Hemodynamic predictors of aortic dilatation in bicuspid aortic valve by velocity-encoded cardiovascular magnetic resonance

Journal of Cardiovascular Magnetic Resonance

Research

Senthil Ramamurthy¹  Marijn E Brummer²  Trevor Q Robbie²  Carey Lamphier²  Giorgina Donati²  Rudolf P Beekman³  Petra van der Velden³  Eline R Zaaijer³  P Martijn den Reijer⁴  Denver Sallee⁵  W James Parks⁵ 

[1] Children's Healthcare of Atlanta, Atlanta, Georgia, USA;Emory University School of Medicine, Atlanta, Georgia, USA;Leiden University Medical Center, Leiden, The Netherlands;Leiden University Medical Center, Leiden, The Netherlands;Emory University School of Medicine, Atlanta, Georgia, USA;Sibley Heart Center Cardiology, Atlanta, Georgia, USA;Emory University School of Medicine, Atlanta, Georgia, USA;

关键词: Cardiovascular Magnetic Resonance;    Bicuspid Aortic Valve;    Left Ventricular Outflow Tract;    Aortic Diameter;    Aortic Dilatation;   

DOI  :  10.1186/1532-429X-12-4

 received in 2009-10-07, accepted in 2010-01-13,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundCongenital Bicuspid Aortic Valve (BAV) is a significant risk factor for serious complications including valve dysfunction, aortic dilatation, dissection, and sudden death. Clinical tools for identification and monitoring of BAV patients at high risk for development of aortic dilatation, an early complication, are not available.MethodsThis paper reports an investigation in 18 pediatric BAV patients and 10 normal controls of links between abnormal blood flow patterns in the ascending aorta and aortic dilatation using velocity-encoded cardiovascular magnetic resonance. Blood flow patterns were quantitatively expressed in the angle between systolic left ventricular outflow and the aortic root channel axis, and also correlated with known biochemical markers of vessel wall disease.ResultsThe data confirm larger ascending aortas in BAV patients than in controls, and show more angled LV outflow in BAV (17.54 ± 0.87 degrees) than controls (10.01 ± 1.29) (p = 0.01). Significant correlation of systolic LV outflow jet angles with dilatation was found at different levels of the aorta in BAV patients STJ: r = 0.386 (N = 18, p = 0.048), AAO: r = 0.536 (N = 18, p = 0.022), and stronger correlation was found with patients and controls combined into one population: SOV: r = 0.405 (N = 28, p = 0.033), STJ: r = 0.562 (N = 28, p = 0.002), and AAO r = 0.645 (N = 28, p < 0.001). Dilatation and the flow jet angle were also found to correlate with plasma levels of matrix metallo-proteinase 2.ConclusionsThe results of this study provide new insights into the pathophysiological processes underlying aortic dilatation in BAV patients. These results show a possible path towards the development of clinical risk stratification protocols in order to reduce morbidity and mortality for this common congenital heart defect.

【 授权许可】

Unknown   
© den Reijer et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.