Bicuspid aortic valve patients had significantly greater pressure drop (9.5 vs 2.8 mm Hg; P<0.01), viscous energy loss, and circumferential wall shear stress in the ascending aorta than controls.
Observational (n=85)
Does bicuspid aortic valve disease alter ascending aorta hemodynamics (pressure drop, viscous energy loss, wall shear stress) compared to healthy controls?
4D-flow MRI reveals that bicuspid aortic valve disease is associated with significantly increased pressure drop and viscous energy loss in the ascending aorta, which correlates with aortic dilation.
Tasa de eventos absoluta: 9.5% vs 2.8%
valor p: p=<.01
ABSTRACT: Bicuspid aortic valve (BAV) disease has significant gaps in its clinical management practices. To highlight the potential utility of advanced hemodynamic biomarkers in strengthening BAV assessment, we used 4-dimentional flow magnetic resonance imaging to investigate altered hemodynamics in the ascending aorta (AAo).A total of 32 healthy controls and 53 age-matched BAV patients underwent cardiac magnetic resonance imaging at 3T, with cine imaging and 4D-flow. Analysis planes were placed along 3D-segmented aortas at the left ventricular outflow tract (LVOT), sinuses of Valsalva, mid-ascending aorta (MAA), and proximal to the first aortic branch. Locations were analyzed for aortic diameter (normalized to body surface area), pressure drop (PD), viscous energy loss (EL), and wall shear stress (WSS) sub-vectors (axial wall shear stress, circumferential wall shear stress WSSC, magnitude wall shear stress). Student's t tests, or non-parametric equivalents, compared parameters between cohorts. Univariable and multivariable analyses explored the associations of AAo diameter with hemodynamics within the BAV cohort.Compared to control cohort, BAV patients showed significantly greater PD (MAA: 9.5 ± 8.0 vs 2.8 ± 2.4 mm Hg; P < .01), EL (from LVOT-AA1: 7.39 ± 4.57 mW vs 2.90 ± 1.07 mW; P < .01), and WSSC (MAA: 0.3 ± 0.1 vs 0.2 ± 0.06 Pa; P ≤ .01) throughout the AAo. Correlational analyses revealed an inverse association between AAo diameter and both magnitude wall shear stress and axial wall shear stress.BAV patients exhibited increased PD, EL, and WSSC in the AAo, and an inverse association between AAo diameter and WSS sub-vectors. This demonstrated the impact of PD, EL, and WSS in BAV disease and the importance of altered hemodynamics in aortic remodelling.
Geeraert et al. (Wed,) conducted a observational in Bicuspid aortic valve (BAV) disease (n=85). Bicuspid aortic valve disease vs. Healthy controls was evaluated on Pressure drop at mid-ascending aorta (mm Hg) (p=<.01). Bicuspid aortic valve patients had significantly greater pressure drop (9.5 vs 2.8 mm Hg; P<0.01), viscous energy loss, and circumferential wall shear stress in the ascending aorta than controls.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: