Division of Cardiology, Department of Internal Medicine, Iwate Medical University.
Department of Radiology, Iwate Medical University.
Int Heart J. 2022 Mar 30;63(2):319-326. doi: 10.1536/ihj.21-244. Epub 2022 Mar 18.
Bicuspid aortic valve (BAV) patients with aortic stenosis (AS) are known to develop dilatation of the ascending aorta at a younger age, but the morphology of the aorta in these patients is yet to be investigated. Thus, in this study, we aim to evaluate the aortic morphology of BAV patients with severe AS using thin-slice electrocardiogram (ECG) -gated computed tomography (CT) and identify the possible contributing effect of age.In this retrospective study, 122 BAV and 154 tricuspid aortic valve (TAV) patients who received aortic valve replacement for severe AS were assessed by thin-slice ECG-gated CT and three-dimensional reconstruction. The morphology of the ascending aorta was also evaluated among BAV patients aged < 70 (n = 72) and ≥ 70 (n = 50) years old. As per our findings, BAV patients with severe AS had significantly greater diameter (P < 0.01), elongation (P < 0.01), and tortuosity (P = 0.03) of the ascending aorta; minimum aortic arch angle (P < 0.01); and significantly lower calcified plaque (P < 0.01) compared with those of TAV patients even after adjusting for background. Multiple regression analysis showed that standardized partial regression coefficients (β) of dilatation (0.5) and elongation (0.35) were higher among other measurements of aortic morphology for BAV patients. BAV patients with severe AS aged ≥ 70 years had significantly greater diameter (42.0 [37.2-46.1] mm versus 40.4 [35.2-44.2] mm, P = 0.049) and elongation (133.8 [123.5-147.3] mm versus 127.0 [111.0-140.0] mm, P = 0.01) of the ascending aorta than those aged < 70 years.BAV patients with severe AS were determined to have greater dilatation and elongation of the ascending aorta. Moreover, BAV patients older than 70 years had greater diameter and elongation of the ascending aorta.
二叶式主动脉瓣（BAV）合并主动脉瓣狭窄（AS）的患者已知在年轻时会出现升主动脉扩张，但这些患者的主动脉形态尚未得到研究。因此，在这项研究中，我们旨在使用薄层心电图（ECG）门控计算机断层扫描（CT）评估严重 AS 的 BAV 患者的主动脉形态，并确定年龄可能的影响。
在这项回顾性研究中，对 122 例 BAV 和 154 例三尖瓣主动脉瓣（TAV）患者进行了薄层 ECG 门控 CT 和三维重建评估。还评估了年龄<70 岁（n=72）和≥70 岁（n=50）的 BAV 患者的升主动脉形态。根据我们的发现，严重 AS 的 BAV 患者的升主动脉直径（P<0.01）、长度（P<0.01）和扭曲度（P=0.03）明显更大；最小主动脉弓角度（P<0.01）；以及钙化斑块明显较少（P<0.01），即使在调整背景后也是如此。多元回归分析显示，BAV 患者的扩张（0.5）和伸长（0.35）标准化偏回归系数（β）高于其他主动脉形态测量值。年龄≥70 岁的严重 AS 的 BAV 患者的升主动脉直径（42.0[37.2-46.1]mm 与 40.4[35.2-44.2]mm，P=0.049）和长度（133.8[123.5-147.3]mm 与 127.0[111.0-140.0]mm，P=0.01）明显大于年龄<70 岁的患者。
严重 AS 的 BAV 患者的升主动脉扩张和伸长程度更大。此外，年龄大于 70 岁的 BAV 患者的升主动脉直径和长度更大。
