Key result
Aortic stenosis severity was not independently associated with proximal ascending aortic dimensions, indicating that post-stenotic dilatation is not explained by the stenosis severity itself.
Why the study?
Does aortic stenosis severity correlate with poststenotic dilatation of the ascending aorta in patients with bicuspid or tricuspid aortic valve stenosis?
Cross-Sectional (n=296)
No
Does aortic stenosis severity correlate with poststenotic dilatation of the ascending aorta in patients with bicuspid or tricuspid aortic valve stenosis?
Poststenotic dilatation of the ascending aorta in patients with aortic stenosis is not explained by the severity of the stenosis itself, but is independently associated with bicuspid valve morphology, height, and degree of aortic regurgitation.
Clinicians should evaluate bicuspid morphology and AR over AS severity for dilatation risk; hypothesis-generating in cross-sectional data.
BACKGROUND: Dilatation of the ascending aorta in aortic stenosis may be partly explained by intrinsic wall structure changes, but the relative contribution of altered hemodynamics is unclear. The aim of this study was to assess the association between ascending aortic dimensions and valve stenosis severity. METHODS AND RESULTS: An analysis of echocardiographic examinations was conducted in 296 patients with aortic stenosis (179 males, mean age 71 years), 57 with bicuspid and 239 with tricuspid aortic valve, mean transaortic gradient 43+/-20 mmHg, and not more than moderate aortic regurgitation. Aortic dimensions at the level of annulus, sinuses of Valsalva, sinotubular junction and proximal ascending aorta were measured. Only height (p<0.001), degree of aortic regurgitation (p<0.01) and presence of bicuspid aortic valve (p<0.001) were independent predictors of ascending aortic dimensions. CONCLUSIONS: An independent association between aortic pressure gradients and proximal ascending aortic dimensions was not observed in patients with bicuspid or tricuspid aortic valve stenosis. Therefore, the poststenotic dilatation of the ascending aorta is not explained by aortic stenosis severity itself. Possible nonhemodynamic causes deserve detailed study at the time of diagnosis.
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Linhartová et al. (2006) conducted a cross-sectional in Aortic stenosis (n=296). Aortic stenosis severity (transaortic pressure gradients) was evaluated on Independent association between ascending aortic dimensions and aortic jet velocity/gradients (p=NS). Aortic stenosis severity was not independently associated with proximal ascending aortic dimensions, indicating that post-stenotic dilatation is not explained by the stenosis severity itself.
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