Key result
Wall shear stress has the potential to serve as a specific noninvasive hemodynamic imaging biomarker of risk for directing clinical management in patients with bicuspid aortic valve aortopathy.
Why the study?
Finding and validating noninvasive hemodynamic biomarkers of aortic risk to assist in the management of bicuspid aortic valve patients is of clinical importance.
Wall shear stress has the potential to serve as a noninvasive hemodynamic imaging biomarker to guide monitoring and surgical intervention in patients with bicuspid aortopathy.
Heterogeneous BAV aortopathy supports individualized surveillance; leaves open precise risk thresholds for intervention.
PURPOSE OF REVIEW: Bicuspid aortic valve (BAV) results from fusion of two adjacent aortic valve cusps, and is associated with dilatation of the aorta, known as BAV-associated aortopathy, or bicuspid aortopathy. Bicuspid aortopathy is progressive, increasing the risk of life-threatening clinical events, such as aortic dissection. Regular monitoring and timely intervention with prophylactic surgical resection of the proximal aorta is recommended. RECENT FINDINGS: Aortopathy is heterogeneous among patients. Studies have shown that different flow patterns lead to specific phenotypes of aortopathy. Although not uniform, BAV morphology affects flow patterns. Recent work has demonstrated the role of wall shear stress (WSS) in driving aortopathy, and it is suggested that individualized WSS 'heat maps' can be used for clinically monitoring patients with BAV. WSS has the potential to be an imaging biomarker for directing resection timing, surgical strategies, and postsurgical follow-up care. SUMMARY: Finding and validating noninvasive hemodynamic biomarkers of aortic risk to assist in the management of BAV patients is of clinical importance. Herein, we will review the latest findings pertaining to the utility of WSS as a specific biomarker of risk for BAV patients with aortopathy.
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Hassanabad et al. (2019) conducted a review in Bicuspid valve-associated aortopathy. Wall shear stress (WSS) was evaluated. Wall shear stress has the potential to serve as a specific noninvasive hemodynamic imaging biomarker of risk for directing clinical management in patients with bicuspid aortic valve aortopathy.
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