Morphologic and Functional Markers of Aortopathy in Patients With Bicuspid Aortic Valve Insufficiency Versus Stenosis
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Morphologic and Functional Markers of Aortopathy in Patients With Bicuspid Aortic Valve Insufficiency Versus Stenosis. / Girdauskas, Evaldas; Rouman, Mina; Disha, Kushtrim; Fey, Beatrix; Dubslaff, Georg; von Kodolitsch, Yskert; Reichenspurner, Hermann; Borger, Michael A; Kuntze, Thomas.
in: ANN THORAC SURG, Jahrgang 103, Nr. 1, 01.2017, S. 49-57.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Morphologic and Functional Markers of Aortopathy in Patients With Bicuspid Aortic Valve Insufficiency Versus Stenosis
AU - Girdauskas, Evaldas
AU - Rouman, Mina
AU - Disha, Kushtrim
AU - Fey, Beatrix
AU - Dubslaff, Georg
AU - von Kodolitsch, Yskert
AU - Reichenspurner, Hermann
AU - Borger, Michael A
AU - Kuntze, Thomas
N1 - Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
PY - 2017/1
Y1 - 2017/1
N2 - BACKGROUND: Bicuspid aortic valve (BAV)-associated aortopathy is heterogeneous and still insufficiently defined. We prospectively analyzed the morphologic and functional variables of aortopathy in patients undergoing operations for BAV insufficiency (BAV-AI) vs stenosis (BAV-AS).METHODS: A total of 172 consecutive patients (71% male, 59 ± 10 years) underwent aortic valve replacement with or without proximal aortic operation for BAV-AS (n = 137), and BAV-AI (n = 35) from January 2012 through December 2014. All patients underwent preoperative cardiac magnetic resonance imaging to evaluate morphologic and functional variables of the aortic root. Magnetic resonance imaging data were used to guide sampling of aortic tissue intraoperatively (ie, from the area where flow jet impacts on the aortic wall [jet sample] and the opposite aortic wall [control sample]). Aortic wall lesions were graded based on the histologic sum score (range, 0 to 21). Expression and severity of aortopathy were quantified by means of proximal aortic phenotype, indexed aortic diameters, and a sum score.RESULTS: Cross-sectional aortic diameters were significantly larger in the BAV-AI group vs the BAV-AS group (47 ± 8 mm vs 41 ± 8 mm, p = 0.001). Moreover, root dilatation phenotype was more frequent in the BAV-AI group (27% vs 6%, p = 0.01) and was associated with a significantly larger aortic annulus diameter (32 ± 3 mm vs 27 ± 3 mm, p < 0.001). The histologic sum score was significantly different between the study groups (3.7 ± 2.6 BAV-AI vs 2.5 ± 1.4 BAV-AS, p = 0.03). Logistic regression revealed a significant association between BAV-AI and indexed aortic diameter exceeding 22 mm/m2 (odds ratio, 4.7; p = 0.007).CONCLUSIONS: Our study demonstrates that BAV functional phenotype correlates significantly with the expression and severity of bicuspid aortopathy.
AB - BACKGROUND: Bicuspid aortic valve (BAV)-associated aortopathy is heterogeneous and still insufficiently defined. We prospectively analyzed the morphologic and functional variables of aortopathy in patients undergoing operations for BAV insufficiency (BAV-AI) vs stenosis (BAV-AS).METHODS: A total of 172 consecutive patients (71% male, 59 ± 10 years) underwent aortic valve replacement with or without proximal aortic operation for BAV-AS (n = 137), and BAV-AI (n = 35) from January 2012 through December 2014. All patients underwent preoperative cardiac magnetic resonance imaging to evaluate morphologic and functional variables of the aortic root. Magnetic resonance imaging data were used to guide sampling of aortic tissue intraoperatively (ie, from the area where flow jet impacts on the aortic wall [jet sample] and the opposite aortic wall [control sample]). Aortic wall lesions were graded based on the histologic sum score (range, 0 to 21). Expression and severity of aortopathy were quantified by means of proximal aortic phenotype, indexed aortic diameters, and a sum score.RESULTS: Cross-sectional aortic diameters were significantly larger in the BAV-AI group vs the BAV-AS group (47 ± 8 mm vs 41 ± 8 mm, p = 0.001). Moreover, root dilatation phenotype was more frequent in the BAV-AI group (27% vs 6%, p = 0.01) and was associated with a significantly larger aortic annulus diameter (32 ± 3 mm vs 27 ± 3 mm, p < 0.001). The histologic sum score was significantly different between the study groups (3.7 ± 2.6 BAV-AI vs 2.5 ± 1.4 BAV-AS, p = 0.03). Logistic regression revealed a significant association between BAV-AI and indexed aortic diameter exceeding 22 mm/m2 (odds ratio, 4.7; p = 0.007).CONCLUSIONS: Our study demonstrates that BAV functional phenotype correlates significantly with the expression and severity of bicuspid aortopathy.
KW - Aorta, Thoracic/diagnostic imaging
KW - Aortic Diseases/diagnosis
KW - Aortic Valve/abnormalities
KW - Aortic Valve Insufficiency/diagnosis
KW - Aortic Valve Stenosis/diagnosis
KW - Bicuspid Aortic Valve Disease
KW - Female
KW - Follow-Up Studies
KW - Heart Valve Diseases/complications
KW - Heart Valve Prosthesis
KW - Humans
KW - Magnetic Resonance Imaging, Cine
KW - Male
KW - Middle Aged
KW - Retrospective Studies
U2 - 10.1016/j.athoracsur.2016.05.085
DO - 10.1016/j.athoracsur.2016.05.085
M3 - SCORING: Journal article
C2 - 27526648
VL - 103
SP - 49
EP - 57
JO - ANN THORAC SURG
JF - ANN THORAC SURG
SN - 0003-4975
IS - 1
ER -
