Key result
Patients with bicuspid aortic valves experience larger regional shear strains in their aortic roots compared to those with normal trileaflet aortic valves, potentially contributing to higher aneurysm risk.
Why the study?
Estimating mechanical deformation and strains in-vivo remains an ongoing practical challenge despite the recognized central role of mechanics in the cardiovascular system.
Does a 4D echocardiography-based strain estimation framework detect differences in aortic root strains between patients with bicuspid and trileaflet aortic valves?
Observational (n=17)
No
Does a 4D echocardiography-based strain estimation framework detect differences in aortic root strains between patients with bicuspid and trileaflet aortic valves?
A novel 4D echocardiography strain estimation framework demonstrates that patients with bicuspid aortic valves experience elevated regional shear strains in the aortic root even before aneurysm development, potentially explaining their higher risk of aortopathy.
Answers are grounded in this paper and cite their sources.
New 4D-echo strain framework is feasible in TAV/BAV roots; leaves open clinical utility pending validation.
Even though the central role of mechanics in cardiovascular system is widely recognized, estimating mechanical deformation and strains in-vivo remains an ongoing practical challenge. Herein, we present a semi-automated framework to estimate strains from four-dimensional (4D) echocardiography images and apply it to the aortic roots of patients with normal trileaflet aortic valves (TAV) and congenital bicuspid aortic valves (BAV). The method is based on fully nonlinear shell-based kinematics, which divides the strains into in-plane (shear and dilatational) and out-of-plane components. The results indicate that, even for size-matched non-aneurysmal aortic roots, BAV patients experience larger regional shear strains in their aortic roots. This elevated strains might be a contributing factor to the higher risk of aneurysm development in BAV patients. The proposed framework is openly available and applicable to any tubular structures.
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Aggarwal et al. (2022) conducted an observational in Bicuspid aortic valve (n=17). Bicuspid aortic valve vs. Trileaflet aortic valve was evaluated on Regional shear strains in the aortic root. Patients with bicuspid aortic valves experience larger regional shear strains in their aortic roots compared to those with normal trileaflet aortic valves, potentially contributing to higher aneurysm risk.
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