation (AR) in none, mild, moderate or severe, and we evaluated: a) their echocardiographic parameters' differences throughout the disease; and b) which values predicted the existence of at least moderate AR. Results:In our sample, values of LV dimensions and aortic diameter were higher in BAV population.Regarding their mechanics, LV global longitudinal strain (GLS) was impaired (p<0.001) and aortic global circumferential strain (GCS) did not differ among the two groups. Aortic GLS was significantly increased (p=0.027) and was a reliable discriminator of BAV presence, though aortic diameter was better (area under the curve = 0.92). In BAV patients with AR, aortic GCS decreased with the increment of severity (p=0.004) and severe AR had an exponentially augmented aortic GLS (45.2 ± 32.3%). Aortic valve replacement was the only outcome observed and its only predictor was LV end-diastolic volume (indexed).Discussion: BAV patients had impaired LV contraction, despite having preserved LV ejection fraction.Our population had pronounced aortic dilatation, which caused a distortion in strain calculation, with high values of aortic GLS. Increasing severity of AR caused a reduction in aortic GCS, partly reflecting its significant vascular wall impairment throughout the disease.Conclusion: STE aortic strain was not a reliable predictor of surgery in BAV patients.

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Aortic distensibility in bicuspid aortic valve patients with normal aortic diameter

Abstract: Regardless of the valve morphology and also in the absence of aortic dilation, aortic distensibility is impaired in BAV subjects compared with TAV subjects. This finding supports the idea of an intrinsic aortic wall anomalies underlying the impaired elasticity of the aorta in BAV patients.

Cited by 9 publications

References 23 publications

Elasticity of ascending aorta and left ventricular myocardial functions in children with bicuspid aortic valve

Elasticity of ascending aorta and left ventricular myocardial functions in children with bicuspid aortic valve

Evolution of Precision Medicine and Surgical Strategies for Bicuspid Aortic Valve-Associated Aortopathy

Aortic strain in bicuspid aortic valve: an analysis

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