Functional Aortic Root Parameters and Expression of Aortopathy in Bicuspid Versus Tricuspid Aortic Valve Stenosis

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:67

Article

Girdauskas, Evaldas¹  Rouman, Mina²  Disha, Kushtrim²  Fey, Beatrix³  Dubslaff, Georg³  Theis, Bernhard⁴  Petersen, Iver⁴  Gutberlet, Matthias⁵  Borger, Michael A.⁶  Kuntze, Thomas² 

[1] Univ Heart Ctr, Dept Cardiovasc Surg, Hamburg, Germany

[2] Cent Hosp, Dept Cardiac Surg, Bad Berka, Germany

[3] Cent Hosp, Dept Radiol, Bad Berka, Germany

[4] Univ Jena, Inst Pathol, Jena, Germany

[5] Ctr Heart, Dept Radiol, Leipzig, Germany

[6] Columbia Univ, Med Ctr, New York, NY USA

关键词: aorta;    bicuspid aortic valve;    hemodynamics;    valves;   

DOI  :  10.1016/j.jacc.2016.02.015

来源: Elsevier

【 摘 要 】

BACKGROUND The correlation between bicuspid aortic valve (BAV) disease and aortopathy is not fully defined. OBJECTIVES This study aimed to prospectively analyze the correlation between functional parameters of the aortic root and expression of aortopathy in patients undergoing surgery for BAV versus tricuspid aortic valve (TAV) stenosis. METHODS From January 1, 2012 through December 31, 2014, 190 consecutive patients (63 +/- 8 years, 67% male) underwent aortic valve replacement +/- proximal aortic surgery for BAV stenosis (n = 137, BAV group) and TAV stenosis (n = 53, TAV group). All patients underwent pre-operative cardiac magnetic resonance imaging to evaluate morphological/functional parameters of the aortic root. Aortic tissue was sampled during surgery on the basis of the location of eccentric blood flow contact with the aortic wall, as determined by cardiac magnetic resonance (i.e., jet sample and control sample). Aortic wall lesions were graded using a histological sum score (0 to 21). RESULTS The largest cross-sectional aortic diameters were at the mid-ascending level in both groups and were larger in BAV patients (40.2 +/- 7.2 mm vs. 36.6 +/- 3.3 mm, respectively, p < 0.001). The histological sum score was 2.9 +/- 1.4 in the BAV group versus 3.4 +/- 2.6 in the TAV group (p = 0.4). The correlation was linear and comparable between the maximum indexed aortic diameter and the angle between the left ventricular outflow axis and aortic root (left ventricle/ aorta angle) in both groups (BAV group: r = 0.6, p < 0.001 vs. TAV group r = 0.45, p = 0.03, z = 1.26, p = 0.2). Logistic regression identified the left ventricle/aorta angle as an indicator of indexed aortic diameter >22 mm/m(2) (odds ratio: 1.2; p < 0.001). CONCLUSIONS Comparable correlation patterns between functional aortic root parameters and expression of aortopathy are found in patients with BAV versus TAV stenosis. (C) 2016 by the American College of Cardiology Foundation.

【 授权许可】

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