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

Sophocleous, Froso; Berlot, B; Ordóñez, María Victoria; Baquedano, Mai; Milano, Elena Giulia; Viola, Francesco; Stuart, Graham; Caputo, Massimo; Bucciarelli-Ducci, Chiara; Biglino, Giovanni

doi:10.1136/openhrt-2019-001095

Cited by 5 publications

(3 citation statements)

References 32 publications

(41 reference statements)

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“…As the disease progresses, violations of the mechanical function of the valve increase, those of stenosis or regurgitation. In addition, it has been established that a variant anatomy in the form of a bicuspid form of the aortic valve leads to its degeneration at an earlier age [ 10 ]. In our study, a similar result was obtained: in the BAV group, the mean age was 69.9±6.5 years; in the TAV group, it was 75.0±5.9 years.…”

Section: Discussionmentioning

confidence: 99%

A New Look at Structural Changes in the Aortic Root in Aortic Valve Stenosis

Kobelev¹,

Bergen²,

Tarkova³

et al. 2022

Sovrem Tehnol Med

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The aim of the study was to identify new anatomical landmarks of the aortic root and the relationship between the sizes of anatomical structures using the method of computed tomography angiography to improve models of heart valves and the methods for their selection in clinical practice. Materials and Methods The dataset of computed tomography angiography prior to aortic valve replacement in 262 patients was analyzed. The mean age was 75.0±5.9 years. 99 (37.8±3.0%) men and 163 (62.2±3.0%) women took part in the study. The annulus fibrosus, sinotubular junction, and height of the sinuses of Valsalva were measured. Results In the tricuspid aortic valve group (n=251), in more than 50% of the cases, the diameter of the annulus fibrosus ranged from 23 to 26 mm. No significant association between the diameter of the annulus fibrosus and patient height (r=0.35; p=0.01) or body surface area (r=0.25; p=0.01) and the height of the sinuses of Valsalva (r=0.34; p=0.01) were revealed. Based on the ratio of the height of the sinuses of Valsalva and the diameter of the annulus fibrosus, three variants of the structure of the aortic root were identified: type A — K >1.05; type B— 0.95≤ K ≤1.05; type C— K <0.95. Type C of the aortic root was found to predominate in most cases, namely, in 98.0±0.9% (n=246). In the bicuspid aortic valve group (n=11), 2 patients had a type A of the aortic root, 1 patient had a type B, and 8 patients had a type C. Conclusion A classification of variants of the aortic root structure has been proposed, which will be useful not only for practitioners when choosing a treatment method, but also for researchers to understand the structural characteristics of the aortic root in patients with its pathology.

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Section: Discussionmentioning

confidence: 99%

A New Look at Structural Changes in the Aortic Root in Aortic Valve Stenosis

Kobelev¹,

Bergen²,

Tarkova³

et al. 2022

Sovrem Tehnol Med

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“…Specifically, the isolated growth captured at the level of the aortic root and ascending aorta reflects the real-life scenario of disease progression in patients with BAV aortopathy [16]. However, given limited sample size, we avoided over-interpreting the results from a clinical standpoint and comparing with the existing BAV clinical literature, including our own work [17] looking at aortic dimensional changes over time, e.g., comparing different valve morphotypes. This was not the purpose of the study, but rather showing the feasibility of comparing sub-groups of interest in a population and get meaningful information regarding differences in disease progression and/or shape variability.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a longitudinal statistical atlas model to study aortic growth in congenital heart disease

Sophocleous

Bone

Shearn

et al. 2022

European Heart Journal

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Background Studying anatomical shape progression over time is of utmost importance to refine our understanding of clinically relevant processes. These include vascular remodelling, such as aortic dilation, which is particularly important in some congenital heart defects (CHD). Purpose A novel methodological framework for analysing three-dimensional (3D) shape changes over time (“growth”) has been applied for the first time in a CHD scenario, i.e., bicuspid aortic valve (BAV) disease, the most common CHD. Methods Three-dimensional aortic shapes (n=94) reconstructed as surface meshes from cardiovascular magnetic resonance imaging (MRI) data represented the input for a longitudinal shape atlas model, using multiple scans over time (n=2–4 scans per patient). This model relies on diffeomorphic transformations in the absence of point-to-point correspondence, and on the correct combination of initialization, estimation, and registration parameters. Results We computed the 3D shape trajectory of an average disease progression over time in our cohort (Picture 1, grey to blue shapes), as well as time-dependent parameters, geometric variations and the average shape of the population (Picture 1, red shape). Results cover a spatiotemporal spectrum of visual and numerical information that can be further used to investigate clinical associations and stratify patients, as such capturing aortic remodelling in the presence of BAV aortopathy. Conclusion This proof-of-concept study demonstrates the feasibility of applying advanced statistical shape models to track disease progression and stratify patients with CHD. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): British Heart Foundation and NIHR BRC

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“…There was no significant difference in the annual growth rate of the ascending aortic dilatation in asymptomatic BAV patients with R-L and R-N (0.47 mm/year and 0.46 mm/year, respectively; Avadhani et al, 2015 ). The aortic root growth rate was the highest in BAV patients with R-N morphotype and the smallest in BAV patients with type 0 (3.0 mm/year vs. 0.8 mm/year; Sophocleous et al, 2019 ).…”

Section: Natural Coursementioning

confidence: 92%

Aortic Dilatation in Patients With Bicuspid Aortic Valve

et al. 2021

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Bicuspid aortic valve (BAV) is the most common congenital cardiac abnormality. BAV aortic dilatation is associated with an increased risk of adverse aortic events and represents a potentially lethal disease and hence a considerable medical burden. BAV with aortic dilatation warrants frequent monitoring, and elective surgical intervention is the only effective method to prevent dissection or rupture. The predictive value of the aortic diameter is known to be limited. The aortic diameter is presently still the main reference standard for surgical intervention owing to the lack of a comprehensive understanding of BAV aortopathy progression. This article provides a brief comprehensive review of the current knowledge on BAV aortopathy regarding clinical definitions, epidemiology, natural course, and pathophysiology, as well as hemodynamic and clinically significant aspects on the basis of the limited data available.

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

Cited by 5 publications

References 32 publications

A New Look at Structural Changes in the Aortic Root in Aortic Valve Stenosis

A New Look at Structural Changes in the Aortic Root in Aortic Valve Stenosis

Feasibility of a longitudinal statistical atlas model to study aortic growth in congenital heart disease

Aortic Dilatation in Patients With Bicuspid Aortic Valve

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