Zhang Yu, Choi Bo Hwa, Chee Hyun Keun, Kim Jun Seok, Ko Sung Min
Department of Radiology, Yuhuangding Hospital, Yantai 264008, China.
Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju 22070, Republic of Korea.
J Cardiovasc Dev Dis. 2023 Aug 31;10(9):372. doi: 10.3390/jcdd10090372.
(1) Background: To identify the association between the presence or absence of a raphe and aortic valve dysfunction, as well as the presence of aortopathy in patients with a bicuspid aortic valve (BAV); (2) Methods: This retrospective study enrolled 312 participants (mean (SD) age, 52.7 (14.3) years; 227 men (72.8%)) with BAV. The BAVs were divided into those with the presence (raphe+) or absence (raphe-) of a raphe. Valvular function was classified as normal, aortic regurgitation (AR), or aortic stenosis (AS) using TTE. The pattern of BAV aortopathy was determined by the presence of dilatation at the sinus of Valsalva and the middle ascending aorta using CCT; (3) Results: BAVs with raphe+ had a higher prevalence of AR (148 (79.5%) vs. 48 (37.8%), < 0.001), but a lower prevalence of AS (90 (48.6%) vs. 99 (78.0%), < 0.001) compared with those with raphe-. The types of BAV aortopathy were significantly different ( = 0.021) according to those with BAV-raphe+ and BAV-raphe-; (4) Conclusions: The presence of a raphe was significantly associated with a higher prevalence of AR, but a lower prevalence of AS and combined dilatation of the aortic root and middle ascending aorta. The presence of a raphe was an independent determinant of AR.
（1）背景：确定有或无嵴与主动脉瓣功能障碍之间的关联，以及二叶式主动脉瓣（BAV）患者中主动脉病变的存在情况；（2）方法：这项回顾性研究纳入了312例BAV患者（平均（标准差）年龄为52.7（14.3）岁；227例男性（72.8%））。将BAV分为有嵴（嵴阳性）或无嵴（嵴阴性）的类型。使用经胸超声心动图（TTE）将瓣膜功能分类为正常、主动脉反流（AR）或主动脉狭窄（AS）。使用心脏计算机断层扫描（CCT）通过观察主动脉瓣窦和升主动脉中部是否存在扩张来确定BAV主动脉病变的类型；（3）结果：与嵴阴性的BAV相比，嵴阳性的BAV中AR的患病率更高（148例（79.5%）对48例（37.8%），<0.001），但AS的患病率更低（90例（48.6%）对99例（78.0%），<0.001）。根据BAV-嵴阳性和BAV-嵴阴性患者，BAV主动脉病变的类型有显著差异（=0.021）；（4）结论：嵴的存在与AR的较高患病率显著相关，但与AS的较低患病率以及主动脉根部和升主动脉中部的联合扩张相关。嵴的存在是AR的独立决定因素。
