Peeters Frederique E C M, Van der Linden Noreen, Thomassen Alissa L L, Crijns Harry J G M, Meex Steven J R, Kietselaer Bas L J H
Department of Cardiology, MUMC+ CARIM, School for Cardiovascular Diseases Department of Clinical Chemistry Department of Radiology, MUMC+, Maastricht, the Netherlands.
Medicine (Baltimore). 2016 Dec;95(52):e5699. doi: 10.1097/MD.0000000000005699.
Bicuspid aortic valve (BAV) disease is associated with aortic dilatation. Timing of follow-up and surgery is challenging. Hence, there is an unmet clinical need for additional risk stratification. It is unclear whether valve morphology is associated with dilatation rates. Therefore, the objective of this study was to examine the association between clinical and echocardiographic determinants (including valve morphology) and aortic dimension and the progression rate of dilatation.Aortic dimensions were assessed on serial echocardiographic images between 1999 and 2014 in a population of 392 patients with BAVs in a tertiary care center in the Netherlands. Analyses using mixed linear models were performed.Mean age of participants was 48 ± 17 years and 69% were male. BAV morphology was associated with aortic dimensions, as well as age, sex, BSA, and valvular dysfunction. Tubular ascending aorta, sinus of Valsalva, and sinotubular junction showed a dilatation rate of 0.32, 0.18, and 0.06 mm/year, respectively. Dilatation rate was not associated with valve morphology.In the present study, there is no association between BAV morphology and aortic dilatation rates. Therefore, morphology is of limited use in prediction of aortic growth. Discovering fast progressors remains challenging.
二叶式主动脉瓣（BAV）疾病与主动脉扩张相关。随访和手术时机的选择具有挑战性。因此，临床上对额外的风险分层存在未满足的需求。尚不清楚瓣膜形态是否与扩张率相关。因此，本研究的目的是检查临床和超声心动图决定因素（包括瓣膜形态）与主动脉尺寸以及扩张进展率之间的关联。1999年至2014年间，在荷兰一家三级医疗中心对392例BAV患者进行了系列超声心动图图像分析，评估主动脉尺寸。采用混合线性模型进行分析。参与者的平均年龄为48±17岁，69%为男性。BAV形态与主动脉尺寸、年龄、性别、体表面积和瓣膜功能障碍相关。升主动脉、主动脉瓣窦和窦管交界处的扩张率分别为每年0.32、0.18和0.06毫米。扩张率与瓣膜形态无关。在本研究中，BAV形态与主动脉扩张率之间无关联。因此，形态在预测主动脉生长方面的作用有限。发现快速进展者仍然具有挑战性。
