Key result
BAVA showed higher ascending aorta wall shear stress (0.42 vs 0.28 Pa, p=0.020) and lower systemic PWV (6.2 vs 7.8 m/s, p<0.001) than HTAD, with similar adverse aortic event rates.
Why the study?
Bicuspid aortic valve-associated aortopathy (BAVA) and heritable thoracic aortic disease (HTAD) share clinical manifestations, but whether they have distinct morphological and haemodynamic profiles on CMR and non-invasive systemic assessment was unclear.
Does cardiovascular magnetic resonance imaging (4D-flow) and oscillometry distinguish morphological and haemodynamic profiles and predict composite adverse aortic events in patients with bicuspid aortic valve-associated aortopathy compared to heritable thoracic aortic disease?
Cohort (n=185)
Does cardiovascular magnetic resonance imaging (4D-flow) and oscillometry distinguish morphological and haemodynamic profiles and predict composite adverse aortic events in patients with bicuspid aortic valve-associated aortopathy compared to heritable thoracic aortic disease?
Answers are grounded in this paper and cite their sources.
Bicuspid aortic valve aortopathy and heritable thoracic aortic disease exhibit distinct haemodynamic phenotypes and exploratory predictors of adverse aortic events—specifically elevated local wall shear stress in BAVA versus higher systemic arterial stiffness in HTAD.
AIMS: Bicuspid aortic valve-associated aortopathy (BAVA) and heritable thoracic aortic disease (HTAD) share clinical manifestations but may represent distinct pathophysiological entities. We aimed to compare morphological and haemodynamic profiles between both groups using cardiovascular magnetic resonance imaging (CMR) and non-invasive systemic haemodynamic assessment. METHODS AND RESULTS: A total of 185 patients (111 BAVA, 74 HTAD) were prospectively enrolled. CMR 4D-flow assessed aortic distensibility (ADCMR), pulse wave velocity (PWVCMR), global wall shear stress (WSSCMR) and energy loss (ELCMR). Oscillometry assessed systemic PWVM, augmentation index (AIxM) and systemic vascular resistance (SVRM). Composite adverse aortic events (AAE) comprised acute aortic syndrome, cardiovascular death or guideline diameter-based indication for surgery over 42.1±17.6 months. BAVA showed greater tubular ascending aorta and sinotubular junction dilation, ascending aorta WSSCMR (0.42±0.18 vs 0.28±0.12 Pa, p=0.020), ELCMR (19.8±8.4 vs. 12.3±6.1 mW, p<0.001) and ADCMR (6.1 ± 3.5 vs. 4.8 ± 2.9 ×10-3 mmHg-1, p=0.023), yet lower systemic stiffness than HTAD (PWVM 6.2±1.7 vs 7.8±2.1 m/s; AIxM 12.1±7.6 vs 18.4±9.2%; both p<0.001). AAE rates were similar. In exploratory aetiology-specific analyses, ascending aorta WSSCMR was associated with events in BAVA (HR 8.92, 95% CI 2.85-27.95) and systemic PWVM in HTAD (HR 2.16, 95% CI 1.30-3.57). CONCLUSION: BAVA and HTAD show distinct morphological and haemodynamic phenotypes: BAVA with focal dilation, elevated WSSCMR/ELCMR and preserved systemic function; HTAD with reduced local distensibility and greater systemic stiffness. These aetiology-specific predictors are exploratory and require external validation.
No takes yet. Share an insight, caveat, or question.
Segura-Rodríguez et al. (2026) conducted a cohort in Bicuspid aortic valve-associated aortopathy (BAVA) and heritable thoracic aortic disease (HTAD) (n=185). Bicuspid aortic valve-associated aortopathy (BAVA) vs. Heritable thoracic aortic disease (HTAD) was evaluated on Composite adverse aortic events (AAE) comprising acute aortic syndrome, cardiovascular death, or guideline diameter-based indication for surgery. BAVA showed higher ascending aorta wall shear stress (0.42 vs 0.28 Pa, p=0.020) and lower systemic PWV (6.2 vs 7.8 m/s, p<0.001) than HTAD, with similar adverse aortic event rates.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: