Key result
Bicuspid aortic stenosis exhibits higher Vmax and Gmean than tricuspid valves across matched orifice areas.
Why the study?
The study was conducted to compare the hemodynamic parameters of transaortic blood flow in patients with aortic stenosis according to bicuspid or tricuspid aortic valve structure.
Does bicuspid aortic valve structure compared to tricuspid structure affect hemodynamic parameters in patients with isolated aortic stenosis?
Observational (n=180)
Does bicuspid aortic valve structure compared to tricuspid structure affect hemodynamic parameters in patients with isolated aortic stenosis?
Patients with bicuspid aortic stenosis exhibit higher transvalvular velocities and gradients compared to those with tricuspid aortic stenosis for a given effective orifice area.
May require caution interpreting standard velocity/gradient thresholds in bicuspid aortic stenosis; leaves open need for outcome-validated, morphology-specific criteria.
Purpose: comparison of hemodynamic parameters of transaortic blood flow in patients with aortic stenosis depending on the bivalve or tricuspid structure of the aortic valve. Materials and methods. A study of 180 patients with isolated aortic valve stenosis (AC) with two – and threeleaf structure was conducted. Patients were ranked into 3 comparison subgroups by the area of the effective AC opening from 4 to 1.5 cm2; 1.5 to 1 cm2 and less than 1 cm2. An echocardiographic study was performed with the calculation of all the necessary parameters for the study. Results. The comparison subgroups were comparable in terms of effective orifice area (AVA), effective orifice area index (IAVA), body mass index (BMI), LV UO index, and LV FV (p > 0.05). However, the indicators Vmax, Gmean, and AT in patients with a bivalve AK structure in all comparison subgroups were significantly higher than in patients with a tricuspid structure. Comparison subgroup with AVA from 4 to 1.5 cm2: Vmax 2.8 ± 9 m/s and 2.5 ± 6 m/s p = 0.02. Gmean 18.6 ± 7.2 mm Hg and 15 ± 6 mm Hg p = 0.03, AT 82 ± 12 ms and 70 ± 10 ms p = 0.002. Comparison subgroup with AVA from 1.5 to 1 cm2: Vmax 3.7 ± 0.8 m/s and 3.5 ± 0.6 m/s p = 0.02. Average transaortic gradient 37 ± 10 mm Hg and 29 ± 5 mm Hg p = 0.04, AT 103 ± 11 ms and 94 ± 10 ms p = 0.02. Comparison subgroup with an effective area of less than 1 cm2: Vmax 5.7 ± 1.2 m/s and 4.7 ± 0.7 m/s p = 0.001, Gmean 54 ± 15 and 43 ± 11 mm Hg p < 0.001, AT 127 ± 20 ms and 112 ± 10 ms p = 0.002. Conclusion. Echocardiographic indicators of Vmax and Gmean in patients with bivalve AC structure have higher values than in patients with tricuspid AC structure with a comparable opening area.
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Базылев et al. (2020) conducted an observational in isolated aortic valve stenosis (n=180). Bicuspid aortic valve structure vs. Tricuspid aortic valve structure was evaluated on Hemodynamic parameters of transaortic blood flow (Vmax, Gmean, AT). Patients with bicuspid aortic stenosis had significantly higher Vmax and Gmean than those with tricuspid valves across all comparable orifice areas (e.g., Vmax 5.7 vs 4.7 m/s, p=0.001 for AVA <1 cm2).
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