Key result
The right-left bicuspid aortic valve phenotype was associated with a significantly higher frequency of aortic stenosis (56.3% vs. 31.4%) compared to the anteroposterior phenotype.
Why the study?
BAV morphology may have implications for associated pathologies including aortic stenosis, aortic insufficiency, and aortic dilation, but the patterns associated with different phenotypes required investigation.
Does bicuspid aortic valve phenotype correlate with specific patterns of valvular dysfunction and aortopathy in patients with BAV?
Cross-Sectional (n=300)
No
Does bicuspid aortic valve phenotype correlate with specific patterns of valvular dysfunction and aortopathy in patients with BAV?
Bicuspid aortic valve phenotype is significantly associated with specific patterns of valvular dysfunction and aortopathy, suggesting that leaflet morphology can aid in risk stratification.
Answers are grounded in this paper and cite their sources.
BAV right-left phenotype may warrant intensified aortic stenosis surveillance; supports phenotype-specific risk stratification in future studies.
Introduction: Morphology of bicuspid aortic valve (BAV) may have implication in the associated pathologies including aortic stenosis (AS), aortic insufficiency (AI) and aortic dilation. The aim of this study is to investigate the frequency and patterns of valvular dysfunction and aortopathy associated with different phenotypes of BAV in a referral center in northwest of Iran. Methods: In this prospective study patients who presented to our echocardiography lab between January 2014 and December 2015 and were diagnosed with BAV were assessed. Frequency of various BAV phenotypes and their association with valvular dysfunction and aortopathy was evaluated. A P value less than 0.05 was considered statistically significant. Results: The average age of the study patients was 40±16 years, with predominance of male sex (72%). Patients with anteroposteriorly located BAV (BAV-AP) phenotype constituted majority of our cases with prevalence of 62.7%, while 37.3% of cases had right-left (BAV-RL) located valves. BAV-RL patients when compared to BAV-AP patients had higher frequencies of dilated aortic arch (25% vs. 4.3%, P < 0.001), AS (56.3% vs. 31.4%, P < 0.001), mass or vegetation on aortic valve (14.3 vs. 6.4%, P = 0.023) and lower frequencies of dilated aortic root (42.9% vs. 57.4%, P = 0.01), aortic insufficiency (68.8% vs. 79.8%, P = 0.034) and co-arctation of aorta (3.6% vs. 11.7%, P = 0.01). Conclusion: There seems to be a relationship between various BAV phenotypes, and frequency and pattern of aortic valve dysfunction and aortopathy. These findings suggest that examining leaflet morphology in BAV might help in risk stratification of these patients.
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Toufan et al. (2018) conducted a cross-sectional in Bicuspid aortic valve (n=300). Right-left bicuspid aortic valve phenotype (BAV-RL) vs. Anteroposterior bicuspid aortic valve phenotype (BAV-AP) was evaluated on Aortic stenosis (p=<0.001). The right-left bicuspid aortic valve phenotype was associated with a significantly higher frequency of aortic stenosis (56.3% vs. 31.4%) compared to the anteroposterior phenotype.
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